Brown Poppy, Waite Felicity, Lambe Sinéad, Rosebrock Laina, Freeman Daniel
Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
Oxford Health NHS Foundation Trust, Oxford, United Kingdom.
JMIR Res Protoc. 2020 Aug 20;9(8):e20300. doi: 10.2196/20300.
Patients in psychiatric wards typically have very limited access to individual psychological therapy. Inpatients often have significant time available, and an important transition back to everyday life to prepare for-but historically, there have been few trained therapists available on wards for the delivery of evidence-based therapy. Automated virtual reality (VR) therapy may be one route to increase the provision of powerful psychological treatments in psychiatric hospitals. The gameChange automated VR cognitive therapy is targeted at helping patients overcome anxious avoidance and re-engage in everyday situations (such as walking down the street, taking a bus, or going to a shop). This treatment target may fit well for many patients preparing for discharge. However, little is known about how VR therapy may be viewed in this setting.
The objectives of the study are to explore psychiatric hospital staff and patients' initial expectations of VR therapy, to gather patient and staff views of an automated VR cognitive therapy (gameChange) after briefly experiencing it, and to identify potential differences across National Health Service (NHS) mental health trusts for implementation. Guided by an implementation framework, the knowledge gained from this study will be used to assess the feasibility of VR treatment adoption into psychiatric hospitals.
Focus groups will be conducted with NHS staff and patients in acute psychiatric wards at 5 NHS mental health trusts across England. Staff and patients will be interviewed in separate groups. Individual interviews will also be conducted when preferred by a participant. Within each of the 5 trusts, 1 to 2 wards will be visited. A total of 8-15 staff and patients per ward will be recruited, with a minimum total of 50 staff and patients recruited across all sites. Focus group questions have been derived from the nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) framework. Focus groups will discuss expectations of VR therapy before participants are given the opportunity to briefly try the gameChange VR therapy. Questions will then focus on opinions about the therapy and investigate feasibility of adoption, with particular consideration given to site specific issues. A thematic analysis will be conducted.
As of May 15, 2020, 1 patient focus group has been conducted.
The study will provide unique insight from patients and staff into the potential for implementing automated VR therapy in psychiatric wards. Perspectives will be captured both on the use of immersive technology hardware and therapy-specific issues in such settings.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/20300.
精神科病房的患者通常很难获得个体心理治疗。住院患者往往有大量可支配时间，且面临着为回归日常生活做准备这一重要转变——但从历史上看，病房里具备资质提供循证治疗的治疗师寥寥无几。自动化虚拟现实（VR）治疗可能是增加精神病医院有效心理治疗供给的一种途径。“改变游戏”自动化VR认知疗法旨在帮助患者克服焦虑回避行为，重新融入日常情境（如在街上行走、乘坐公交车或去商店）。这一治疗目标可能非常适合许多准备出院的患者。然而，对于在这种环境下如何看待VR治疗，我们知之甚少。
本研究的目的是探讨精神病医院工作人员和患者对VR治疗的初步期望，在他们短暂体验自动化VR认知疗法（“改变游戏”）后收集患者和工作人员的看法，并确定英国国民医疗服务体系（NHS）各心理健康信托机构在实施过程中的潜在差异。在一个实施框架的指导下，本研究获得的知识将用于评估在精神病医院采用VR治疗的可行性。
将在英格兰5家NHS心理健康信托机构的急性精神科病房对NHS工作人员和患者进行焦点小组访谈。工作人员和患者将分别分组进行访谈。如果参与者愿意，也将进行个别访谈。在5家信托机构中的每家机构，将走访1至2个病房。每个病房将招募8至15名工作人员和患者，所有地点总共至少招募50名工作人员和患者。焦点小组问题源自未采用、放弃以及扩大规模、推广和可持续性面临的挑战（NASSS）框架。在参与者有机会短暂试用“改变游戏”VR疗法之前，焦点小组将讨论对VR治疗的期望。随后问题将聚焦于对该疗法的看法，并调查采用的可行性，尤其会考虑特定地点的问题。将进行主题分析。
截至2020年5月15日，已进行了1次患者焦点小组访谈。
本研究将为患者和工作人员提供关于在精神科病房实施自动化VR治疗潜力的独特见解。将收集关于在这种环境下使用沉浸式技术硬件以及特定治疗问题的观点。
国际注册报告识别码（IRRID）：DERR1-10.2196/20300。
