Experiences of patients undergoing chemotherapy with Virtual Reality: A mixed methodology study (Preprint)

2021 ◽  
Author(s):  
Anna Janssen ◽  
Jennifer Fletcher ◽  
Melanie Keep ◽  
Naseem Ahmadpour ◽  
Anika Rouf ◽  
...  

BACKGROUND Current research into virtual reality (VR) use during chemotherapy shows that it can be an effective distraction intervention. There is limited research in adult patients and how VR can be sustainably implemented in healthcare organisations. This study explored the feasibility and acceptability of VR for adult patients undergoing chemotherapy. OBJECTIVE This study aimed to explore the feasibility and acceptability of using virtual reality for adult patients undergoing chemotherapy, and the factors that would enable sustained use of VR during chemotherapy in healthcare organisations. METHODS Participants undergoing chemotherapy were recruited to participate in a VR intervention during chemotherapy infusion. Participants were observed during the session and completed a post-intervention survey. Each participant was invited to participate in a semi-structured interview about their experience. RESULTS A total of 18 patients participated in the study, of whom five participated in semi-structured interviews. Findings indicated that the use of VR was acceptable for patients undergoing chemotherapy, and was also feasible. Some participants felt the VR was an effective distraction during chemotherapy infusion, but most still seemed aware of how long their treatment was undertaken for. Although VR was acceptable and feasible to patients, interviews identified a number of barriers to sustained implementation including access to a reliable application library, and impact on staff workloads. CONCLUSIONS VR was acceptable to patients with a diagnosis of cancer undergoing chemotherapy treatment. Patients found VR beneficial for breaking up the monotony of treatment, to provide an additional choice of activity in addition to other recreation, and in some instances as a distraction from treatment itself. There are, however, challenges to address if VR is to be implemented in practice for this patient group.

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3155-3155 ◽  
Author(s):  
Christina J. Bemrich-Stolz ◽  
Jeffrey D. Lebensburger ◽  
Jewell H Halanych ◽  
Thomas H. Howard

Abstract Abstract 3155 Background: With improvements in care in the pediatric age group, most patients with sickle cell disease (SCD) live to adulthood. Though life expectancy is increasing, there is evidence that patients experience increasing mortality at the time of transition from pediatric to adult care. As care of adult patients is beyond the scope of pediatrics, transition to adult providers becomes a necessary part of comprehensive care for youths with SCD. When present, transition programs often focus on development of self management skills, improving health literacy, and other life skills beyond simply identifying and transferring to an adult provider. Most studies of pediatric patients with SCD and other chronic illnesses have focused on the concerns of patients prior to transition, but few have examined the experience of patients who have entered adult care. Using semi-structured interviews, our study examined adult SCD patients' transition experiences and difficulties faced in adult care that may contribute to the increased mortality during this time. Methods: Participants seen at the UAB Sickle Cell Clinic were recruited to participate in a semi-structured interview. To elicit the broadest experiences of adult care, we did not restrict the interviews to young adults, but recruited any interested participant with SCD >18 years old. The interview consisted of open ended questions with additional prompts regarding specific barriers found in the literature. One author (CB) performed all interviews, either in the UAB Sickle Cell Clinic or by telephone. Interviews continued until data saturation was achieved. All interviews were audio recorded and transcribed, then analyzed in three stages. First, transcripts were reviewed and coded independently by two authors (CB and JL). Second, the authors met to reconcile code definitions and agree on an overall coding scheme, which was based both on a priori themes from previous studies as well as inductive codes noted during analysis. Finally, the authors re-coded the transcripts based on the agreed upon coding scheme and reconciled differences. Results: Interviews were completed with 10 participants aged 24–55 years old. All patients had medical insurance, with 9 on disability. Transition topics discussed included timing of and preparation for transfer, development of independence, feelings about and experiences in pediatric and adult care. We confirmed that adults with SCD experienced many of the concerns noted in previous studies of pre-transition adolescents. Participants experienced distrust from adult physicians, mostly regarding pain. Though all participants feel that as adults, they successfully transitioned to independence in care for their disease, a number of them continue to regularly consult their parents regarding their care and/or live with their parents. Participants confirmed that a number of physicians they encountered were not familiar with sickle cell care and were concerned that the care they received from non-hematologists was inappropriate. None of the participants received formal preparation for transfer, though half were referred directly to an adult hematologist from pediatric care. Participants noted poor coordination of care between primary care physicians and hematologists, and difficulty identifying physicians willing to care for them. Those who had spent time in the work force noted difficulty maintaining employment. Conclusions: We found that concerns expressed by adolescents prior to transition in previous studies were well-founded and experienced in adulthood by a number of participants. Many patients feel poorly treated and have found few adult providers familiar with SCD. Since this study included patients engaged in a specialized sickle cell clinic, selection bias is a limitation. Though skills taught in many transition programs may help to overcome these barriers, systemic changes must also take place to address these external issues reported by patients who have transitioned to adult care. Disclosures: No relevant conflicts of interest to declare.


