Brimelow Rachel E, Thangavelu Karthick, Beattie Romana, Dissanayaka Nadeeka N
UQ Centre for Clinical Research, Royal Brisbane & Women's Hospital, Faculty of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia.
Wesley Mission Queensland, Chermside, Brisbane, Queensland, Australia.
J Am Med Dir Assoc. 2022 May;23(5):831-837.e2. doi: 10.1016/j.jamda.2021.07.026. Epub 2021 Aug 26.
OBJECTIVES: To assess the feasibility of using group-based fully immersive virtual reality (VR) across multiple sessions to reduce behavioral and psychological symptoms (BPSs), including depression, anxiety, and agitated behaviors, in cognitively diverse aged care residents. DESIGN: A 6-session feasibility trial was conducted within a residential aged care facility using convenience sampling to recruit N = 25 residents of varying cognitive capacity. Groups of 5 residents viewed 360-degree videos on a wireless head-mounted display to provide fully immersive VR experiences. SETTING AND PARTICIPANTS: Half of the participants recruited from the 160-bed facility had a diagnosis of dementia (48%), whereas assessment with the Psychogeriatric Assessment Scale for cognitive impairment revealed that 64% experienced cognitive impairment (mild 20%, moderate 16%, and severe 28%). Additionally, 32% of participants had an existing anxiety or depression diagnosis. MEASURES: The Cornell Scale for Depression in Dementia, Generalized Anxiety Disorder 7-item, and Cohen Mansfield Agitation Inventory-Short were used to assess changes in persisting BPS pre- to postintervention period. The Person-Environment Apathy Rating apathy subscale, Observed Emotions Rating Scale, and a visual analog scale (Smileometer) were used to assess immediate mood responses from residents at every VR session. VR tolerability and resident feedback was also recorded. RESULTS: Pleasure (z = -5.892, P < .001) and general alertness (z = -2.455, P = .014) of participants improved at VR sessions, whereas apathy diminished (z = -5.275, P < .001). Compared to baseline, post-intervention depression was significantly lowered (z = -2.60, P = .009), whereas agitation increased (z = -2.98, P = .003). No significant changes in anxiety were observed. The quality of 360-degree videos and the device used did not induce any major VR-related negative side effects. CONCLUSIONS AND IMPLICATIONS: Overall group-based VR reduced depressive symptoms and apathy, and induced a positive emotional response in most residents, with few observed side effects. Results indicate feasibility of group-based VR technological innovation within RAC.
目的：评估在多个疗程中使用基于群体的完全沉浸式虚拟现实（VR）技术，以减轻认知能力各异的老年护理机构居民的行为和心理症状（BPS），包括抑郁、焦虑和激越行为的可行性。 设计：在一家老年护理机构内进行了一项为期6个疗程的可行性试验，采用便利抽样法招募了N = 25名认知能力各异的居民。每组5名居民通过无线头戴式显示器观看360度视频，以提供完全沉浸式VR体验。 设置与参与者：从这家拥有160张床位的机构招募的参与者中，一半被诊断患有痴呆症（48%），而使用老年精神病学认知障碍评估量表进行评估显示，64%的人存在认知障碍（轻度20%，中度16%，重度28%）。此外，32%的参与者已有焦虑或抑郁诊断。 测量方法：使用康奈尔痴呆抑郁量表、广泛性焦虑障碍7项量表和科恩-曼斯菲尔德激越量表简表来评估干预前后持续存在的BPS变化。使用人-环境冷漠评定量表的冷漠子量表、观察情绪评定量表和视觉模拟量表（微笑量表）来评估每次VR疗程中居民的即时情绪反应。还记录了VR耐受性和居民反馈。 结果：参与者在VR疗程中的愉悦感（z = -5.892，P < .001）和总体警觉性（z = -2.455，P = .014）有所改善，而冷漠感有所减轻（z = -5.275，P < .001）。与基线相比，干预后抑郁显著降低（z = -2.60，P = .009），而激越增加（z = -2.98，P = .003）。未观察到焦虑有显著变化。360度视频的质量和所使用的设备未引发任何与VR相关的重大负面副作用。 结论与启示：总体而言，基于群体的VR减轻了抑郁症状和冷漠感，并在大多数居民中引发了积极的情绪反应，观察到的副作用很少。结果表明在老年护理机构中基于群体的VR技术创新具有可行性。
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