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对入住急症护理医院的痴呆症患者实施虚拟现实疗法以管理其行为和心理症状:一项试点研究的结果。

Administering Virtual Reality Therapy to Manage Behavioral and Psychological Symptoms in Patients With Dementia Admitted to an Acute Care Hospital: Results of a Pilot Study.

作者信息

Appel Lora, Kisonas Erika, Appel Eva, Klein Jennifer, Bartlett Deanna, Rosenberg Jarred, Smith Christopher Nc

机构信息

Faculty of Health, School of Health Policy and Management, York University, Toronto, ON, Canada.

OpenLab, University Health Network, Toronto, ON, Canada.

出版信息

JMIR Form Res. 2021 Feb 3;5(2):e22406. doi: 10.2196/22406.

Abstract

BACKGROUND

As virtual reality (VR) technologies become increasingly accessible and affordable, clinicians are eager to try VR therapy as a novel means to manage behavioral and psychological symptoms of dementia, which are exacerbated during acute care hospitalization, with the goal of reducing the use of antipsychotics, sedatives, and physical restraints associated with negative adverse effects, increased length of stay, and caregiver burden. To date, no evaluations of immersive VR therapy have been reported for patients with dementia in acute care hospitals.

OBJECTIVE

This study aimed to determine the feasibility (acceptance, comfort, and safety) of using immersive VR therapy for people living with dementia (mild, moderate, and advanced) during acute care hospitalization and explore its potential to manage behavioral and psychological symptoms of dementia.

METHODS

A prospective, longitudinal pilot study was conducted at a community teaching hospital in Toronto. The study was nonrandomized and unblinded. A total of 10 patients aged >65 years (mean 86.5, SD 5.7) diagnosed with dementia participated in one or more research coordinator-facilitated sessions of viewing immersive 360° VR footage of nature scenes displayed on a Samsung Gear VR head-mounted display. This mixed-methods study included review of patient charts, standardized observations during the intervention, and pre- and postintervention semistructured interviews about the VR experience.

RESULTS

All recruited participants (N=10) completed the study. Of the 10 participants, 7 (70%) displayed enjoyment or relaxation during the VR session, which averaged 6 minutes per view, and 1 (10%) experienced dizziness. No interference between the VR equipment and hearing aids or medical devices was reported.

CONCLUSIONS

It is feasible to expose older people with dementia of various degrees admitted to an acute care hospital to immersive VR therapy. VR therapy was found to be acceptable to and comfortable by most participants. This pilot study provides the basis for conducting the first randomized controlled trial to evaluate the impact of VR therapy on managing behavioral and psychological symptoms of dementia in acute care hospitals.

摘要

背景

随着虚拟现实(VR)技术越来越容易获得且价格亲民,临床医生渴望尝试将VR疗法作为一种新方法,来管理痴呆症患者的行为和心理症状。这些症状在急性护理住院期间会加剧,目标是减少与负面不良影响、住院时间延长和护理人员负担相关的抗精神病药物、镇静剂和身体约束的使用。迄今为止,尚未有关于急性护理医院中痴呆症患者沉浸式VR疗法的评估报告。

目的

本研究旨在确定在急性护理住院期间,对不同程度(轻度、中度和重度)痴呆症患者使用沉浸式VR疗法的可行性(接受度、舒适度和安全性),并探索其管理痴呆症行为和心理症状的潜力。

方法

在多伦多的一家社区教学医院进行了一项前瞻性纵向试点研究。该研究非随机且未设盲。共有10名年龄大于65岁(平均86.5岁,标准差5.7)、被诊断患有痴呆症的患者参加了由研究协调员协助的一个或多个观看在三星Gear VR头戴式显示器上播放的沉浸式360°自然场景VR视频的环节。这项混合方法研究包括查阅患者病历、干预期间的标准化观察,以及干预前后关于VR体验的半结构化访谈。

结果

所有招募的参与者(N = 10)均完成了研究。在这10名参与者中,7名(70%)在VR环节中表现出愉悦或放松,每次观看平均时长为6分钟,1名(10%)经历了头晕。未报告VR设备与助听器或医疗设备之间存在干扰。

结论

让入住急性护理医院的不同程度痴呆症老年人接受沉浸式VR疗法是可行的。大多数参与者认为VR疗法是可接受且舒适的。这项试点研究为开展第一项随机对照试验奠定了基础。该试验旨在评估VR疗法对急性护理医院中痴呆症患者行为和心理症状管理的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b0/7889418/245ec4addd58/formative_v5i2e22406_fig1.jpg

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