2016 ◽  
Vol 13 (3) ◽  
Author(s):  
Dean Vlahaki

IntroductionPre-hospital analgesia is administered at a suboptimal rate. We aimed to identify barriers to pre-hospital oral analgesia administration to adult patients, as perceived by paramedics, using qualitative methods.MethodsParamedics from a county emergency medical service were invited to participate in semi-structured interviews. The interviews consisted of two questions regarding barriers to pre-hospital administration of oral analgesia using a previously established medical directive. The same investigator completed all interviews, which were audio recorded and transcribed verbatim. Barriers to analgesia administration to adult patients were identified from the interview transcripts using open coding of the data. Two investigators completed the coding process independently and discrepancies were then resolved by consensus. Code frequencies were tabulated and thematic analysis was used to organise the data into broad domains and themes.ResultsIn total, 44 paramedics of a possible 46 (95.7%) completed a semi-structured interview. The final sample size was 43 after exclusion criteria were applied. The median paramedic age and practice experience was 39 and 9.5 years respectively, 58% of the participants were male. Barriers to oral analgesia administration emerged in the domains of patient, medical directive, and paramedic factors.ConclusionParamedic perceived barriers to pre-hospital oral analgesia administration were identified and include those related to patient, medical directive, and paramedic factors. Minimising these barriers should be undertaken to reduce rates of pre-hospital under-treatment of pain and improve pre-hospital pain management. 


2021 ◽  
Vol 2 (9) ◽  
pp. 705-709
Author(s):  
Jonathan Wright ◽  
Anna Timms ◽  
Sharon Fugazzotto ◽  
David Goodier ◽  
Peter Calder

Aims Patients undergoing limb reconstruction surgery often face a challenging and lengthy process to complete their treatment journey. The majority of existing outcome measures do not adequately capture the patient-reported outcomes relevant to this patient group in a single measure. Following a previous systematic review, the Stanmore Limb Reconstruction Score (SLRS) was designed with the intent to address this need for an effective instrument to measure patient-reported outcomes in limb reconstruction patients. We aim to assess the face validity of this score in a pilot study. Methods The SLRS was designed following structured interviews with several groups including patients who have undergone limb reconstruction surgery, limb reconstruction surgeons, specialist nurses, and physiotherapists. This has subsequently undergone further adjustment for language and clarity. The score was then trialled on ten patients who had undergone limb reconstruction surgery, with subsequent structured questioning to understand the perceived suitability of the score. Results Ten patients completed the score and the subsequent structured interview. Considering the tool as a whole, 100% of respondents felt the score to be comprehensible, relevant, and comprehensive regarding the areas that were important to a patient undergoing limb reconstruction surgery. For individual questions, on a five-point Likert scale, importance/relevance was reported as a mean of 4.78 (4.3 to 5.0), with ability to understand rated as 4.92 (4.7 to 5.0) suggesting high levels of relevance and comprehension. Flesch-Kincaid reading grade level was calculated as 5.2 (10 to 11 years old). Conclusion The current SLRS has been shown to have acceptable scores from a patient sample regarding relevance, comprehensibility, and comprehensiveness. This suggests face validity, however further testing required and is ongoing in a larger cohort of patients to determine the reliability, responsiveness, precision, and criterion validity of the score in this patient group. Cite this article: Bone Jt Open 2021;2(9):705–709.


