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Effect of virtual reality on time perception in patients receiving chemotherapy
Open accessAbstract
Purpose Virtual reality (VR) during chemotherapy has resulted in an elapsed time compression effect, validating the attention diversion capabilities of VR. Using the framework of the pacemaker-accumulator cognitive model of time perception, this study explored the influence of age, gender, state anxiety, fatigue, and cancer diagnosis in predicting the difference between actual time elapsed during receipt of intravenous chemotherapy while immersed in a VR environment versus patient's retrospective estimates of time elapsed during this treatment. Materials and methods This secondary analysis from three studies yielded a pooled sample of N = 137 participants with breast, lung, or colon cancer. Each study employed a crossover design requiring two matched intravenous chemotherapy treatments, with participants randomly assigned to receive VR during one treatment. Regressions modeled the effect of demographic variables, diagnosis, and Piper Fatigue Scale and State Anxiety Inventory scores on the difference between actual and estimated time elapsed during chemotherapy with VR. Results In a forward regression model, three predictors (diagnosis, gender, and anxiety) explained a significant portion of the variability for altered time perception (F=5.06, p = 0.0008). Diagnosis was the strongest predictor; individuals with breast and colon cancer perceived time passed more quickly. Conclusions VR is a noninvasive intervention that can make chemotherapy treatments more tolerable. Women with breast cancer are more likely and lung cancer patients less likely to experience altered time perception during VR (a possible indicator of effectiveness for this distraction intervention). Understanding factors that predict responses to interventions can help clinicians tailor coping strategies to meet each patient's needs.
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“Other research in people having chemotherapy20 argues that VR may not be effective for all as those with greater symptom distress had more accurate perception of time, suggesting they were not able to block out negative external cues.”
From SafeSpace: what is the feasibility and acceptability of a codesigned virtual reality intervention, incorporating compassionate mind training, to support people undergoing cancer treatment in a clinical setting? (2022) · cites this paper as [20]
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“The majority of studies used tools to capture symptom change15 20 67 with only one74 using open-ended questions in their methodology.”
From SafeSpace: what is the feasibility and acceptability of a codesigned virtual reality intervention, incorporating compassionate mind training, to support people undergoing cancer treatment in a clinical setting? (2022) · cites this paper as [20]
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“Aversive stimuli distort time perception by promoting negative physiological arousal, which accelerates the rate of pulse generation in the pacemaker; they also focus patients’ attention on the passage of time during chemotherapy, which keeps the switch between pacemaker and accumulator in the “on” position [5, 12, 43…”
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Influential
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Cited by
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“Existing research suggests that VR interventions may be a bene fi cial method of diversion for chemotherapy patients for various types of cancer ( Sajeev et al., 2021 ; Schneider & Hood, 2007 ; Schneider, Kisby & Flint, 2011 ).”
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“A este respecto, Schneider, Kisby y Flint (2011)(23) han observado que el diagnóstico es una variable relevante, encontrando que es más probable que los pacientes con cáncer de mama y colon experimenten una mayor percepción alterada del tiempo durante las sesiones con RV.”
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“Schneider et al. [44, 45] already demonstrated that by immersing patients inside a virtual environment (VE), time perception can be passively influenced by the VR headset as a distraction itself.”
BackgroundErickson, A., Bruder, G., Wiśniewski, P., & Welch, G. (2020) · IEEE Conference on Virtual Reality and 3D User Interfaces (VR) · doi:10.1109/vr46266.2020.00070 · Cited by 8
“For example, Schneider et al. evaluated the effects of virtual reality immersion on patients perception of time and found that it had the effect of compressing time for the patients and allowed them to more comfortably sit through chemotherapy treatments [26].”
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“For instance, patients undergoing medical procedures can experience shorter durations of time, helping them cope with anxiety [1]; urban planning is also affected by time perception, since perceived waiting times in transit can be altered by the presence of basic amenities, indirectly affecting productivity [2]; and r…”
BackgroundInfluentialMay, S. L., Genest, C., Francoeur, M., Hung, N., Guingo, E., Khadra, C., Noel, M. E., Paquette, J., & Roy, A.-A. (2022) · Paediatric and Neonatal Pain · doi:10.1002/pne2.12086 · Cited by 8
A Survey on the Effectiveness of Virtual Reality-based Therapy and Pain Management
Ibrahim, F. E., ElSayed, N., & Zayed, H. H. (2021) · International Journal of Advanced Computer Science and Applications · doi:10.14569/ijacsa.2021.0120769 · Cited by 7
“Thus, further research studies with a larger sample size along with applying VR intervention repeatedly are required to investigate the benefits of using VR for long-term treatment [45], [68], [72], [71].”
