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Kokorelias KM, Chiu M, Paul S, Zhu L, Choudhury N, Craven CG, Dubrowski A, Redublo T, Kapralos B, Smith MSD, Shnall A, Sadavoy J, Burhan A. Use of Virtual Reality and Augmented Reality Technologies to Support Resilience and Skill-Building in Caregivers of Persons With Dementia: A Scoping Review. Cureus 2024; 16:e64082. [PMID: 39114214 PMCID: PMC11305335 DOI: 10.7759/cureus.64082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Dementia presents a growing public health challenge with most affected individuals living at home, placing significant responsibility on their caregivers. Various interventions, from traditional support groups and education programs to emerging technologies, and more specifically virtual reality (VR) and augmented reality (AR), aim to enhance caregiver skills. While VR/AR shows promise in educating and fostering empathy among caregivers and healthcare professionals, its overall effectiveness and practicality in older adults and dementia care warrant further exploration. This review aimed to summarize currently available VR and AR interventions tailored for family caregivers of persons living with dementia (PLWD) in home or clinical settings, including their level of effectiveness, and to compile a summary of features that contributed to technology acceptance in family caregivers of PLWD. We conducted a systematic search in OVID PsychInfo, CINAHL, Google Scholar, and ERIC, as well as CADTH's Grey Matters, OpenGrey, National Technical Information Service, OAIster, and Health Quality Ontario, to comprehensively summarize the existing evidence underscoring the role of VR and AR in supporting education, resilience-building, and skills training for family caregivers of PLWD. The search terms were built with the assistance of a research librarian and involved synonyms for VR, AR, and dementia. Two screeners conducted a rigorous screening and data extraction to analyze and summarize findings. Studies were included if they focused on family caregivers engaging in interventions utilizing a three-dimensional VR environment and/or Metaverse for group learning in psychotherapeutic modalities such as psychoeducation, therapy, communication, and skill-building. The primary outcome of the studies was assessing measures of well-being (e.g., quality of life, communication, interaction, personhood) and learning outcomes for caregivers, while the secondary outcomes focused on identifying barriers and facilitators influencing the acceptability of VR/AR among dementia caregivers. Content analysis and descriptive statistics were used to summarize key trends in technology and evidence effectiveness and acceptability. Of the 1,641 articles found, 112 were included, with six articles meeting inclusion for analysis. Studies differed in duration and frequency of data collection, with interventions varying from single events to months-long programs, often employing home-based approaches using VR or online platforms. No study used AR. Usability issues and unclear benefits of use were identified as factors that hinder technology acceptance for dementia caregivers. However, technologies demonstrated engaging user experiences, fostering skill-building, confidence, and competence among caregivers. Positive psychological effects were also observed, facilitated by immersive VR and AR interventions, resulting in improved caregiver empathy and reduced stress, depression, and loneliness. VR and AR interventions for family caregivers of PLWD show the potential to enhance empathy and skills and reduce stress. Challenges such as technological limitations and user inexperience issues persist. Home-based VR training aligns with caregiver comfort but lacks focus on financial aspects and cultural competencies. Co-design approaches offer solutions by addressing user concerns and promoting end-user engagement or empowerment.
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Affiliation(s)
- Kristina M Kokorelias
- Section of Geriatrics, Sinai Health and University Health Network, Toronto, CAN
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Mary Chiu
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, CAN
- Faculty of Health Sciences, Ontario Tech University, Oshawa, CAN
| | - Sayani Paul
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, CAN
| | - Lynn Zhu
- Research & Academics, Ontario Shores Centre for Mental Health Sciences, Whitby, CAN
| | - Nusrat Choudhury
- Medical Devices, National Research Council Canada, Boucherville, CAN
| | - Cole G Craven
- Computer Science, Ontario Tech University, Oshawa, CAN
| | - Adam Dubrowski
- Faculty of Health Sciences, Ontario Tech University, Oshawa, CAN
- maxSIMhealth Group, Ontario Tech University, Oshawa, CAN
| | - Tyler Redublo
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Bill Kapralos
- Software Informatics Research Centre, Ontario Tech University, Oshawa, CAN
- maxSIMhealth Group, Ontario Tech University, Oshawa, CAN
| | | | - Adriana Shnall
- The Koschitzky Centre for Innovations in Caregiving, Baycrest Centre, Toronto, CAN
- Factor Inwentash Faculty of Social Work, University of Toronto, Toronto, CAN
| | - Joel Sadavoy
- Department of Geriatric Psychiatry, Mount Sinai Hospital, Toronto, CAN
- Department of Psychiatry, Temerty Faculty of Medicine, Unviersity of Toronto, Toronto, CAN
| | - Amer Burhan
- Applied Mental Health, Ontario Shores Centre for Mental Health Sciences, Toronto, CAN
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, CAN