1970 ◽  
Vol 6 (1) ◽  
pp. 52-58
Author(s):  
Fellipe Afonso de Azevedo ◽  
Noé D’jalma Araújo ◽  
Néliton Célio de Novais ◽  
José Vítor da Silva ◽  
Renato Augusto Passos

RESUMOObjetivo: o presente trabalho teve como objetivo identificar os significados de morte emergentes das equipes de enfermagem que atuam nas unidades de Pronto Socorro e Unidade de Terapia Intensiva (UTI) em uma entidade de médio porte situada no Sul de Minas Gerais. Materiais e métodos: estudo de abordagem qualitativa, do tipo descritivo, de campo e transversal. A amostra estudada foi composta de oito enfermeiros, 22 técnicos e quatro auxiliares de enfermagem, totalizando 34 profissionais, sendo utilizado o instrumento de caracterização pessoal e profissional da equipe de enfermagem e o roteiro de entrevista semiestruturada. A amostragem foi proposital. A coleta de dados foi realizada através de entrevista semiestruturada, gravada e transcrita. As diretrizes metodológicas do Discurso do Sujeito Coletivo foram utilizadas para a seleção das ideias centrais e expressões-chave correspondentes, a partir das quais foram extraídos os discursos dos sujeitos, no cenário da instituição hospitalar. Resultados e Discussão: ao analisar o tema “significados de morte”, obtiveram-se as seguintes ideias centrais: “passagem”, “diversos significados”, “fim da vida” e “fim e começo de outra vida”. Conclusão: As concepções acerca do tema morte para os profissionais participantes deste trabalho reforça a necessidade de estudos sobre o tema durante a formação acadêmica. Certos de que irão vivenciar este tipo de situação no dia-a-dia profissional, é preciso prepará-los psicologicamente para isso.Palavras-chave: Morte, Equipe de enfermagem, Assistência ao paciente.ABSTRACTObjective: This study aimed to identify the meanings of emerging death of the nursing staff working in the Emergency Units and Intensive Care Unit (ICU) in a medium-sized entity located in southern Minas Gerais. Materials and methods: A cross-sectional qualitative field research. The sample was composed of 8 nurses, 22 technicians and 4 nursing assistants, totaling 34 professionals. It was used a tool of personal and professional characterization of the nursing team and a semi-structured interview. Sampling was intentional. Data collection was conducted through semi-structured interviews, that were recorded and transcribed. The methodological guidelines of the Collective Subject Speech were used for the selection of the central ideas and corresponding key expressions, from which the speeches of the subjects were taken, in the hospital setting. Results and discussion: to examine the topic "death meanings" yielded the following core ideas: "pass", "different meanings", "end of life" and "end and beginning of another life." Conclusion: The conceptions about the death theme for the professional participants of this study reinforces the need for studies on the subject during their academic training. It is certain that they will experience this type of situation on their daily professional routine, therefore there is a need to prepare them psychologically for this.Keywords: Death, Nursing staff, Patient care.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M.-C. Audétat ◽  
S. Cairo Notari ◽  
J. Sader ◽  
C. Ritz ◽  
T. Fassier ◽  
...  

Abstract Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. Methods A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a “button camera” (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. Conclusion Study results will contribute to the scientific community’s overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient’s care and treatments.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Viveca Lindberg ◽  
Sofia Louca Jounger ◽  
Maria Christidis ◽  
Nikolaos Christidis

