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van Rijn MM, de Heer LM, Nieuwenhuis-Wendt J, van der Kaaij NP, Moolenaar EGE, van der Ham DH, van der Plank L, Westland H, Weldam SWM. Use of virtual reality in preoperative education of cardiac surgery patients - A feasibility study. PATIENT EDUCATION AND COUNSELING 2024; 129:108394. [PMID: 39168039 DOI: 10.1016/j.pec.2024.108394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/15/2024] [Accepted: 08/08/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE A Virtual Patient Tour (VPT) was developed to inform cardiac surgery patients about their hospitalization from the admission to their postoperative stay on the ward. The objective of our study was to assess the feasibility and acceptability of this VPT following the framework of the Virtual Reality Clinical Outcomes Research Experts Committee. METHODS In this single-centre cross-sectional study, adult patients admitted to the hospital for elective cardiac surgery were included. Acceptability, usability, and tolerability were measured by the validated questionnaires Unified Theory of Acceptance and Use of Technology (acceptability), System Usability Scale (usability), and Virtual Reality Sickness Questionnaire (tolerability). Descriptive statistics were used for the analysis. RESULTS Twenty-eight participants used the VPT. Results showed high acceptability (mean 16.7 ± 1.5), acceptable usability (mean 86.7 ± 9.3), and high tolerability (sickness score, median 7.1 % [0-17.1 %]). CONCLUSION The use of the VPT is a feasible and promising technique. The next step is to optimize the content and technique of the VPT based on the suggestions of the participants. PRACTICE IMPLICATIONS We recommend incorporating the VPT into preoperative patient education in addition to the routine information in cardiac surgery patients.
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Affiliation(s)
- Michelle M van Rijn
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Linda M de Heer
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Jenny Nieuwenhuis-Wendt
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Niels P van der Kaaij
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Eveline G E Moolenaar
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Daan Halle van der Ham
- Department Technology Enhanced Learning, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Lars van der Plank
- Department Technology Enhanced Learning, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Heleen Westland
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Saskia W M Weldam
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Lonati C, Wellhausen M, Pennig S, Röhrßen T, Kircelli F, Arendt S, Tschulena U. The Use of a Novel Virtual Reality Training Tool for Peritoneal Dialysis: Qualitative Assessment Among Health Care Professionals. JMIR MEDICAL EDUCATION 2024; 10:e46220. [PMID: 39106093 PMCID: PMC11336508 DOI: 10.2196/46220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Effective peritoneal dialysis (PD) training is essential for performing dialysis at home and reducing the risk of peritonitis and other PD-related infections. Virtual reality (VR) is an innovative learning tool that is able to combine theoretical information, interactivity, and behavioral instructions while offering a playful learning environment. To improve patient training for PD, Fresenius Medical Care launched the stay•safe MyTraining VR, a novel educational program based on the use of a VR headset and a handheld controller. OBJECTIVE This qualitative assessment aims to investigate opinions toward the new tool among the health care professionals (HCPs) who were responsible for implementing the VR application. METHODS We recruited nursing staff and nephrologists who have gained practical experience with the stay•safe MyTraining VR within pilot dialysis centers. Predetermined open-ended questions were administered during individual and group video interviews. RESULTS We interviewed 7 HCPs who have 2 to 20 years of experience in PD training. The number of patients trained with the stay•safe MyTraining VR ranged from 2 to 5 for each professional. The stay•safe MyTraining VR was well accepted and perceived as a valuable supplementary tool for PD training. From the respondents' perspective, the technology improved patients' learning experience by facilitating the internalization of both medical information and procedural skills. HCPs highlighted that the opportunity offered by VR to reiterate training activities in a positive and safe learning environment, according to each patient's needs, can facilitate error correction and implement a standardized training curriculum. However, VR had limited use in the final phase of the patient PD training program, where learners need to get familiar with the handling of the materials. Moreover, the traditional PD training was still considered essential to manage the emotional and motivational aspects and address any patient-specific application-oriented questions. In addition to its use within PD training, VR was perceived as a useful tool to support the decision-making process of patients and train other HCPs. Moreover, VR introduction was associated with increased efficiency and productivity of HCPs because it enabled them to perform other activities while the patient was practicing with the device. As for patients' acceptance of the new tool, interviewees reported positive feedback, including that of older adults. Limited use with patients experiencing dementia or severe visual impairment or lacking sensomotoric competence was mentioned. CONCLUSIONS The stay•safe MyTraining VR is suggested to improve training efficiency and efficacy and thus could have a positive impact in the PD training scenario. Our study offers a process proposal that can serve as a guide to the implementation of a VR-based PD training program within other dialysis centers. Dedicated research is needed to assess the operational benefits and the consequences on patient management.