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Zhi S, Gao S, Sun J, Ma D, Zhao Y, He M, Zhu X, Dong Y, Aini B, Sun J. Virtual reality-based dementia educational programmes for formal and informal caregivers of people with dementia: A scoping review. J Clin Nurs 2024. [PMID: 38685766 DOI: 10.1111/jocn.17198] [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: 07/23/2023] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
AIM To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal caregivers. DESIGN A scoping review. METHODS A comprehensive search of nine databases was conducted to find studies from the inception of the databases to October 2023. Two authors independently screened the titles and abstracts related to the eligibility criteria. Full texts of potentially relevant studies were read by one author and checked by a second. Data extraction and synthesis using NVivo 12 were undertaken by one author and checked by two other authors. RESULTS Nineteen studies published between 2002 and 2022. The four randomised controlled studies and five qualitative studies were of moderate to good methodological quality. The 10 quasi-experimental studies were of weak to moderate quality. Fifteen virtual reality-based educational programmes had a positive influence on formal and informal caregivers, including improving caregivers' perceptions changing attitudes towards people with dementia, while the nursing competence of formal caregivers did not improve in short term. Educational programmes that covered dementia-related information and care strategies better improved the knowledge level of dementia formal and informal caregivers. CONCLUSIONS The qualitative and quantitative studies of moderate to good quality included in this study support the idea that virtual reality-based dementia educational programmes may be a safe and effective way and have potential benefits for improving knowledge, perceptions, attitudes and nursing competence. IMPACT This scoping review will provide an emerging teaching model for formal and informal caregivers of people with dementia and help them better understand the types and the influence of virtual reality-based dementia educational programmes. REPORTING METHOD PRISMA-ScR. NO PATIENT OR PUBLIC CONTRIBUTION Not required as this review in accordance with the aim to map existing literature from the dementia formal and informal caregivers' perspective.
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Affiliation(s)
- Shengze Zhi
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Shizheng Gao
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Juanjuan Sun
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Dongfei Ma
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Yanjie Zhao
- School of Nursing, Xinjiang Medical University, Xinjiang, People's Republic of China
| | - Meng He
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Xiangning Zhu
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Yueyang Dong
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Buheliqianmu Aini
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, People's Republic of China
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Stargatt J, Bhar S, Petrovich T, Bhowmik J, Sykes D, Burns K. The Effects of Virtual Reality-Based Education on Empathy and Understanding of the Physical Environment for Dementia Care Workers in Australia: A Controlled Study. J Alzheimers Dis 2021; 84:1247-1257. [PMID: 34633323 DOI: 10.3233/jad-210723] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is support for the effectiveness of virtual reality (VR) technology in dementia education. However, it is not yet known if VR is a useful tool for improving empathy and understanding of dementia care environments among dementia care workers. OBJECTIVE This study compared learning outcomes of VR versus non-VR (control) workshops for dementia care workers of different ages and English-speaking backgrounds. METHODS Dementia care workers enrolled in workshops on dementia care principles. Once participants were enrolled, workshops were assigned at random to deliver non-VR or VR-based education. Participants (N = 114, 91.8%female, mean age = 46.4; SD = 13.2; n = 60VR condition, 54control condition) completed self-report measures of empathy towards people living with dementia, understanding of dementia care environments, dementia knowledge, and attitudes towards dementia at pre- and post-workshop. RESULTS Significant pre-post main effects were observed for empathy, understanding of dementia care environments, and attitudes. Interaction effects were not found; improvements in outcomes were similar between conditions. However, interaction effects were observed for subgroups. Empathy improved significantly more in the VR condition for older participants. Understanding of dementia care environments improved more in the VR condition for younger and non-English-speaking background participants. CONCLUSION Using VR may not augment teaching outcomes for all learners. VR may differentially assist leaners of different ages and English-speaking backgrounds. More research is needed to understand for which variables and for whom VR is a useful teaching tool.
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Affiliation(s)
- Jennifer Stargatt
- Department of Psychological Sciences, Swinburne University of Technology, Victoria, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, Swinburne University of Technology, Victoria, Australia
| | | | - Jahar Bhowmik
- Department of Health Science and Biostatistics, Swinburne University of Technology, Victoria, Australia
| | - David Sykes
- Centre for Dementia Learning, Dementia Australia
| | - Kelly Burns
- Centre for Dementia Learning, Dementia Australia
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