Authors (including presenting author) :
PMH/ANC Mr Chu Shun Fai
PMH/APN Ms To Wing Lam
PMH/RN Ms Fan Shuk Fuk
PMH/RN Mr Yeung Ka Pong
PMH/RN Ms Kong Sze Wai
PMH/RN Ms Lei Mei Suet
Affiliation :
Department of Surgery, Princess Margaret Hospital
Introduction :
According to Hong Kong Cancer registry (2024), the incidence of prostate cancer in Hong Kong is ranked 3rd among different kind of cancers with mortality rate of 6.2%. Transperineal prostate biopsy is an important diagnostic procedure to obtain histological confirmation of cancer before starting respective treatment. However, this procedure can be associated with significant pain and anxiety. Non-pharmacological methods like music therapies and Virtual Reality (VR) Interventions are often used in clinical settings alongside with pharmacological interventions to reduce these experiences. The use of non-pharmacological approaches can decrease the need for pain medication, thereby reducing side effects or risk of drug interactions. Non-pharmacological methods aim to use auditory stimuli to modulate mood, relaxation, and pain perception or to immerse patients in digital environments to distract from the procedure and pain.
Besides, non-pharmacological techniques can be more cost-effective and sustainable in the long term, particularly given the low cost of tools like music players. Due to the advancement in technology and reduction in cost of VR device in recent years, VR intervention become a feasible approach for pain control of prostate biopsy. Although there are various studies showed significant reductions in pain intensity and anxiety during medical procedures with the use of music or VR intervention, there are lack of evidence to demonstrate which approaches provide better effects.
Objectives :
This study aims to compare the effect of music and virtual reality (VR) interventions on the pain and anxiety control during transperineal prostate biopsy.
Methodology :
A total of 144 patients aged over 18 years old who undergone transperineal prostate biopsy due to suspicious of prostate cancer were included in this prospective designed study. Patients are divided into 3 groups by convenience sampling method: Music intervention group (23), Virtual Reality (VR) intervention group (26) and control group (95).
Intervention:
Music intervention group: Music with various styles selected according to patients' preference via music player adjunct to usual pharmacological intervention
VR internvention group: VR with various video styles selected according to patients' preference via visual-audio headset adjunct to usual pharmacological intervention
Control group: Usual pharmacological intervention only
Assessment
Numerical rating scale (NRS) is used to assess patient pain level throughout the prostate biopsy procedure
State and Trait Anxiety Inventory (STAI) scale is used to assess anxiety status of patients before and after the procedure
Result & Outcome :
Mean STAI-state scores in both music and VR intervention groups showed significant decrease after prostate biopsy with P-value 0.028 and 0.037 respectively. The mean decrease of STAI-state score in music and VR intervention groups are -3.52 +/- SD: 8.355 & -4.31 +/- SD: 11.77 and the difference in change in STAI-state score among 2 intervention groups is statistically insignificant with P-value=0.79.
For the pain score, there are no significant different among the 3 groups with mean overall pain score 4.43 (control group); 4.83 (music intervention group) & 4.92 (VR intervention group)
From the above study, it showed that patients' anxiety level significantly reduced after completed transperineal prostate biopsy under either music or VR intervention. However, the effect is not significantly different among 2 intervention groups.
It also showed that music and VR intervention do not result in objective improvement in pain score during biopsy procedure although most patient showed satisfactory in non-pharmacological intervention provided with satisfactory score (7.35-7.39 out of 10)