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“Furthermore, psychological stress may lead to an increase in side effects such as chemotherapyrelated nausea and vomiting [8, 9].”
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Object Motion Manipulation and time perception in virtual reality
Landeck, M., Unruh, F., Lugrin, J.-L., & Latoschik, M. E. (2024) · Frontiers in Virtual Reality · doi:10.3389/frvir.2024.1390703 · Cited by 7
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The Overview Effect and Well-Being
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“[51] have observed that people’s perception of time can alter whilst engaged in a VR experience.”
BackgroundSerenity: A Low-Cost and Patient-Guided Mobile Virtual Reality Intervention for Cancer Coping
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“Another study showed a VR intervention during chemotherapy resulted in time compression, potentially making chemotherapy treatments more tolerable [28].”
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“21 However, previous studies are limited by methodological weaknesses, such as the use of pretest and post-test design, small sample size, lack of blinding of outcome assessors and use of only a single IVR session.”
BackgroundSystematic Representative Design and Clinical Virtual Reality
Mozgai, S., Hartholt, A., & Rizzo, A. (2019) · Psychological Inquiry · doi:10.1080/1047840x.2019.1693873 · Cited by 5
Réalité virtuelle pour la relaxation avant les soins
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Virtual Reality Technology for Pain Management
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“6–12 The analgesic effects of VR are thought to stem from distraction: by shifting the patient’s attention away from the procedure they are undergoing, focus is placed on VR-associated stimuli, and the pain signal is partially ignored.”
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Accuracy of Time Duration Estimations in Virtual Reality
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“…2004), health and therapeutic applications, such as the pe rceived length of chemotherapy sessions for cancer patients (Schneider & Hood, 2007; Schneider, Kisby & Flint, 2011), pain management (Li, Montaño, Chen & Gold, 2011) and rehabilitation (Bansal, Weech & Barnett-Cowan, 2019), and…”
BackgroundSolbiati, S., Buffoli, A., Megale, V., Damato, G., Lenzi, B., Langfelder, G., & Caiani, E. G. (2021) · E-Health and Bioengineering Conference (EHB) · doi:10.1109/ehb52898.2021.9657564 · Cited by 4
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BackgroundAğrı ve Anksiyete Yönetiminde Sanal Gerçeklik
Aktura, S. Ç., Sarıtaş, S. Ç., & Sarıtaş, S. (2022) · Samsun Sağlık Bilimleri Dergisi · doi:10.47115/jshs.1100557 · Cited by 4
Does Adding Physical Realism to Virtual Reality Training Reduce Time Compression?
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BackgroundVR for Vocational and Ecological Rehabilitation of Patients With Cognitive Impairment: A Survey
Hummel, E., Cogné, M., Lange, M., Lécuyer, A., Joly, F., & Gouranton, V. (2023) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2023.3324131 · Cited by 5
“VR has been used for various purposes in the medical field, such as motricity training [17], [18], pain distraction [19], [20] or cognitive rehabilitation [2], [21].”
MethodAdvances and Tendencies: A Review of Recent Studies on Virtual Reality for Pain Management
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Virtual reality in bioinformatics
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“Results show that VR decreases perception of time (14).”
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Studying the Effect of Physical Realism on Time Perception in a HAZMAT VR Simulation
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La musicoterapia para disminuir la ansiedad. Su empleo en pacientes pediátricos con cáncer
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Study of gender differences in VR response following cardiac surgery.
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“As chemotherapy-related symptom distress was reduced significantly immediately after using VR during treatment [26-28].”
BackgroundMixed Reality for supporting Remote-Meetings
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“This can make monoto - nous therapies more engaging through a time-compression effect (Schneider et al. 2011 ).”
Virtual reality and surgical oncology
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“The Mann-Whitney U [8] test was used to analyze the data.”
