沉浸式虚拟现实在重症监护病房作为一种放松方法的应用。

Usage of immersive virtual reality as a relaxation method in an intensive care unit.

机构信息

Área de Críticos, Consorcio Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain.

I3PT, Fundación Parc Taulí, Sabadell, Barcelona, Spain.

出版信息

Enferm Intensiva (Engl Ed). 2024 Apr-Jun;35(2):107-113. doi: 10.1016/j.enfie.2023.08.005. Epub 2023 Aug 28.

DOI:10.1016/j.enfie.2023.08.005

PMID:37648599

Abstract

INTRODUCTION

The usage of immersive virtual reality (iVR) in the context of an intensive care unit (ICU) is scarce. Our objective was to assess the feasibility of the usage of iVR in critical patients with or without mechanical ventilation (MV) and to determine the anxiety degree before and after each session.

METHODS

Analytical, descriptive, prospective, and cross-sectional research. Pilot test with 20 patients from a polyvalent ICU of a tertiary hospital. Adult patients were included, either connected or not to MV, watchful and calmed (RASS -1/+1) and without delirium (negative CAM-ICU). Oculus Go (Facebook Technologies, LLC) iVR glasses were the model used. The relaxation strategy consisted in the visualization of an experience of 15 min with scenes related to nature and fantasy, relaxing music with a plot. The sessions were individual, with the patient monitored in a fowler position or seated. The anxiety degree before and after each session was evaluated following a reduced version of the Spanish "Cuestionario de Ansiedad Estado-Rasgo (STAI-e)" and they were analysed using T samples coupled (statistical significance when p-value was <0.05).

RESULTS

Incorporation of 20 patients with an average age of 63.9 years old (60% men). A total of 34 sessions of iVR were conducted. 32% patients mechanically ventilated, 32% high-flow oxygen therapy, 36% other breathing supports. 80% of the sessions were completed without serious side effects. A significant decrease in the anxiety degree was observed after each iVR session: first session mean change -2.68 (SD = 2.75), p = 0.000; second session mean change -1.86 (SD = 1.57), p = 0.021; third session mean change -1.67 (SD = 1.63), p = 0.054.

CONCLUSION

The usage of iVR in the context of an ICU is feasible, even with patients mechanically ventilated. iVR reduces the anxiety degree in the critic patient, which suggests that "digital therapies" can be effective to improve the emotional state during their stay in the ICU.

摘要

介绍

沉浸式虚拟现实（iVR）在重症监护病房（ICU）中的应用还很少见。我们的目的是评估 iVR 在有或没有机械通气（MV）的危重症患者中的使用可行性，并确定每次治疗前后的焦虑程度。

方法

分析性、描述性、前瞻性和横截面研究。在一家三级医院的多科 ICU 中对 20 名患者进行了试点测试。纳入成人患者，无论是否连接 MV，镇静（RASS -1/+1）且无谵妄（CAM-ICU 阴性）。使用 Oculus Go（Facebook Technologies，LLC）iVR 眼镜。放松策略包括 15 分钟的体验，包括与自然和幻想相关的场景、有情节的放松音乐。治疗为个体化，患者以 Fowler 位或坐位接受监测。使用简化版西班牙“状态特质焦虑问卷（STAI-e）”评估每次治疗前后的焦虑程度，并使用 T 样本配对进行分析（当 p 值 <0.05 时具有统计学意义）。

结果

纳入 20 名平均年龄 63.9 岁（60%为男性）的患者。共进行了 34 次 iVR 治疗。32%的患者接受机械通气，32%接受高流量氧疗，36%接受其他呼吸支持。80%的治疗无严重不良反应。每次 iVR 治疗后，焦虑程度均显著下降：第一次治疗的平均变化为-2.68（标准差=2.75），p=0.000；第二次治疗的平均变化为-1.86（标准差=1.57），p=0.021；第三次治疗的平均变化为-1.67（标准差=1.63），p=0.054。