Jehl Nicole M, Hess Courtney W, Choate Ellison S, Nguyen Hannah T, Yang Yerin, Simons Laura E
Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, United States.
Vice Provost of Undergraduate Research, Stanford University, Stanford, United States.
J Pediatr Psychol. 2025 Jan 1;50(1):76-85. doi: 10.1093/jpepsy/jsae056.
Virtual reality (VR) can enhance engagement in outpatient physical therapy (PT) through distraction and gamification of movement. This study assessed barriers and facilitators to VR-enhanced PT.
Data were collected during a feasibility trial of VR-enhanced PT for youth with chronic musculoskeletal pain. Semistructured and informal interviews were conducted with youth participants, their caregivers, and collaborating physical therapists. To analyze transcriptions, content analysis was employed in multiple rounds. Barriers and facilitators to VR implementation were coded using a deductive approach, then an inductive approach was used to identify emergent themes within each deductive code category.
We completed interviews with youth participants (n = 9), caregivers (n = 7), and clinician stakeholders (n = 5). Coded barriers included: (1) participant identity and self-narrative inconsistent with the intervention, (2) system-level, structural constraints of healthcare, (3) lack of guidance and leadership from clinicians around VR use, (4) research burnout, (5) expectation violation and disappointment, and (6) missing the optimal treatment window. Coded facilitators included: (1) viewing VR as a bridge to achieving treatment goals, (2) having access to resources, (3) sustained positive experience and immersion in the game, (4) alignment between identity and the intervention, and (5) champion-level collaborations.
This study highlights the importance of considering the VR technology, person using the VR, and the context in which VR is being implemented to optimize uptake and acceptability. Adopting an implementation science lens to the field of VR for chronic pain will enhance the applicability and scale of impact.
虚拟现实（VR）可通过分散注意力和将运动游戏化来提高门诊物理治疗（PT）的参与度。本研究评估了VR增强型PT的障碍和促进因素。
在一项针对患有慢性肌肉骨骼疼痛的青少年的VR增强型PT可行性试验期间收集数据。对青少年参与者、他们的照顾者以及合作的物理治疗师进行了半结构化和非正式访谈。为了分析转录内容，进行了多轮内容分析。采用演绎法对VR实施的障碍和促进因素进行编码，然后采用归纳法在每个演绎编码类别中识别新出现的主题。
我们完成了对青少年参与者（n = 9）、照顾者（n = 7）和临床利益相关者（n = 5）的访谈。编码的障碍包括：（1）参与者身份和自我叙述与干预不一致，（2）医疗保健的系统层面、结构限制，（3）临床医生在VR使用方面缺乏指导和引领，（4）研究倦怠，（5）期望违背和失望，以及（6）错过最佳治疗窗口。编码的促进因素包括：（1）将VR视为实现治疗目标的桥梁，（2）能够获取资源，（3）在游戏中持续获得积极体验并沉浸其中，（4）身份与干预之间的契合，以及（5）顶级合作。
本研究强调了考虑VR技术、使用VR的人以及实施VR的背景对于优化采用率和可接受性的重要性。将实施科学视角应用于慢性疼痛的VR领域将提高其适用性和影响范围。