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Affiliation(s)
- Caterina Lonati
- Center for Preclinical Research, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Drozdova A, Polokova K, Jiravsky O, Jiravska Godula B, Chovancik J, Ranic I, Jiravsky F, Hecko J, Sknouril L. Comparing Conventional Physician-Led Education with VR Education for Pacemaker Implantation: A Randomized Study. Healthcare (Basel) 2024; 12:976. [PMID: 38786387 PMCID: PMC11121498 DOI: 10.3390/healthcare12100976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/26/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Education of patients prior to an invasive procedure is pivotal for good cooperation and knowledge retention. Virtual reality (VR) is a fast-developing technology that helps educate both medical professionals and patients. OBJECTIVE To prove non-inferiority of VR education compared to conventional education in patients prior to the implantation of a permanent pacemaker (PPM). METHODS 150 participants scheduled for an elective implantation of a PPM were enrolled in this prospective study and randomized into two groups: the VR group (n = 75) watched a 360° video about the procedure using the VR headset Oculus Meta Quest 2, while the conventional group (n = 75) was educated by a physician. Both groups filled out a questionnaire to assess the quality of education pre- and in-hospital, their knowledge of the procedure, and their subjective satisfaction. RESULTS There was no significant difference in the quality of education. There was a non-significant trend towards higher educational scores in the VR group. The subgroup with worse scores was older than the groups with higher scores (82 vs. 76 years, p = 0.025). Anxiety was reduced in 92% of participants. CONCLUSION VR proved to be non-inferior to conventional education. It helped to reduce anxiety and showed no adverse effects.
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Affiliation(s)
- Adela Drozdova
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
| | - Karin Polokova
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
| | - Otakar Jiravsky
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Medicine, Masaryk University, 601 77 Brno, Czech Republic
| | - Bogna Jiravska Godula
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Medicine, Palacky University, 779 00 Olomouc, Czech Republic
| | - Jan Chovancik
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
| | - Ivan Ranic
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Medicine, University of Ostrava, 701 03 Ostrava, Czech Republic
| | - Filip Jiravsky
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Philosophical Faculty, Masaryk University, 601 77 Brno, Czech Republic
| | - Jan Hecko
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
- Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 708 00 Ostrava, Czech Republic
| | - Libor Sknouril
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic
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Finch E, Coleman A, Cameron A, Moro C. Utilising interactive technology for stroke patient education: a systematic review. Disabil Rehabil Assist Technol 2024; 19:1236-1248. [PMID: 36622858 DOI: 10.1080/17483107.2022.2161649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 10/26/2022] [Accepted: 12/16/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE As a leading cause of death and disability worldwide, how to effectively manage and prevent stroke is a key consideration for health care systems. Throughout the world stroke management recommendations include education; however, not all patients receive this intervention. Advances in technology have provided health professionals with a range of innovative, effective, and modern tools that may be useful in delivering stroke education. This study aimed to systematically review the current evidence for the use of interactive technology in stroke patient education, and whether this was effective for increasing patients' stroke knowledge and behaviours that lower stroke risk. METHODS AND MATERIALS The protocol was registered with PROSPERO (#225223) and a literature search undertaken in Embase (including MEDLINE and PubMed), PsycInfo and CINAHL from inception until August 2022. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the included articles. RESULTS From an initial yield of 760 articles, 10 articles met the study inclusion criteria. The articles explored a range of interactive technologies, with none of them includes articles using the same technology. All of the articles reported at least one positive effect from the technology. Two articles reported on stroke incidence post-intervention. The methodological quality of the articles varied, but was largely medium to high. CONCLUSION The paucity of evidence highlights a need for future studies to provide insights into the benefits of quality interactive technology-based stroke education and to identify options for optimal delivery modes in stroke education.
