Phiri Peter, Pemberton Laura, Liu Yang, Yang Xiaojie, Salmon Joe, Boulter Isabel, Sajid Sana, Clarke Jackie, McMillan Andy, Shi Jian Qing, Delanerolle Gayathri
Department of Research & Innovation, Southern Health National Health Service Foundation Trust, Southampton SO30 3JB, United Kingdom.
Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China.
World J Psychiatry. 2024 Oct 19;14(10):1521-1537. doi: 10.5498/wjp.v14.i10.1521.
Restrictive practices (RPs) are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency. Seclusion is an equal part of RPs intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity. Using interventions by way of virtual reality (VR) could assist with reducing the need for RPs as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments. This could also aid staff to and change current RPs.
To assess the feasibility and effectiveness of using a VR platform to provide reduction in RP training.
A randomised controlled feasibility study, accompanied by evaluations at 1 month and 6 months, was conducted within inpatient psychiatric wards at Southern Health National Health Service Foundation Trust, United Kingdom. Virti VR scenarios were used on VR headsets to provide training on reducing RPs in 3 inpatient psychiatric wards. Outcome measures included general self-efficacy scale, generalised anxiety disorder assessment 7 (GAD-7), Burnout Assessment Tool 12, the Everyday Discrimination Scale, and the Compassionate Engagement and Action Scale.
Findings revealed statistically significant differences between the VR and treatment as usual groups, in the Everyday Discrimination Scale items Q8 and Q9: = 0.023 and = 0.040 respectively, indicating higher levels of perceived discrimination in the VR group. There were no significant differences between groups in terms of general self-efficacy, generalised anxiety disorder assessment 9, and Burnout Assessment Tool 12 scores. A significant difference was observed within the VR group for compassionate engagement from others ( = 0.005) over time. Most respondents recorded System Usability Scale scores above 70, with an average score of 71.79. There was a significant reduction in rates of RPs in the VR group treatment as usual group with a fluctuating variability observed in the VR group likely due to external factors not captured in the study.
Ongoing advancement of VR technology enables the possibility of creating scenarios and simulations tailored to healthcare environments that empower staff by providing more comprehensive and effective training for handling situations.
限制性措施(RPs)是指在任何紧急情况下,与身体和化学约束相关的措施,以减少活动或控制行为。隔离是限制性措施的一个组成部分,旨在隔离并减少感官刺激,以保护患者及附近人员。通过虚拟现实(VR)进行干预有助于减少对限制性措施的需求,因为它可以通过将用户置于逼真且身临其境的环境中,帮助减轻焦虑或躁动。这也有助于工作人员并改变当前的限制性措施。
评估使用VR平台减少限制性措施培训的可行性和有效性。
在英国南部国民保健服务基金会信托基金的住院精神科病房内,进行了一项随机对照可行性研究,并在1个月和6个月时进行评估。在VR头戴设备上使用Virti VR场景,为3个住院精神科病房提供减少限制性措施的培训。结果指标包括一般自我效能量表、广泛性焦虑障碍评估量表7(GAD - 7)、职业倦怠评估工具12、日常歧视量表以及同情参与和行动量表。
研究结果显示,在日常歧视量表的第8项和第9项中,VR组与常规治疗组之间存在统计学上的显著差异,分别为 = 0.023和 = 0.040,表明VR组的感知歧视水平更高。在一般自我效能、广泛性焦虑障碍评估量表9以及职业倦怠评估工具12得分方面,两组之间没有显著差异。随着时间的推移,VR组在他人的同情参与方面观察到显著差异( = 0.005)。大多数受访者的系统可用性量表得分高于70,平均得分为71.79。VR组的限制性措施发生率显著低于常规治疗组,VR组中观察到的变异性波动可能是由于研究中未捕捉到的外部因素。
VR技术的不断进步使得创建针对医疗环境的场景和模拟成为可能,通过提供更全面、有效的应对情况培训来增强工作人员的能力。