Virtual Reality

Virtual Reality

PEP Topic 
Chemotherapy-Induced Nausea and Vomiting—Adult

Virtual reality refers to a computer-simulated environment with sensual stimuli and interactive software and hardware that can create the feeling of physical presence in an imaginary environment.  Virtual reality has been evaluated as a distractive intervention to prevent chemotherapy-induced nausea and vomiting (CINV) in patients with cancer and for its effect on anxiety.

Benefits Balanced With Harm

Research Evidence Summaries

Oyama, H., Kaneda, M., Katsumata, N., Akechi, T., & Ohsuga, M. (2000). Using the bedside wellness system during chemotherapy decreases fatigue and emesis in cancer patients. Journal of Medical Systems, 24 (3), 173-182.

doi: 10.1023/A:1005591626518

Study Purpose:

To develop a new treatment using virtual reality technology as an intervention to decrease chemotherapy-related side effects in patients with cancer

Intervention Characteristics/Basic Study Process:

Patients chose a preferred aromatic essential oil, sound system (headphone or speakers), and content. Three virtual worlds (lake, forest, and country town) were available, and each lasted about 20 minutes. The length of the intervention depended on the length of chemotherapy. If chemotherapy was long, patients could rest and restart the intervention.

Sample Characteristics:

  • The study consisted of 30 patients (6 males and 24 females).
  • The average age of participants was 53.5 years, with a range of 18–70 years.


The setting was an outpatient clinic at a national cancer center hospital in Japan.

Study Design:

The study had a randomized, controlled design.

Measurement Instruments/Methods:

The following scales were used.

  • Hospital Anxiety and Depression Scale
  • Cancer Fatigue Scale
  • Face Visual Analogue Scale (VAS)

Emesis was measured using a VAS after the experience.


Fatigue and emesis scores showed a statistically significant decrease three to five days after chemotherapy (p < 0.05 for both symptoms). Carry-over effects were detected. Emesis was strongly related to psychological state. The intervention also was associated with decreased postinfusion emesis.


Virtual reality may be a new way to treat emesis.


  • Nausea was not measured. Only the number of times a patient vomited was measured.
  • The VAS was used postemesis as a measure of vomiting.
  • The study did not use available tools to measure nausea, vomiting, and retching.
  • The fatigue scale was developed by an institution.
  • Motion sickness is a potential side effect when using virtual reality.
  • The cost of the virtual reality system and setup must be considered.