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Affiliation(s)
- Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Adele Coleman
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Ashley Cameron
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Clinical Support Services, Metro South Health, Brisbane, Australia
| | - Christian Moro
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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Colback AA, Velazquez-Castro O, Agarrado M, Reddy R, Strong EB, Wilson M, Strong EB. Evaluating Mixed Reality as a Tool for Patient Education of Facial Fractures. Facial Plast Surg Aesthet Med 2024. [PMID: 38530099 DOI: 10.1089/fpsam.2023.0302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Background: Patients may be educated about facial fractures using two-dimensional computed tomography (2DCT); however, three-dimensional mixed reality (3DMR) goggles may improve patient education by delivering content in an immersive environment. Objective: To compare the effectiveness of 2DCT and 3DMR formats used for patient education on facial fractures, as measured by surveys. Methods: In this prospective, randomized, crossover study, video tutorials intended for facial fracture informed consent were created in 2DCT and 3DMR formats from a single CT data set of a zygomaticomaxillary complex (ZMC) fracture. Subjects were randomly assigned into two groups. Group 1 (n = 25) viewed the 2DCT tutorial, answered self-assessment and information recall surveys, viewed the 3DMR tutorial, repeated the prior surveys as well as a comparison survey. Group 2 (n = 25) followed the same sequence but viewed the 3DMR tutorial and then the 2DCT tutorial. Results: Participants (n = 50) had no differences in age (group 1-51.9 years/standard deviation [SD] 20.9; group 2-44.7 years/SD 17.6 years; p = 0.223), gender (group 1-10 male/15 female; group 2-11 male/14 female; p = 0.999), college education level (group 1-25 yes; group 2-25 yes; p = 0.844), or prior 2DCT or 3DMR experience (group 1-9 yes/16 no; group 2-13 yes/12 no; p = 0.393). The 3DMR format was preferred over 2DCT (p < 0.05), and it was reported to enhance understanding as compared to 2DCT (p < 0.05). No differences for information recall were noted (p = 0.753). Conclusion: In this study, participants preferred 3DMR goggles over 2DCT for a simulated ZMC fracture-informed consent.
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Affiliation(s)
- Angela A Colback
- University of California, Davis-School of Medicine, Sacramento, California, USA
| | | | - Michael Agarrado
- University of California, Davis-School of Medicine, Sacramento, California, USA
| | - Renuka Reddy
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
| | - E Brandon Strong
- Department of BioEngineering, University of California, Berkeley, Berkeley, California, USA
| | - Machelle Wilson
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - E Bradley Strong
- Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA
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Yadav S. Transformative Frontiers: A Comprehensive Review of Emerging Technologies in Modern Healthcare. Cureus 2024; 16:e56538. [PMID: 38646390 PMCID: PMC11027446 DOI: 10.7759/cureus.56538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
The rapid evolution of emerging technologies in healthcare is reshaping the field of medical practices and patient outcomes, ushering in an era of unprecedented innovation. This narrative review touches upon the transformative impacts of various technologies, including virtual reality (VR), augmented reality (AR), the internet of medical things (IoMT), remote patient monitoring (RPM), financial technology (fintech) integration, cloud migration, and the pivotal role of machine learning (ML). It emphasizes the collaborative impact of these technologies, which is reshaping the healthcare landscape. Virtual reality and AR revolutionize medical training, IoMT extends healthcare boundaries, RPM facilitates proactive care, and fintech integration enhances financial processes. Cloud migration ensures scalable and efficient data management, while ML harnesses algorithms for diagnostic precision and personalized treatment.
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Affiliation(s)
- Sankalp Yadav
- Medicine, Shri Madan Lal Khurana Chest Clinic, New Delhi, IND
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Wang LJ, Casto B, Reyes-Molyneux N, Chance WW, Wang SJ. Smartphone-based augmented reality patient education in radiation oncology. Tech Innov Patient Support Radiat Oncol 2024; 29:100229. [PMID: 38293267 PMCID: PMC10825366 DOI: 10.1016/j.tipsro.2023.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 02/01/2024] Open
Abstract
We built an augmented reality (AR) patient education application for portable iOS and Android devices that allows patients to view a virtual simulation of themselves receiving radiation treatment. We created software that reads data from the clinical treatment planning system and renders the patient's actual radiotherapy plan in AR on a tablet or smartphone. The patient's CT simulation data are converted into a 3D translucent virtual human shown being treated with visible radiation beams from a virtual linear accelerator. We conducted a patient study to determine if showing patients this AR simulation improves patient understanding of radiotherapy and/or reduces anxiety about treatment. A total of 75 patients completed this study. The most common plans were 3D breast tangents and intensity modulated radiotherapy lung plans. Patients were administered questionnaires both before and after their AR viewing experience. After their AR viewing, 95% of patients indicated that they had a better understanding of how radiotherapy will be used to treat their cancer. Of the 35 patients who expressed anxiety about radiotherapy beforehand, 21 (60%) indicated that they had decreased anxiety after the AR session. In our single-arm prospective patient study, we found that this simplified low-cost tablet-based personalized AR simulation can be a helpful educational tool for cancer patients undergoing radiotherapy.