Abstract Background The transition from upper secondary to higher education and from higher education to professional practice requires that students adapt to new literacy practices, academic and professional. However, there is a gap of knowledge regarding literacy practices in dental education. Therefore, the aim of this study was to identify what characterizes dental students’ notetaking and secondarily to determine what dental students express regarding their notetaking. Methods To analyze students’ perspectives about the purposes of notetaking and to examine their written notes in depth, three volunteer students, out of the 24 students that voluntarily and anonymously handed in their notes, were interviewed. The three undergraduate dental students that participated in this material-based, semi-structured interview study, framed within a New Literacy Studies approach, were on their third year (6th semester). The focus of these material-based interviews was on each student’s notes. Questions prepared for semi-structured interviews were open-ended and allowed for individual follow-up questions related to the interviewee’s answer. To analyze the outcome of the interviews a thematic analysis was used. Results From the material-based interviews eight themes that relate to what, how and for what purpose students write were discerned. These eight themes include professional vocabulary, core content as well as clinical examples that belong to what students read and write; multimodal accentuation as well as synthesis that belong to how students read and write; and mnemonic strategies, academic purposes, and professional purposes that belong to for what purpose students read and write. Conclusions Findings from the interviews indicate that the digital development, offering a variety of available tools, has expanded the notion of notetaking. This study identified that dental students’ notetaking has changed during their education from initially being synchronous, to also include multimodal and asynchronous writing, making notetaking more of a writing practice. Further, students’ writing practices seem to be motivated by their knowledge formation in relation to a subject matter, but also in relation to their experiences during clinical training. Although, our hypothesis was that the main purpose of notetaking and writing was to pass their course examinations, this study showed that students that were half-way through their dental education, are aware that literacy practices are for learning for their future profession, and not only for passing their exams.


Author(s):  
Yu-Sheng Yang ◽  
Alicia M. Koontz ◽  
Yu-Hsuan Hsiao ◽  
Cheng-Tang Pan ◽  
Jyh-Jong Chang

Maneuvering a wheelchair is an important necessity for the everyday life and social activities of people with a range of physical disabilities. However, in real life, wheelchair users face several common challenges: articulate steering, spatial relationships, and negotiating obstacles. Therefore, our research group has developed a head-mounted display (HMD)-based intuitive virtual reality (VR) stimulator for wheelchair propulsion. The aim of this study was to investigate the feasibility and efficacy of this VR stimulator for wheelchair propulsion performance. Twenty manual wheelchair users (16 men and 4 women) with spinal cord injuries ranging from T8 to L2 participated in this study. The differences in wheelchair propulsion kinematics between immersive and non-immersive VR environments were assessed using a 3D motion analysis system. Subjective data of the HMD-based intuitive VR stimulator were collected with a Presence Questionnaire and individual semi-structured interview at the end of the trial. Results indicated that propulsion performance was very similar in terms of start angle (p = 0.34), end angle (p = 0.46), stroke angle (p = 0.76), and shoulder movement (p = 0.66) between immersive and non-immersive VR environments. In the VR episode featuring an uphill journey, an increase in propulsion speed (p < 0.01) and cadence (p < 0.01) were found, as well as a greater trunk forward inclination (p = 0.01). Qualitative interviews showed that this VR simulator made an attractive, novel impression and therefore demonstrated the potential as a tool for stimulating training motivation. This HMD-based intuitive VR stimulator can be an effective resource to enhance wheelchair maneuverability experiences.


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii22-ii22
Author(s):  
Kyle Walsh

Abstract BACKGROUND Preliminary evidence indicates that glioma patients are at higher risk for COVID-19 complications due to systemic immunosuppression. Interruptions in cancer care may exacerbate patient and caregiver anxiety, but surveying patients/caregivers about their COVID-19 experiences is often limited by attainable sample sizes and over-reliance upon single-institution experiences. METHODS To explore how COVID-19 is impacting brain tumor patients/caregivers across the U.S., we performed semi-structured interviews with brain tumor patient navigators employed by two different 501(c)3 nonprofit organizations. A semi-structured interview guide was used, utilizing prompts and open-ended questions to facilitate dialogue. A core set of COVID-19 topics were covered, including: financial issues, coping strategies, geographic variability, variability by tumor grade/histology, disruptions in care continuity, accessing clinical trials, psychosocial issues, and end-of-life care. Interviews were audio-recorded, transcribed, and organized by discussion topic to identify emerging themes. Inductive sub-coding was completed using the constant comparison method, within and between transcripts. RESULTS/CONCLUSIONS Ten patient navigators were interviewed between April 15th and May 8th, with interviews lasting approximately one hour (range 38-77minutes). Navigators reported having contact with 183 unique brain tumor families during the pandemic (range 7–38 families per navigator). High concordance emerged across narratives, revealing important considerations for the neuro-oncology workforce. The most prominent theme was increased caregiver burden, attributed to maintaining social distancing by reducing visits from home-health aides and friends/family. A related theme that applied to both patients and caregivers was increased social isolation due to social distancing, suspension of in-person support groups, and church/temple closures. Accessing clinical trials was a recurrent issue, exacerbated by patients’ increasing unwillingness to travel. Glioblastoma patients, especially those with recurrent tumors, expressed greater reluctance to travel. Access to standard-of-care treatment was rarely interrupted, but reduced access to supportive services – especially physical and occupational therapy – was identified as an emerging COVID-related deficiency in clinical care.


