Lu Zhipeng, Wang Wenjin, Yan Wei, Kew Chung Lin, Seo Jinsil Hwaryoung, Ory Marcia
Department of Architecture, Texas A&M University, College Station, TX, United States.
School of Public Health, Texas A&M University, College Station, TX, United States.
JMIR Serious Games. 2023 Oct 6;11:e45539. doi: 10.2196/45539.
The increasing number of older adults with mental, behavioral, and memory challenges presents significant public health concerns. Reminiscence is one type of nonpharmacological intervention that can effectively evoke memories, stimulate mental activities, and improve psychological well-being in older adults through a series of discussions on previous experiences. Fully immersive virtual reality (FIVR) may be a useful tool for reminiscence interventions because it uses realistic virtual environments connected to a person's significant past stories.
This review aims to examine empirical evidence regarding the application of FIVR in reminiscence interventions, its usability and acceptability, and its effectiveness in assisting the intervention to achieve optimal outcomes.
We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach for scoping reviews. The PubMed, PsycINFO, Embase, CINAHL, Web of Science, ACM, and IEEE Xplore electronic databases were used for the search. We included peer-reviewed studies that used FIVR as an assistive tool for reminiscence interventions; were published between January 1, 2000, and August 1, 2022; reported empirical research; involved older adults as participants; and addressed health- and behavior-related outcomes or the feasibility and usability of FIVR. We used Endnote X9 to organize the search results and Microsoft Excel for data extraction and synthesis.
Of the 806 articles collected from the databases and other resources, 11 were identified. Most of the studies involved participants aged between 70 and 90 years. Only 1 study did not involve those with cognitive impairments, whereas 3 specifically targeted people living with dementia. The results indicated that FIVR reminiscence interventions enhanced engagement and reduced fatigue. Although some studies have observed positive effects on anxiety, apathy, depression, cognitive functions, and caregiver burden reduction, these findings were inconsistent across other research. In addition, FIVR showed overall usability and acceptability with manageable side effects among older adults across various health conditions during reminiscence sessions. However, 1 study reported adverse feelings among participants, triggered by unpleasant memories evoked by the virtual reality content.
The role of FIVR in reminiscence interventions remains nascent, with limited studies evaluating its impacts on older adults. Many of the reviewed studies had notable limitations: small sample sizes, absence of rigorous research design, limited assessment of long-term effects, lack of measures for health and behavior outcomes, and quality of life. Beyond these limitations, this review identified a list of future research directions in 6 categories. On the basis of the review findings, we provide practical recommendations to enhance FIVR reminiscence interventions, covering topics such as virtual reality content, device choice, intervention types, and the role and responsibility of facilitators.
患有精神、行为和记忆障碍的老年人数量不断增加，这引发了重大的公共卫生问题。回忆疗法是一种非药物干预措施，通过一系列关于既往经历的讨论，能有效唤起记忆、刺激心理活动并改善老年人的心理健康。完全沉浸式虚拟现实（FIVR）可能是回忆疗法干预的有用工具，因为它使用与个人重要过往经历相关的逼真虚拟环境。
本综述旨在研究关于FIVR在回忆疗法干预中的应用、其可用性和可接受性，以及其在协助干预实现最佳效果方面的有效性的实证证据。
我们遵循PRISMA（系统评价和Meta分析的首选报告项目）方法进行范围综述。使用PubMed、PsycINFO、Embase、CINAHL、Web of Science、ACM和IEEE Xplore电子数据库进行检索。我们纳入了经过同行评审的研究，这些研究将FIVR用作回忆疗法干预的辅助工具；发表于2000年1月1日至2022年8月1日之间；报告了实证研究；涉及老年人作为参与者；并涉及与健康和行为相关的结果或FIVR的可行性和可用性。我们使用Endnote X9来整理检索结果，并使用Microsoft Excel进行数据提取和综合。
从数据库和其他资源中收集的806篇文章中，确定了11篇。大多数研究的参与者年龄在70至90岁之间。只有1项研究未纳入认知障碍者，而3项研究专门针对痴呆症患者。结果表明，FIVR回忆疗法干预增强了参与度并减轻了疲劳。尽管一些研究观察到对焦虑、冷漠、抑郁、认知功能和减轻照顾者负担有积极影响，但这些发现在其他研究中并不一致。此外，FIVR在回忆疗法过程中对各种健康状况的老年人显示出总体可用性和可接受性，且副作用可控。然而，1项研究报告了参与者因虚拟现实内容唤起不愉快记忆而产生的不良情绪。
FIVR在回忆疗法干预中的作用仍处于初期阶段，评估其对老年人影响的研究有限。许多综述研究存在明显局限性：样本量小、缺乏严谨的研究设计、对长期影响的评估有限、缺乏健康和行为结果及生活质量的测量方法。除这些局限性外，本综述确定了6类未来研究方向。基于综述结果，我们提供了增强FIVR回忆疗法干预措施的实用建议，涵盖虚拟现实内容、设备选择、干预类型以及促进者的角色和责任等主题。