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Affiliation(s)
- Liam J. Wang
- Johns Hopkins University, Baltimore, MD 21218, United States
| | - Brian Casto
- Department of Radiation Oncology, Salem Health, 895 Oak St SE, Salem, OR 97301, United States
| | - Nancy Reyes-Molyneux
- Department of Radiation Oncology, Salem Health, 895 Oak St SE, Salem, OR 97301, United States
| | - William W. Chance
- Department of Radiation Oncology, Salem Health, 895 Oak St SE, Salem, OR 97301, United States
| | - Samuel J. Wang
- Department of Radiation Oncology, Salem Health, 895 Oak St SE, Salem, OR 97301, United States
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Jiravska Godula B, Jiravsky O, Matheislova G, Kuriskova V, Valkova A, Puskasova K, Dokoupil M, Dvorakova V, Prifti A, Foral D, Jiravsky F, Hecko J, Hudec M, Neuwirth R, Miklik R. Virtual Reality for Patient Education about Hypertension: A Randomized Pilot Study. J Cardiovasc Dev Dis 2023; 10:481. [PMID: 38132649 PMCID: PMC10744175 DOI: 10.3390/jcdd10120481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Hypertension challenges arise in part from poor adherence due to inadequate patient education. VR offers immersive learning to improve hypertension knowledge. OBJECTIVE To compare VR education with traditional verbal education to improve hypertension knowledge. METHODS In this randomised trial, 182 patients with hypertension were assigned to receive either traditional physician-led education (n = 88) or VR education (n = 94) with equivalent content. The VR group experienced a 3D video using Oculus Quest 2 headsets. Knowledge was assessed post-intervention using a 29-item questionnaire. The primary outcome was the objective score. Subjective satisfaction and responder characteristics were secondary outcomes. RESULTS Median objective scores were significantly higher for VR (14, IQR 3) versus traditional education (10, IQR 5), p < 0.001, indicating superior hypertension knowledge acquisition with VR. Subjective satisfaction was high in both groups. Participants were categorized into low (first quartile) and medium-high (second to fourth quartiles) responders based on their scores. Low responders had a significantly higher prevalence of older women than medium-high responders (57% vs. 40% female, p = 0.024; 68 vs. 65 years), p = 0.036). CONCLUSIONS VR outperforms traditional education. Tailoring to groups such as older women can optimise learning.
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Affiliation(s)
- Bogna Jiravska Godula
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic (J.H.)
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
- Faculty of Medicine, Palacky University, 779 00 Olomouc, Czech Republic
| | - Otakar Jiravsky
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic (J.H.)
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Gabriela Matheislova
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
| | - Veronika Kuriskova
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
- Agel Hospital Ostrava Vitkovice, 703 00 Ostrava-Vítkovice, Czech Republic
| | - Alena Valkova
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
| | - Kristina Puskasova
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
| | - Martin Dokoupil
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
| | - Veronika Dvorakova
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
| | - Arber Prifti
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
- Agel Hospital Ostrava Vitkovice, 703 00 Ostrava-Vítkovice, Czech Republic
| | - Daniel Foral
- Poliklinika Agel Ostrava, Dopravni Zdravotnictvi, 728 06 Moravian Ostrava, Czech Republic
- Agel Hospital Ostrava Vitkovice, 703 00 Ostrava-Vítkovice, Czech Republic
| | - Filip Jiravsky
- Philosophical Faculty, Masaryk University, 602 00 Brno, Czech Republic
| | - Jan Hecko
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic (J.H.)
- Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 708 33 Ostrava, Czech Republic
| | - Miroslav Hudec
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic (J.H.)
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Radek Neuwirth
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic (J.H.)
- Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Roman Miklik
- Department of Cardiology, Agel Hospital Trinec-Podlesi, 739 61 Trinec, Czech Republic (J.H.)
