Interest of virtual reality hypnosis in the EP lab in clinical practice : an observational study (Preprint)

2021 ◽  
Author(s):  
Mathieu Granier ◽  
Iklo Coulibaly ◽  
thomas Vacter ◽  
Claire Duflos ◽  
Lionel Moulis ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Conscious Sedation ◽  
Intervention Group ◽  
Drug Consumption ◽  
Control Group ◽  
Clinical Settings ◽  
Baseline Characteristics ◽  
Procedure Duration ◽  
Human Care ◽  
Analogue Scales

UNSTRUCTURED Aims: Virtual reality Hypnosis (VRH) has been used successfully in different clinical settings to treat anxiety and the sensation of pain. We aimed to investigate the feasibility and safety of VRH in patients undergoing electrophysiology and stimulation procedures under conscious sedation. Methods: During a two-month period, VRH support was proposed to patients undergoing interventions. Data were compared with a control group (n=61) enrolled during the following three-month period. In the intervention group (n=25), the dedicated VR hypnosis programme was projected during the procedure. In both groups, pain and comfort were measured at the end of the procedure and at discharge, using visual analogue scales (VASs; 0-10). Results: Baseline characteristics were comparable in both groups. There was no difference in procedure duration (46 (±29) vs 56 (±32) min, p=0,18) nor in hypnotic / antalgic consumption (1.95 (±1.44) vs 2.00 (±1.22) mg, p=0,83 and 3.78 (±2.87) vs 3.58 (±2.48) μg, p=0,9) for the control and VR groups respectively. In a multivariate analysis, the use of VR was independently associated with lower comfort during the procedure, assessed by post-operative VAS (OR 15.00 (IC95%4.77;47.16), p<0.01). There was no influence of VR use on pain or drug consumption. Conclusions: In our experience, VR hypnosis in the EP lab doesn’t improve comfort during the procedure, compared to conventional human care. It has no influence on pain or drug consumption.

scholarly journals Virtual reality to improve patient information and reduce anxiety towards atrial fibrillation ablation in times of remote patient care (and after)

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
ANL Hermans ◽  
P Van Duijnhoven ◽  
DVM Verhaert ◽  
S Philippens ◽  
M Lahaije ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Virtual Reality ◽  
Patient Care ◽  
Patient Information ◽  
Intervention Group ◽  
Control Group ◽  
Af Ablation ◽  
Significant Difference ◽  
Remote Patient ◽  
Preoperative Patient

Abstract Funding Acknowledgements Type of funding sources: None. Background. Nowadays frequently deployed invasive catheter ablation therapy in patients with symptomatic atrial fibrillation (AF) is unfortunately associated with distress such as preoperative anxiety. Improving preoperative patient information may lower anxiety towards AF ablation procedures. Purpose. To evaluate whether a lifelike 360˚ virtual reality (VR) patient information video decreases anxiety levels and improves patient preparation towards AF ablation as compared to standard preoperative patient information. Methods. Consecutive patients planned for AF ablation were recruited from the outpatient AF clinic and were randomized into two groups: the control group and the intervention group (VR group). The control group received standard preoperative information through oral counselling and information leaflets, the VR group received the standard information as well as a short dedicated 360˚ VR video (via in-hospital VR headset and disposable cardboard VR glasses for home use). Online questionnaires (aimed at information provision, anxiety and procedural experience) were administered both pre- and post-ablation. Results. A total of 103 patients (39.8% female, age 64 [58-71] years) were included in the analysis. The VR group (n = 58) reported to be clearly better informed about catheterization laboratory environment (78% vs. 73%) and the course of the procedure (82% vs. 78%), indicated fewer concerns about the procedure (47% vs. 55%) and were eager to learn even more (82% vs. 74%) as compared to controls (n = 45). However, there was no significant difference in the anxiety scores between the VR group and controls (10 [8-12] vs. 10 [8-14], p = 0.548). Home use of the video was satisfactory and resulted in discussion with relatives. Patient overall satisfaction was higher in VR group as compared to controls (84% vs. 81%). Conclusions. This study shows that a dedicated 360˚ VR video reduces concerns but does not reduce anxiety scores. Though, it easily improves procedural knowledge, patient information and patient satisfaction. Especially in times of remote patient care, this new way of informing patients may be of added value.

scholarly journals Feasibility, Safety and Efficacy of a Virtual Reality Exergame System to Supplement Upper Extremity Rehabilitation Post-Stroke: A Pilot Randomized Clinical Trial and Proof of Principle

