{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T15:06:24Z","timestamp":1774969584678,"version":"3.50.1"},"reference-count":57,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100027861","name":"Clemson University Research Foundation","doi-asserted-by":"crossref","award":["PPN 2022001197"],"award-info":[{"award-number":["PPN 2022001197"]}],"id":[{"id":"10.13039\/100027861","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,9,30]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Patients with advanced cancer often experience high levels of debilitating pain and pain-related psychological distress. Although there is increasing evidence that non-pharmacological interventions are needed to manage their pain, pharmacologic modalities remain the preferred treatment . Guided imagery is a form of focused relaxation that helps create harmony between the mind and body and has been shown to significantly improve cancer pain. Our study presents Virtual Reality Assisted Guided Imagery (VRAGI) as a complementary treatment modality to manage chronic pain in patients with cancer. We will conduct a randomised controlled trial to test its impact on patients with advanced cancer in a home setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>We will recruit 80 patients from Prisma Health, a tertiary-level healthcare centre based in Greenville, South Carolina, USA. The prospective 2\u00d72 randomised controlled trial will randomise participants into four groups: (1) VRAGI, (2) laptop-assisted guided imagery, (3) VR (no guided imagery) and (4) laptop (no guided imagery). Patients allocated to VR groups will be trained to use a head-mounted display that immerses them in 3D audio\u2013video content. The non-VR group will use a laptop displaying 2D video content. We will collect measures before and during the 3-week intervention as well as 3\u2009weeks after the intervention ends. Measures will include patient-reported outcomes of pain, anxiety, depression and fatigue in addition to opioid use. The primary objective of the current study is to assess the efficacy of VRAGI on pain in the home setting. The secondary objective is to assess the efficacy of VRAGI on opioid use, anxiety, depression and fatigue.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>This study was approved by the Prisma Health Institutional Review Board (#Pro00114598) in November 2021. All participants enrolled in the study will provide written informed consent. Dissemination will be through peer-reviewed publications and conference presentations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\" xlink:href=\"NCT05348174\">NCT05348174<\/jats:ext-link>, clinicaltrials.gov.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-064363","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T10:25:02Z","timestamp":1670235902000},"page":"e064363","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of virtual reality assisted guided imagery (VRAGI) in a home setting for pain management in patients with advanced cancer: protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct05348174","registry":"10.18810\/clinical-trials-gov","type":"results"},{"clinical-trial-number":"nct05348174","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1267-7583","authenticated-orcid":false,"given":"George","family":"Hartshorn","sequence":"first","affiliation":[{"name":"University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2296-7602","authenticated-orcid":false,"given":"Matthew","family":"Browning","sequence":"additional","affiliation":[{"name":"Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kapil","family":"Chalil Madathil","sequence":"additional","affiliation":[{"name":"Departments of Civil and Industrial Engineering, Clemson University College of Health Education and Human Development, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredric","family":"Mau","sequence":"additional","affiliation":[{"name":"Watermark Counseling, Columbia, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam","family":"Ranganathan","sequence":"additional","affiliation":[{"name":"School of Mathematical and Statistical Sciences, Clemson University, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Todd","sequence":"additional","affiliation":[{"name":"Department of Computing and Applied Sciences, Clemson University, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeff","family":"Bertrand","sequence":"additional","affiliation":[{"name":"Center for Workforce Development, Clemson University, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Maynard","sequence":"additional","affiliation":[{"name":"Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"McAnirlin","sequence":"additional","affiliation":[{"name":"Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kailan","family":"Sindelar","sequence":"additional","affiliation":[{"name":"Communication and Information Design, Clemson University, Clemson, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalba","family":"Hernandez","sequence":"additional","affiliation":[{"name":"School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5554-6930","authenticated-orcid":false,"given":"Teny","family":"Henry Gomez","sequence":"additional","affiliation":[{"name":"Division of Palliative Care, Department of Internal Medicine, University of South Carolina School of Medicine Greenville, Prisma Health, Greenville, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"2025101812163281000_12.12.e064363.1","unstructured":"Understanding advanced and metastatic cancer [Internet]. . 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