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Skórka P, Kargul M, Seemannová D, Gajek B, Gutowski P, Kazimierczak A, Rynio P. The Influence of Individualized Three-Dimensional Holographic Models on Patients' Knowledge Qualified for Intervention in the Treatment of Peripheral Arterial Disease (PAD). J Cardiovasc Dev Dis 2023; 10:464. [PMID: 37998522 PMCID: PMC10671973 DOI: 10.3390/jcdd10110464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/27/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
We sought to determine the role of the patient-specific, three-dimensional (3D) holographic vascular model in patient medical knowledge and its influence on obtaining a more conscious informed consent process for percutaneous balloon angioplasty (PTA). Patients with peripheral arterial disease who had been scheduled for PTA were enrolled in the study. Information regarding the primary disease, planned procedure, and informed consent was recorded in typical fashion. Subsequently, the disease and procedure details were presented to the patient, showing the patients their individual model. A patient and medical supervisor equipped with mixed reality headsets could both simultaneously manipulate the hologram using gestures. The holographic 3D model had been created on a scale of 1:1 based on computed tomography scans. The patient's knowledge was tested by the completion of a questionnaire before and after the interaction in a mixed reality environment. Seventy-nine patients manipulated arterial holograms in mixed reality head-mounted devices. Before the 3D holographic artery model interaction, the mean ± standard deviation score of the knowledge test was 2.95 ± 1.21 points. After the presentation, the score had increased to 4.39 ± 0.82, with a statistically significant difference (p = 0.0000) between the two scores. Using a Likert scale from 1 to 5, the patients had scored the use of the 3D holographic model at 3.90 points regarding its usefulness in comprehending their medical condition; at 4.04 points regarding the evaluation of the holograms as helpful in understanding the course of surgery; and rated the model at 1.99 points in reducing procedure-related stress. Using a nominal scale (know or don't know), the patients had self-assessed their knowledge of the procedure before and after the 3D model presentation, with a score of 6.29 ± 2.01 and 8.39 ± 1.54, respectively. The study group tolerated the use of head-mounted devices. Only one patient had nausea and dizziness, while four patients experienced transient eye pain. The 3D holographic arterial model aided in the understanding of patients' knowledge regarding the disease and procedure, making the informed consent process more conscious. The holograms improved the patient's self-consciousness. Mixed reality headset-related complications were rare and within acceptable rates.
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Affiliation(s)
| | | | | | | | | | | | - Paweł Rynio
- Department of Vascular Surgery and Angiology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.S.)
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Rizzo MG, Costello JP, Luxenburg D, Cohen JL, Alberti N, Kaplan LD. Augmented Reality for Perioperative Anxiety in Patients Undergoing Surgery: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2329310. [PMID: 37589975 PMCID: PMC10436133 DOI: 10.1001/jamanetworkopen.2023.29310] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
Importance Both augmented reality (AR) and virtual reality (VR) have had increasing applications in medicine, including medical training, psychology, physical medicine, rehabilitation, and surgical specialties, such as neurosurgery and orthopedic surgery. There are little data on AR's effect on patients' anxiety and experiences. Objective To determine whether the use of an AR walkthrough effects patient perioperative anxiety. Design, Setting, and Participants This randomized clinical trial was conducted at an outpatient surgery center in 2021 to 2022. All patients undergoing elective orthopedic surgery with the senior author were randomized to the treatment or control group. Analyses were conducted per protocol. Data analysis was performed in November 2022. Intervention AR experience explaining to patients what to expect on their day of surgery and walking them through the surgery space. The control group received the standard educational packet. Main Outcomes and Measures The main outcome was change in State-Trait Anxiety Inventory (STAI) from the screening survey to the preoperative survey. Results A total of 140 patients were eligible, and 45 patients either declined or were excluded. Therefore, 95 patients (63 [66.3%] male; mean [SD] age, 38 [16] years) were recruited for the study and included in the final analysis; 46 patients received the AR intervention, and 49 patients received standard instructions. The AR group experienced a decrease in anxiety from the screening to preoperative survey (mean score change, -2.4 [95% CI, -4.6 to -0.3]), while the standard care group experienced an increase (mean score change, 2.6 [95% CI, 0.2 to 4.9]; P = .01). All patients postoperatively experienced a mean decrease in anxiety score compared with both the screening survey (mean change: AR, -5.4 [95% CI, -7.9 to -2.9]; standard care, -6.9 [95% CI, -11.5 to -2.2]; P = .32) and preoperative survey (mean change: AR, -8.0 [95% CI, -10.3 to -5.7]; standard care, -4.2 [95% CI, -8.6 to 0.2]; P = .19). Of 42 patients in the AR group who completed the postoperative follow-up survey, 30 (71.4%) agreed or strongly agreed that they enjoyed the experience, 29 (69.0%) agreed or strongly agreed that they would recommend the experience, and 28 (66.7%) agreed or strongly agreed that they would use the experience again. No differences were observed in postoperative pain levels or narcotic use. Conclusions and Relevance In this randomized clinical trial, the use of AR decreased preoperative anxiety compared with traditional perioperative education and handouts, but there was no significant effect on postoperative anxiety, pain levels, or narcotic use. These findings suggest that AR may serve as an effective means of decreasing preoperative patient anxiety. Trial Registration ClinicalTrials.gov Identifier: NCT04727697.