2019 ◽  
Vol 17 (1) ◽  
pp. 113 ◽  
Author(s):  
Nahid Norouzi-Gheidari ◽  
Alejandro Hernandez ◽  
Philippe S. Archambault ◽  
Johanne Higgins ◽  
Lise Poissant ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Extremity ◽  
Intervention Group ◽  
Outpatient Rehabilitation ◽  
Control Group ◽  
Stroke Survivors ◽  
Post Intervention ◽  
Serious Adverse Events ◽  
Traditional Therapy ◽  
Post Stroke

(1) Background: Increasing the amount of therapy time has been shown to improve motor function in stroke survivors. However, it is often not possible to increase the amount of therapy time provided in the current one-on-one therapy models. Rehabilitation-based virtual reality exergame systems, such as Jintronix, can be offered to stroke survivors as an adjunct to traditional therapy. The goal of this study was to examine the safety and feasibility of providing additional therapy using an exergame system and assess its preliminary clinical efficacy. (2) Methods: Stroke survivors receiving outpatient rehabilitation services participated in this pilot randomized control trial in which the intervention group received 4 weeks of exergaming sessions in addition to traditional therapy sessions. (3) Results: Nine subjects in the intervention and nine subjects in the control group completed the study. The intervention group had at least two extra sessions per week, with an average duration of 44 min per session and no serious adverse events (falls, dizziness, or pain). The efficacy measures showed statistically meaningful improvements in the activities of daily living measures (i.e., MAL-QOM (motor activity log-quality of movement) and both mobility and physical domains of the SIS (stroke impact scale) with mean difference of 1.0%, 5.5%, and 6.7% between the intervention and control group, respectively) at post-intervention. (4) Conclusion: Using virtual reality exergaming technology as an adjunct to traditional therapy is feasible and safe in post-stroke rehabilitation and may be beneficial to upper extremity functional recovery.

scholarly journals Turning unprofessional behaviors around using Holmes' reflection approach: a randomized controlled study

2020 ◽  
Author(s):  
Leila Naeimi ◽  
Fariba Asghari ◽  
Saharnaz Nedjat ◽  
Azim Mirzazadeh ◽  
Mahsa Abbaszadeh ◽  
...  
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
Clinical Settings ◽  
Professional Behaviors ◽  
Formal Curriculum ◽  
Long Term Follow Up ◽  
Students Attitudes ◽  
Professionalism Training

Many medical schools around the world have included professionalism training in their formal curriculum. However, these efforts may not be adequate; given the exposure of students to unprofessional behaviors in the clinical settings. In the present study, we aimed to design, implement, and evaluate a longitudinal program to improve professionalism among medical students upon their transition to clinical settings. A total of 75 medical students were enrolled in the study and randomly assigned to two groups. The control group did not receive any training, while for the intervention group; a 10-hour program through 16 weeks was organized based on the Holmes' reflection approach. The effectiveness of the program was evaluated by measuring three outcomes in both groups. Data analysis was performed using paired t-test and Multiple Linear Regression. Scores of judgment of professionalism increased in the intervention group (from 7.56 to 10.17; P< 0.001), while there was no significant improvement in the control group’s scores. Students' attitudes towards professionalism and their professional behaviors did not change significantly. Based on our findings, the Holmes reflection approach helps students improve their cognitive base of professionalism. Long-term follow-up and further qualitative studies will help us better understand the effects of this approach on other desirable outcomes.

scholarly journals Impact of virtual reality anatomy training on ultrasound competency development: A randomized controlled trial

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242731
Author(s):  
Kai-Chun Hu ◽  
Daniel Salcedo ◽  
Yi-No Kang ◽  
Che-Wei Lin ◽  
Chin-Wang Hsu ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Controlled Trial ◽  
Group Analysis ◽  
Intervention Group ◽  
Spatial Relationship ◽  
Control Group ◽  
Psychomotor Skills ◽  
Anatomical Structures ◽  
Image Identification ◽  
The Impact

Purpose The use of Virtual Reality (VR) in health professions education has increased dramatically in recent years, yet there is limited evidence of its impact on educational outcomes. The purpose of the study was to assess the impact of VR anatomy instruction on the ultrasound competency of novice learners participating in a ultrasonography workshop. Method We designed a VR-enhanced ultrasonography training program and utilized a plane transection tool to interact with a three-dimensional (3D) VR model of the human body which facilitated the 3D conceptualization of the spatial relationship of anatomical structures, leading to faster and better development of ultrasonographic competency. This was a randomized control study which enrolled third-year medical students (n = 101) without previous exposure to formal or informal ultrasonography training. The participants were randomly divided into an intervention and control group. We assessed participants’ competency through ultrasound performance stations on live subjects, we also measured anatomical and ultrasound image identification ability using multiple choice tests. Result Participants in the intervention group (median = 16; interquartile 13 to 19) had significantly higher scores in ultrasonography task performance tests than the control group (median = 10; interquartile 7 to 14; Mann-Whitney U = 595; P < 0.01). In sub-group analysis, the intervention group performed significantly better in the six out of ten ultrasound tasks. Participants in the intervention group also had greater improvement in ultrasonographic image identification MCQ tests than the control group (Mann-Whitney U = 914; P < 0.05). Conclusion This study suggests that VR-enhanced anatomical training could be of significant benefit in ultrasonography training by promoting a better understanding of the spatial relationships of anatomical structures and the development of early psychomotor skills transferable to the handling of ultrasonographic probes.