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii175-ii175
Author(s):  
Deborah Forst ◽  
Michelle Mesa ◽  
Emilia Kaslow-Zieve ◽  
Areej El-Jawahri ◽  
Joseph Greer ◽  
...  

Abstract BACKGROUND Caregivers of patients with malignant gliomas experience substantial anxiety symptoms while caring for someone with progressive neurological decline. Yet, interventions to reduce psychological distress and improve quality of life (QoL) in this caregiver population are lacking. METHODS We conducted an open pilot study evaluating feasibility and acceptability of a cognitive behavioral therapy-based intervention for caregivers of patients with malignant gliomas with clinically significant anxiety (Generalized Anxiety Disorder [GAD-7] score ≥ 5). Caregivers participated in six videoconference sessions with a mental health provider. We defined the intervention as feasible if ≥ 70% of eligible caregivers enrolled and ≥ 70% of those enrolled completed ≥ 50% of sessions. We evaluated intervention acceptability in semi-structured interviews. Caregivers completed baseline and post-intervention surveys assessing anxiety and depression symptoms (Hospital Anxiety and Depression Scale), QoL (Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), self-efficacy (Lewis Cancer Self-Efficacy Scale), and perceived coping skills (Measure of Current Status-Part A). We explored post-intervention changes using paired t-tests. RESULTS We obtained consent from 70.0% (21/30) of caregivers approached, of which 66.7% (14/21) had clinically significant anxiety and thus were eligible to participate (mean age=55.7 years, 64.3% female). Among enrolled caregivers, 71.4% (10/14) completed ≥ 50% of sessions. In semi-structured interviews, all participants found the intervention helpful and valued the ability to participate remotely via videoconference. Among caregivers who completed at least one session, 80.0% (8/10) completed all assessments and were included in analyses. Post-intervention, caregivers reported reduced anxiety symptoms (P=.02) and improved QoL (P=.03) and coping skills (P=.001). We found no significant change in depression, caregiving burden, or self-efficacy. CONCLUSION Our videoconference-based intervention is feasible and acceptable to caregivers. Participants reported significant improvements in anxiety symptoms, quality of life, and coping skills post-intervention, supporting further investigation of the intervention in a randomized controlled trial.


2021 ◽  
Vol 14 (2) ◽  
pp. 205979912110307
Author(s):  
Dennis Mathysen ◽  
Ignace Glorieux

Virtual reality (VR) is still very much a niche technology despite its increasing popularity since recent years. VR has now reached a point where it can offer photorealistic experiences, while also being consumer-friendly and affordable. However, so far only a very limited amount of software has been developed for the specific purpose of conducting (social science) research. In this article, we illustrate that integrating virtual reality to good effect in social science research does not necessarily require specialized hardware or software, an abundance of expertise regarding VR-technology or even a large budget. We do this by discussing our use of a method we have come to call ‘VR-assisted interviews’: conducting a (semi-structured) interview while respondents are confronted with a virtual environment viewed via a VR-headset. This method allows respondents to focus on what they are seeing and experiencing, instead of having them worry about how to operate a device and navigate an interface they are using for the first time. ‘VR-assisted interviews’ are very user-friendly for respondents but also limits options for interactiveness. We believe this method can be a valuable alternative, both because of methodological and practical considerations, for more complex applications of VR-technology in social science research.


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