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Affiliation(s)
- Michael G. Rizzo
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
| | | | - Dylan Luxenburg
- Miller School of Medicine, University of Miami, Miami, Florida
| | - Jacob L. Cohen
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
| | - Nicolas Alberti
- Center for Computational Science, University of Miami, Miami, Florida
| | - Lee D. Kaplan
- UHealth Sports Medicine Institute, Department of Orthopaedics, University of Miami, Miami, Florida
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11
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Hatzl J, Hartmann N, Böckler D, Henning D, Peters A, Meisenbacher K, Uhl C. "Mixed Reality" in patient education prior to abdominal aortic aneurysm repair. VASA 2023; 52:160-168. [PMID: 36891667 DOI: 10.1024/0301-1526/a001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Background: To investigate the usability of Mixed-Reality (MR) during patient education in patients scheduled for abdominal aortic aneurysm (AAA) repair. Patients and methods: Consecutive patients scheduled for elective AAA repair were block-randomized in either the Mixed-Reality group (MR group) or the conventional group (control group). Patients of both groups were educated about open and endovascular repair of their respective AAA. The MR group was educated using a head-mounted display (HMD) demonstrating a three-dimensional virtual reconstruction of the respective patient's vascular anatomy. The control group was educated using a conventional two-dimensional monitor to display the patient's vasculature. Outcomes were informational gain as well as patient satisfaction with the educational process. (DRKS-ID: DRKS00025174). Results: 50 patients were included with 25 patients in either group. Both groups demonstrated improvements in scores in the Informational Gain Questionnaire (IGQ) when comparing pre- and post-education scores. (MR group: 6.5 points (±1.8) versus 7.9 points (±1.5); Control group: 6.2 points (±1.8) versus 7.6 points (±1.6); p<0.01) There was no significant difference between the MR group and the control group either in informational gain (MR group: 1.4±1.8; Control group: 1.4±1.8; p=0.5) nor in patient satisfaction scores (MR group: mean 18.3 of maximum 21 points (±3.7); Control group: mean 17 of 21 points (±3.6); p=0.1) Multiple regression revealed no correlation between the use of MR and informational gain or patient satisfaction. Usability of the system was rated high, and patients' subjective assessment of MR was positive. Conclusions: The use of MR in patient education of AAA patients scheduled for elective repair is feasible. While patients reported positively on the use of MR in education, similar levels of informational gain and patient satisfaction can be achieved with MR and conventional methods.
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Affiliation(s)
- Johannes Hatzl
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Niklas Hartmann
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Dittmar Böckler
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Daniel Henning
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Andreas Peters
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Katrin Meisenbacher
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
| | - Christian Uhl
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Germany
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12
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Foronda C, Lee J, Santiesteban Z. Use of Virtual Reality in Family Caregiver Education: A Literature Review. Comput Inform Nurs 2023; 41:125-127. [PMID: 36867464 DOI: 10.1097/cin.0000000000001004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- Cynthia Foronda
- Author Affiliations: School of Nursing and Health Studies, University of Miami, Coral Gables, Florida
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13
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Grilo AM, Almeida B, Rodrigues C, Isabel Gomes A, Caetano M. Using virtual reality to prepare patients for radiotherapy: A systematic review of interventional studies with educational sessions. Tech Innov Patient Support Radiat Oncol 2023; 25:100203. [PMID: 36873800 PMCID: PMC9982317 DOI: 10.1016/j.tipsro.2023.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/06/2023] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose To understand the impact of radiotherapy educational sessions with virtual reality on oncologic adult patients' psychological and cognitive outcomes related to the treatment experience. Methods This review was performed according to the Preferred Reporting Items for Systematic Reviews guidelines. A systematic electronic search in three databases, MEDLINE, Scopus, and Web of Science, was conducted in December 2021 to find interventional studies with adult patients undergoing external radiotherapy who received an educational session with virtual reality before or during the treatment. The studies that provided qualitative or quantitative information about the impact of educational sessions on patients' psychological and cognitive dimensions related to RT experience were retained for analysis. Results Of the 25 records found, eight articles about seven studies were analysed that involved 376 patients with different oncological pathologies. Most studies evaluated knowledge and treatment-related anxiety, mainly through self-reported questionnaires. The analysis showed a significant improvement in patients' knowledge and comprehension of radiotherapy treatment. Anxiety levels also decreased with virtual reality educational sessions and throughout the treatment in almost all the studies, although with less homogeneous results. Conclusion Virtual reality methods in standard educational sessions can enhance cancer patients' preparation for radiation therapy by increasing their understanding of treatment and reducing anxiety.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC − Health & Technology Research Center, ESTeSL − Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Corresponding author.