Effects of Virtual Reality on Pain During Venous Port Access in Pediatric Oncology Patients: A Randomized Controlled Study

2020 ◽  
pp. 104345422097570
Author(s):  
Remziye Semerci ◽  
Melahat Akgün Kostak ◽  
Tuba Eren ◽  
Gülcan Avci
Keyword(s):  
Virtual Reality ◽  
Pediatric Oncology ◽  
Intervention Group ◽  
Controlled Study ◽  
Homogeneous Distribution ◽  
Control Group ◽  
Oncology Patients ◽  
Proxy Reports ◽  
Venous Port ◽  
Port Access

Purpose: Needle procedures are one of the most distressing practices for pediatric oncology patients. Virtual reality (VR) is a distraction method which offers an extremely realistic and interactive virtual environment and helps reduce needle-related pain and distress. The aim of this study was to evaluate the effects of VR method on pain during venous port access in pediatric oncology patients aged 7 to 18 years. Method: Children who had cancer and were between the ages of 7 and 18 years and undergoing a port-a-cath access were randomly assigned through blocked randomization to either the VR intervention group or control group. A commercially available VR headset was fitted to children in the intervention group. Immediately after the port access, pain scores were obtained from children’s self-reports and parents’ proxy reports, using the Wong–Baker FACES Pain Rating Scale. Results: Descriptive characteristics of the children ( n = 71) showed a homogeneous distribution between groups. During the procedure, children in the control group ( n = 36; 5.03 ± 3.35) experienced more pain than the children in VR group ( n = 35; 2.34 ± 2.76; p < .001). Proxy reports of the parents in the experimental group (1.77 ± 2.46) were found to be lower than those in the control group (4.67 ± 2.56; p < .001). Conclusions/Implications for Practice: VR method is effective for reducing pain during venous port access in pediatric oncology patients. VR should be used as a distraction method during venous port access.

scholarly journals Effect of virtual reality simulation training on the response capability of public health emergency reserve nurses in China: a quasiexperimental study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048611
Author(s):  
Dandan Zhang ◽  
Hongwu Liao ◽  
Yitong Jia ◽  
Wenren Yang ◽  
Pingping He ◽  
...  
Keyword(s):  
Public Health ◽  
Virtual Reality ◽  
Disaster Preparedness ◽  
Simulation Training ◽  
Intervention Group ◽  
Technical Skills ◽  
Skills Training ◽  
Control Group ◽  
Virtual Reality Simulation ◽  
Response Capacity

ObjectiveTo develop a virtual reality simulation training programme, and further verify the effect of the programme on improving the response capacity of emergency reserve nurses confronting public health emergencies.DesignA prospective quasiexperimental design with a control group.ParticipantsA total of 120 nurses were recruited and randomly divided into the control group and the intervention group.InterventionParticipants underwent a 3-month training. The control group received the conventional training of emergency response (eg, theoretical lectures, technical skills and psychological training), while the intervention group underwent the virtual reality simulation training in combination with skills training. The COVID-19 cases were incorporated into the intervention group training, and the psychological training was identical to both groups. At the end of the training, each group conducted emergency drills twice. Before and after the intervention, the two groups were assessed for the knowledge and technical skills regarding responses to fulminate respiratory infectious diseases, as well as the capacity of emergency care. Furthermore, their pandemic preparedness was assessed with a disaster preparedness questionnaire.ResultsAfter the intervention, the scores of the relevant knowledge, the capacity of emergency care and disaster preparedness in the intervention group significantly increased (p<0.01). The score of technical skills in the control group increased more significantly than that of the intervention group (p<0.01). No significant difference was identified in the scores of postdisaster management in two groups (p>0.05).ConclusionThe virtual reality simulation training in combination with technical skills training can improve the response capacity of emergency reserve nurses as compared with the conventional training. The findings of the study provide some evidence for the emergency training of reserve nurses in better response to public health emergencies and suggest this methodology is worthy of further research and popularisation.

