Harris Emma, Fenton Steven, Stephenson John, Ewart Fiona, Goharinezhad Salime, Lee Hyunkook, Astin Felicity
School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK.
School of Computing and Engineering, University of Huddersfield, Huddersfield, UK.
J Clin Nurs. 2025 Apr;34(4):1465-1492. doi: 10.1111/jocn.17578. Epub 2024 Dec 12.
Extended reality (XR) interventions have the potential to benefit patients undergoing elective cardiac surgical and interventional procedures. However, there are no systematic reviews with meta-analyses to guide clinical care.
To critically evaluate the evidence on the effectiveness of XR interventions on patient anxiety and pain and other associated outcomes.
Systematic review and meta-analysis following the PRISMA 2020 statement.
A systematic search of five databases (CENTRAL, CINAHL, MEDLINE, PsycInfo, Scopus) from inception to July 2023.
Screening and data extraction was conducted independently by multiple reviewers. Stata (Version 17) was used to conduct meta-analyses for patient anxiety and pain. Secondary patient outcomes were summarised in a synthesis. The Cochrane Risk of Bias (Version 2) tool was applied to trials and the NHLBI Study Quality Assessment tools to all other study designs.
Of the 3372 records identified, 22 were included, 10 of which were eligible for inclusion in the meta-analyses. Fifty-seven percent of randomised trials were rated as high risk of bias. Virtual reality (VR) was the only XR technology evaluated. VR significantly reduced pre-procedural anxiety (standardised mean difference: -1.29; 95% confidence interval - 1.96, -0.62, p < 0.001), and peri-procedural anxiety (standardised mean difference: -0.50; 95% confidence interval - 0.83, -0.18, p < 0.003) but did not reduce pain levels, compared with usual care. VR increased pre-procedural knowledge and postsurgical physical and pulmonary function. VR interventions may also improve emotional wellbeing, care delivery and physiological outcomes, but evidence was inconsistent.
XR potentially benefits cardiac patients undergoing elective invasive procedures and surgery by reducing pre- and peri-procedural anxiety and increasing procedural knowledge and physical function.
Cardiac nurses' role can be supported by VR interventions to improve the patient experience and several aspects of patient care.
Not applicable as this is a systematic review.
扩展现实（XR）干预措施有可能使接受择期心脏手术和介入手术的患者受益。然而，目前尚无系统评价和荟萃分析来指导临床护理。
严格评估关于XR干预措施对患者焦虑、疼痛及其他相关结局有效性的证据。
遵循PRISMA 2020声明进行系统评价和荟萃分析。
对五个数据库（CENTRAL、CINAHL、MEDLINE、PsycInfo、Scopus）从创建至2023年7月进行系统检索。
由多名审阅者独立进行筛选和数据提取。使用Stata（版本17）对患者焦虑和疼痛进行荟萃分析。次要患者结局在综合分析中进行总结。将Cochrane偏倚风险（版本2）工具应用于试验，将美国国立心肺血液研究所（NHLBI）研究质量评估工具应用于所有其他研究设计。
在识别出的3372条记录中，纳入了22条，其中10条符合纳入荟萃分析的条件。57%的随机试验被评为高偏倚风险。虚拟现实（VR）是唯一被评估的XR技术。与常规护理相比，VR显著降低了术前焦虑（标准化均值差：-1.29；95%置信区间-1.96，-0.62，p<0.001）和围手术期焦虑（标准化均值差：-0.50；95%置信区间-0.83，-0.18，p<0.003），但未降低疼痛水平。VR增加了术前知识以及术后身体和肺功能。VR干预措施也可能改善情绪健康、护理提供和生理结局，但证据并不一致。
XR可能通过降低术前和围手术期焦虑、增加手术知识和身体功能，使接受择期侵入性手术和手术的心脏病患者受益。
VR干预措施可支持心脏科护士的工作，以改善患者体验和患者护理的多个方面。
不适用，因为这是一项系统评价。