| | - Bárbara Almeida
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Carolina Rodrigues
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Ana Isabel Gomes
- CICPSI − Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Marco Caetano
- ESTeSL − ESTeSL – Escola Superior de Tecnologia da Saúde de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
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14
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Grab M, Hundertmark F, Thierfelder N, Fairchild M, Mela P, Hagl C, Grefen L. New perspectives in patient education for cardiac surgery using 3D-printing and virtual reality. Front Cardiovasc Med 2023; 10:1092007. [PMID: 36937915 PMCID: PMC10020687 DOI: 10.3389/fcvm.2023.1092007] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Background Preoperative anxiety in cardiac surgery can lead to prolonged hospital stays and negative postoperative outcomes. An improved patient education using 3D models may reduce preoperative anxiety and risks associated with it. Methods Patient education was performed with standardized paper-based methods (n = 34), 3D-printed models (n = 34) or virtual reality models (n = 31). Anxiety and procedural understanding were evaluated using questionnaires prior to and after the patient education. Additionally, time spent for the education and overall quality were evaluated among further basic characteristics (age, gender, medical expertise, previous non-cardiac surgery and previously informed patients). Included surgeries were coronary artery bypass graft, surgical aortic valve replacement and thoracic aortic aneurysm surgery. Results A significant reduction in anxiety measured by Visual Analog Scale was achieved after patient education with virtual reality models (5.00 to 4.32, Δ-0.68, p < 0.001). Procedural knowledge significantly increased for every group after the patient education while the visualization and satisfaction were best rated for patient education with virtual reality. Patients rated the quality of the patient education using both visualization methods individually [3D and virtual reality (VR) models] higher compared to the control group of conventional paper-sheets (control paper-sheets: 86.32 ± 11.89%, 3D: 94.12 ± 9.25%, p < 0.0095, VR: 92.90 ± 11.01%, p < 0.0412). Conclusion Routine patient education with additional 3D models can significantly improve the patients' satisfaction and reduce subjective preoperative anxiety effectively.
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Affiliation(s)
- Maximilian Grab
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
- Correspondence: Maximilian Grab
| | - Fabian Hundertmark
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | - Nikolaus Thierfelder
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | | | - Petra Mela
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
| | - Linda Grefen
- Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany
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15
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Enders C, Duncker T, Schürks M, Scholz P, Dörner J, Müller C, Wachtlin J, Lommatzsch A. See clearer: survey on the subjective and objective information levels as well as perception and information transfer using virtual reality headsets in patients with diabetic macular edema receiving anti-VEGF treatment. Graefes Arch Clin Exp Ophthalmol 2022; 261:1563-1570. [PMID: 36562802 DOI: 10.1007/s00417-022-05942-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/23/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The purpose of this study is to investigate the use of a VR Headset in routine clinical practice as an additional source of information for patients with diabetic macular edema (DME) and their companions. METHODS Survey including 121 patients with DME, 22 companions, and 14 healthcare professionals from 8 ophthalmology centers in Germany. Patients' and their companions' health literacy was assessed by questionnaires including knowledge statements before and after watching a VR-based 3-D educational video. HCPs' perspectives on the usability of a VR Headset were also assessed. RESULTS Patients' mean age was 63.4 ± 12.2 years, 64.5% were men, and 76% (92/121) had previous anti-VEGF (VEGF, vascular endothelial growth factor) injections. After using the VR Headset, over 85% of patients and companions felt better informed about DME and its treatment. Patients' mean (± SD) number of correct answers to knowledge statements increased from 13.2 ± 3.7 before to 15.5 ± 2.3 after using the VR Headset. Over 95% of patients and companions rated content and ease of understanding of the video as "very good" or "good." Most patients and all companions considered the use of a VR Headset as a positive experience, most wishing to obtain information via VR Headset in the future. Most physicians and all medical assistants rated the effect of the VR Headset on patient satisfaction as positive and suggested further VR modules. CONCLUSION After using the VR Headset, patients with DME and their companions demonstrated knowledge gains that may be meaningful individually and contribute to better adherence. This may offer an additional opportunity for knowledge transfer.