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“On the other hand, a more engaging virtual environment can shorten perceived duration, which can be leveraged in designing unpleasant yet unavoidable experiences, such as chemotherapy (see Schneider et al. [33]).”
Investigating the Effectiveness of Pain Masking Through Contextual Modification
Onoda, H., Kon, S., Takami, T., Ushiyama, K., Mizoguchi, I., & Kajimoto, H. (2025) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/3706599.3719794 · Cited by 2
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MOMS IMMERSED IN THEIR WORK: VIRTUAL REALITY AND MENTAL HEALTH PROMOTION AFTER MATERNITY LEAVE
Rapisarda, S., Falco, A., CARLO, A. D., Barbieri, B., & Corso, L. D. (2022) · Psychological applications and trends · doi:10.36315/2022inpact096 · Cited by 2
“Other studies investigated chemotherapy-derived stress (Schneider et al., 2011), pain reduction (Espinoza et al., 2012).”
BackgroundYOUR BEST VIRTUAL SELF-IMPROVEMENT. THE USE OF VIRTUAL REALITY IN STRESS MANAGEMENT TRAINING
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“It has been reported that time compression effects in VR environments might arise according to subjective feeling of immersion [25].”
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Lipom eksizyonu sırasında stres küpü kullanımının ağrı ve anksiyete üzerine etkisi
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A Systematic Review of Studies on Virtual Reality Use in Management of Pain
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“Virtual Reality has shown promise for managing chronic pain and facilitating long-term pain rehabilitation (Schneider et al (2011), Li et al 2011)).”
BackgroundZeitgebers, Time Judgments, and VR: A Constructive Replication Study
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“Interestingly, although there are several studies comparing time perception with respect to virtual reality (VR) [3,4], the impact of VR on the experience of time has not yet been fully understood.”
BackgroundPain Masking by Contextual Modification in VR/AR Environment
Onoda, H., Kon, S., Ushiyama, K., Mizoguchi, I., & Kajimoto, H. (2025) · IEEE World Haptics Conference (WHC) · doi:10.1109/whc64065.2025.11123221 · Cited by 1
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“Schneider et al. (2011) determined that the virtual reality glasses applied to 137 breast, lung and colon cancer patients who received chemotherapy treatment is an application that attracts attention, as well as a tool that reduces the anxiety and fatigue level of the patients who are applied…”
BackgroundAnxiety, applied tension, and vasovagal symptoms in blood donors
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Ahead of its Time: An exploration of virtual environment effects on time estimation
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“[28,29]discusseddifferentpatientsreceiv-ingchemotherapyandfoundthatVRduringchemotherapyleadsto aperceivedcompressionofelapsedtime,showingVR’spotentialto makechemotherapytreatmentsmoretolerable.”
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SAĞLIK ALANINDA SANAL GERÇEKLİK UYGULAMALARI
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Metadata
- Authors
- Schneider, S. M., Kisby, C. K., & Flint, E. P.
- Affiliations
- Duke University (US)
- Corresponding author
- Schneider, Susan M.
- Venue
- Supportive Care in Cancer
- Published
- 2010-03-26
- Volume
- 19
- Issue
- 4
- Pages
- 555-564
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- PMC
- PMC3673561
- OpenAlex
- W2006568735
- Cited by
- 187
- References
- 44
- Citations by year
- 2026: 2 · 2025: 14 · 2024: 25 · 2023: 25 · 2022: 22 · 2021: 28 · 2020: 17 · 2019: 11 · 2018: 10 · 2017: 9 · 2016: 6 · 2015: 2 · 2014: 2 · 2013: 5 · 2012: 4
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Nursing Research (1 P20 NR07795-01, P20NR007795)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- virtual reality, time perception, chemotherapy, pacemaker-accumulator model, distraction therapy, cancer pain management, breast cancer, lung cancer, colon cancer, state anxiety, fatigue, gender differences, cancer diagnosis
- MeSH terms
- Adult, Aged, Antineoplastic Agents, Anxiety, Breast Neoplasms, Colonic Neoplasms, Female, Humans, Infusions, Intravenous, Lung Neoplasms, Male, Middle Aged, Models, Psychological, Regression Analysis, Sex Factors, Time Perception, User-Computer Interface, Cross-Over Studies
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