scholarly journals Virtual reality mobile application to improve videoscopic airway training: A randomised trial

2021 ◽  
Vol 50 (2) ◽  
pp. 141-148
Author(s):  
Ying Wei Yau ◽  
Zisheng Li ◽  
Mui Teng Chua ◽  
Win Sen Kuan ◽  
Gene Wai Han Chan
Keyword(s):  
Virtual Reality ◽  
Teaching Methods ◽  
Mobile Application ◽  
Intervention Group ◽  
Control Group ◽  
Traditional Teaching ◽  
Successful Intubation ◽  
Self Directed Learning ◽  
Traditional Teaching Methods ◽  
Directed Learning

Introduction: Flexible bronchoscopic intubation (FBI) is an important technique in managing an anticipated difficult airway, yet it is rarely performed and has a steep learning curve. We aim to evaluate if the integration of virtual reality gaming application into routine FBI training for emergency department doctors would be more effective than traditional teaching methods. Methods: We conducted a randomised controlled trial to compare self-directed learning using the mobile application, Airway Ex* in the intervention group versus the control group without use of the mobile application. All participants underwent conventional didactic teaching and low-fidelity simulation with trainer’s demonstration and hands-on practice on a manikin for FBI. Participants randomised to the intervention arm received an additional 30 minutes of self-directed learning using Airway Ex, preloaded on electronic devices while the control arm did not. The primary outcome was time taken to successful intubation. Results: Forty-five physicians (20 junior and 25 senior physicians) were enrolled, with male predominance (57.8%, 26/45). There was no difference in time taken to successful intubation (median 48 seconds [interquartile range, IQR 41–69] versus 44 seconds [IQR 37–60], P=0.23) between the control and intervention groups, respectively. However, the intervention group received better ratings (median 4 [IQR 4–5]) for the quality of scope manipulation skills compared to control (median 4 [IQR 3–4], adjusted P=0.03). This difference remains significant among junior physicians in stratified analysis. Conclusion: Incorporating virtual reality with traditional teaching methods allows learners to be trained on FBI safely without compromising patient care. Junior physicians appear to benefit more compared to senior physicians. Keywords: Airway management, emergency medicine, intubation, simulation education, virtual reality

scholarly journals Virtual Reality for Sedation During Atrial Fibrillation Ablation in Clinical Practice: Observational Study (Preprint)

2020 ◽  
Author(s):  
Thomas Roxburgh ◽  
Anthony Li ◽  
Charles Guenancia ◽  
Patrice Pernollet ◽  
Claire Bouleti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Virtual Reality ◽  
Visual Analog Scale ◽  
Conscious Sedation ◽  
Small Sample ◽  
Control Group ◽  
Analog Scale ◽  
Af Ablation ◽  
Transcatheter Aortic Valve ◽  
Valve Implantation

BACKGROUND Connected devices are dramatically changing many aspects in health care. One such device, the virtual reality (VR) headset, has recently been shown to improve analgesia in a small sample of patients undergoing transcatheter aortic valve implantation. OBJECTIVE We aimed to investigate the feasibility and effectiveness of VR in patients undergoing atrial fibrillation (AF) ablation under conscious sedation. METHODS All patients who underwent an AF ablation with VR from March to May 2020 were included. Patients were compared to a consecutive cohort of patients who underwent AF ablation in the 3 months prior to the study. Primary efficacy was assessed by using a visual analog scale, summarizing the overall pain experienced during the ablation. RESULTS The AF cryoablation procedure with VR was performed for 48 patients (mean age 63.0, SD 10.9 years; n=16, 33.3% females). No patient refused to use the device, although 14.6% (n=7) terminated the VR session prematurely. Preparation of the VR headset took on average 78 (SD 13) seconds. Compared to the control group, the mean perceived pain, assessed with the visual analog scale, was lower in the VR group (3.5 [SD 1.5] vs 4.3 [SD 1.6]; <i>P</i>=.004), and comfort was higher in the VR group (7.5 [SD 1.6] vs 6.8 [SD 1.7]; <i>P</i>=.03). On the other hand, morphine consumption was not different between the groups. Lastly, complications, as well as procedure and fluoroscopy duration, were not different between the two groups. CONCLUSIONS We found that VR was associated with a reduction in the perception of pain in patients undergoing AF ablation under conscious sedation. Our findings demonstrate that VR can be easily incorporated into the standard ablation workflow.

scholarly journals Virtual Reality as a Measure to Reduce Stress of Night-Shift Anesthesiologists: Study Protocol for a Cross-Over Design Trial