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Affiliation(s)
| | | | | | | | | | | | - Joachim Wachtlin
- Sankt Gertrauden Hospital, Berlin, Germany
- Medizinische Hochschule Brandenburg, Neuruppin, Germany
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16
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Kok DL, Dushyanthen S, Peters G, Sapkaroski D, Barrett M, Sim J, Eriksen JG. Virtual reality and augmented reality in radiation oncology education - A review and expert commentary. Tech Innov Patient Support Radiat Oncol 2022; 24:25-31. [PMID: 36164438 PMCID: PMC9508152 DOI: 10.1016/j.tipsro.2022.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 12/20/2022] Open
Abstract
The field of radiation oncology is rapidly advancing through technological and biomedical innovation backed by robust research evidence. However, cancer professionals are notoriously time-poor, meaning there is a need for high quality, accessible and tailored oncologic education programs. While traditional teaching methods including lectures and other in-person delivery formats remain important, digital learning (DL) has provided additional teaching options that can be delivered flexibly and on-demand from anywhere in the world. While evidence of this digital migration has been evident for some time now, it has not always been met with the same enthusiasm by the teaching community, in part due to questions about its pedagogical effectiveness. Many of these reservations have been driven by a rudimentary utilisation of the medium and inexperience with digital best-practice. With increasing familiarity and understanding of the medium, increasingly sophisticated and pedagogically-driven learning solutions can be produced. This article will review the application of immersive digital learning tools in radiation oncology education. This includes first and second-generation Virtual Reality (VR) environments and Augmented Reality (AR). It will explore the data behind, and best-practice application of, each of these tools as well as giving practical tips for educators who are looking to implement (or refine) their use of these learning methods. It includes a discussion of how to match the digital learning methods to the content being taught and ends with a horizon scan of where the digital medium may take us in the future. This article is the second in a two-part series, with the companion piece being on Screen-Based Digital Learning Methods in Radiation Oncology. Overall, the digital space is well-placed to cater to the evolving educational needs of oncology learners. Further uptake over the next decade is likely to be driven by the desire for flexible on demand delivery, high-yield products, engaging delivery methods and programs that are tailored to individual learning needs. Educational programs that embrace these principles will have unique opportunities to thrive in this space.
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Affiliation(s)
- David L. Kok
- Peter MacCallum Cancer Centre - Moorabbin Campus, 865 Centre Rd, Bentleigh East Victoria 3165, Australia
- Department of Clinical Pathology, University of Melbourne, Parkville Victoria 3010, Australia
| | - Sathana Dushyanthen
- Department of Clinical Pathology, University of Melbourne, Parkville Victoria 3010, Australia
- Centre for Digital Transformation of Health, University of Melbourne, 700 Swanston St, Carlton, Victoria 3053, Australia
| | - Gabrielle Peters
- Department of Therapeutic Radiology, Yale University, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, United States
| | - Daniel Sapkaroski
- Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne Victoria 3000, Australia
| | - Michelle Barrett
- Victorian Comprehensive Cancer Centre, 305 Grattan St, Melbourne Victoria 3000, Australia
| | - Jenny Sim
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Rd, Clayton Victoria 3800, Australia
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus Municipality, Denmark
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17
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Iop A, El-Hajj VG, Gharios M, de Giorgio A, Monetti FM, Edström E, Elmi-Terander A, Romero M. Extended Reality in Neurosurgical Education: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:6067. [PMID: 36015828 PMCID: PMC9414210 DOI: 10.3390/s22166067] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/06/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Surgical simulation practices have witnessed a rapid expansion as an invaluable approach to resident training in recent years. One emerging way of implementing simulation is the adoption of extended reality (XR) technologies, which enable trainees to hone their skills by allowing interaction with virtual 3D objects placed in either real-world imagery or virtual environments. The goal of the present systematic review is to survey and broach the topic of XR in neurosurgery, with a focus on education. Five databases were investigated, leading to the inclusion of 31 studies after a thorough reviewing process. Focusing on user performance (UP) and user experience (UX), the body of evidence provided by these 31 studies showed that this technology has, in fact, the potential of enhancing neurosurgical education through the use of a wide array of both objective and subjective metrics. Recent research on the topic has so far produced solid results, particularly showing improvements in young residents, compared to other groups and over time. In conclusion, this review not only aids to a better understanding of the use of XR in neurosurgical education, but also highlights the areas where further research is entailed while also providing valuable insight into future applications.
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Affiliation(s)
- Alessandro Iop
- Department of Neurosurgery, Karolinska University Hospital, 141 86 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- KTH Royal Institute of Technology, 114 28 Stockholm, Sweden
| | - Victor Gabriel El-Hajj
- Department of Neurosurgery, Karolinska University Hospital, 141 86 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Maria Gharios
- Department of Neurosurgery, Karolinska University Hospital, 141 86 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Andrea de Giorgio
- SnT—Interdisciplinary Center for Security, Reliability and Trust, University of Luxembourg, 4365 Esch-sur-Alzette, Luxembourg
| | | | - Erik Edström
- Department of Neurosurgery, Karolinska University Hospital, 141 86 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Adrian Elmi-Terander
- Department of Neurosurgery, Karolinska University Hospital, 141 86 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Mario Romero
- KTH Royal Institute of Technology, 114 28 Stockholm, Sweden
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