2020 ◽  
Author(s):  
Chaojin Chen ◽  
Liubing Chen ◽  
Ning Shen ◽  
Chenfang Luo ◽  
Ren Wang ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Group Intervention ◽  
Night Shift ◽  
Intervention Group ◽  
Working Environment ◽  
Control Group ◽  
Severe Deficiency ◽  
The Difference ◽  
Group Control Group ◽  
Night Shifts

Abstract Background: Because of the severe deficiency of global anesthesia workforce, anesthesiologists are forced to face work overload and more night shifts, which can disturbe the biological rhythm and cause major stress and depression, causing negative even devastating outcomes for both themselves and the patients eventually. Virtual reality (VR) as a new measure to reduce stress and pain for patients, has been widely used in biomedical fields.The purpose of the study is to evaluate the potential effectiveness of VR technology in reducing the stress of night-shift anesthesiologists.Methods: In this randomized controlled, cross-over design, single-center clinical trial, a total of 30 anesthesiologists are enrolled and randomized in a 1:1 allocation to either the VR immersion group (intervention group) or the routine night-shift group (control group) with a washout of 1 week. Anesthesiologists in the intervention group undergo VR immersion for twice while anesthesiologists in the control group will not watch VR videos during the night shift. The primary outcome is the difference between two groups about the score of NASA-TLX scale. Secondary outcomes include the score of CPSS, VAS and MFI-20 scales, satisfaction degree of the participants, heart rate (HR), blood pressure (BP), the incidence of arrhythmia as well as incidence of chest tightness, headache, palpitations.Discussion: It is unknown whether the use of VR technology during the night shift can reduce the stress of night-shift anesthesiologists. With the widely use of VR technology, a positive result of the trial could spur the hospital to apply the technology to reduce the stress of night shift doctors in every department as well as offer a relatively relaxed working environment.Trial registration: ChiCTR2000031025 on March 21, 2020.

scholarly journals Effect of a Virtual Reality-enhanced Exercise and Education Intervention on Patient Engagement and Learning in Cardiac Rehabilitation: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Victoria Vavala ◽  
Daniel Graves ◽  
Shannon Ames ◽  
Pavitra Krishnamani
Keyword(s):  
Virtual Reality ◽  
Cardiac Rehabilitation ◽  
Patient Adherence ◽  
Controlled Trial ◽  
Intervention Group ◽  
Standard Of Care ◽  
Final Visit ◽  
Control Group ◽  
Satisfaction With Treatment ◽  
And Control

BACKGROUND Cardiac rehabilitation is clinically proven to reduce morbidity and mortality, but many patients do not attend treatment. Those who do attend frequently do not finish their full course of treatment. This is greatly influenced by socioeconomic factors but is also due to patients’ lack of understanding on the importance of their care and a lack of motivation to maintain attendance. OBJECTIVE The goal of this study was to explore the potential benefits of virtual reality (VR) walking trails within cardiac rehabilitation treatment, specifically on patient education retention, satisfaction with treatment, and overall attendance of treatment sessions. METHODS New cardiac rehabilitation patients were enrolled and randomized on a rolling basis to either control or intervention groups. Intervention patients completed time on the treadmill with VR walking trails, including audio recorded education; control patients completed standard of care therapy. Both groups were assisted by nursing staff for all treatment sessions. Primary outcomes were determined by assessing six-minute-walk-test (6MWT) improvement. Additionally, secondary outcomes of patients’ cardiac knowledge and satisfaction were assessed via computer-based questionnaire; patient adherence to recommended number of sessions was also monitored. Cardiac knowledge assessment included a pre-rehabilitation education quiz, the same quiz repeated at their final visit, and again at a 2-month follow up. The satisfaction questionnaire was completed at their final visit. RESULTS Between January 2018 and May 2019, 72 patients were enrolled, 41 to the intervention group and 31 to the control group. Based upon the results of the pre- and post-rehabilitation 6MWT, no differences were seen between intervention and control groups (P = .23). No statistical differences were seen between groups on education (P = .50) or satisfaction (P = .30) at any time point. The control group had statistically more favorable rates of attendance, both by risk group (P = .024) and by completion of minimum sessions (P = .046), but no correlation was seen between study group and reason for ending treatment. CONCLUSIONS While no improvements were seen in the VR intervention group over the control group, it is worth noting that limitations in the study design may have influenced these outcomes, not the medium itself. Furthermore, qualitative information suggests that patients may have indeed enjoyed their experience with VR in a way that the quantitative data in this study may not have captured. Suggested within this paper are further considerations of how and when VR should be applied to cardiac rehabilitation. CLINICALTRIAL ClinicalTrials.gov NCT03945201

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