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Sánchez-López MI, Lluesma-Vidal M, Ruiz-Zaldibar C, Tomás-Saura I, Martínez-Fleta MI, Gutiérrez-Alonso G, García-Garcés L. The effect of virtual reality versus standard-of-care treatment on pain perception during paediatric vaccination: A randomised controlled trial. J Clin Nurs 2024. [PMID: 38873883 DOI: 10.1111/jocn.17287] [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: 12/20/2023] [Revised: 03/27/2024] [Accepted: 05/14/2024] [Indexed: 06/15/2024]
Abstract
AIMS AND OBJECTIVES To determine the effect of immersive virtual reality (VR) on perceived pain and fear in children during vaccination and parental satisfaction with the procedure. BACKGROUND Virtual reality can reduce the perception of pain by children but only three studies have analysed its use during vaccination to date; these had small sample sizes and imperfect methodological designs. DESIGN A randomised controlled clinical trial. METHODS One hundred and sixty participants from the Tres Forques Health Center were randomly assigned to the intervention group (IG) (n = 82) in which distraction with immersive VR was used during the vaccination, while standard distraction techniques were used for the control group (n = 80). The primary outcome was pain (Wong-Baker FACES). Secondary outcomes included (Children's Fear Scale) and parental satisfaction with the vaccination procedure. Chi-squared tests were used for qualitative variables, relationships between quantitative variables were tested with Spearman correlations, and Mann-Whitney U- or Student t-tests were employed to assess the relationship between quantitative and qualitative variables. RESULTS Compared to the controls, the children in the IG reported significantly less pain and fear, while parental satisfaction was significantly higher. Reported pain and fear did not differ according to the sex of the patient. Child age was not linked to fear but was related to pain: the younger the patient, the greater the pain they described. CONCLUSIONS Immersive VR effectively controlled pain and fear in children during vaccination and increased parent satisfaction with the vaccination process. Patient sex did not influence the level of pain and fear but age did. RELEVANCE TO CLINICAL PRACTICE Improving vaccination experiences can reduce perceived pain and fear in children and increase parent satisfaction, thereby enhancing vaccination schedule adherence and improving group immunity. REPORTING METHOD The CONSORT Statement for non-pharmacological randomised clinical trials were followed.
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Affiliation(s)
- María Inmaculada Sánchez-López
- Department of Nursing and Phisiotherapy, Faculty of Health Sciencies, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Marta Lluesma-Vidal
- Department of Nursing and Phisiotherapy, Faculty of Health Sciencies, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | | | - Inmaculada Tomás-Saura
- Tres Forques Health Centre, General Hospital of Valencia Health Department, Valencia, Spain
| | | | - Gema Gutiérrez-Alonso
- Tres Forques Health Centre, General Hospital of Valencia Health Department, Valencia, Spain
| | - Laura García-Garcés
- Department of Nursing and Phisiotherapy, Faculty of Health Sciencies, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Sungur H, van Berlo ZMC, Lüwa LM. Enhancing Cardiopulmonary Resuscitation Training with Mixed Reality: Improving Cardiopulmonary Resuscitation Performance and Enjoyment. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024; 27:379-386. [PMID: 38330413 DOI: 10.1089/cyber.2023.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Cardiac arrests stand as a leading cause of mortality worldwide. When performed timely, cardiopulmonary resuscitation (CPR) can significantly improve a person's chance of survival during a cardiac arrest. Given that the majority of cardiac arrests happen outside of hospitals, it becomes crucial to equip as many laypeople as possible with CPR skills. Recently, mixed reality has garnered attention as a potential tool for CPR training. This study, with a randomized controlled trial (RCT), tested the effectiveness of a mixed reality CPR training compared to traditional training among laypeople (N = 59). Results revealed that participants in the mixed reality training either showed similar (i.e., compressions per minute, exam scores) or better (i.e., compression depth) CPR performance compared to participants that received the traditional training. Furthermore, the mixed reality training was perceived as more enjoyable than the traditional training. Finally, across conditions, participants reported comparable levels of presence, indicating a similar sense of being in a CPR situation. Based on these findings, we conclude that mixed reality CPR training can serve as a viable alternative for traditional CPR training. Especially, the enjoyable nature of mixed reality can boost motivation and encourage more people to follow or refresh previous CPR training.
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Affiliation(s)
- Hande Sungur
- Department of Communication Science, Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Zeph M C van Berlo
- Department of Communication Science, Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Lisa Marie Lüwa
- Department of Communication Science, Graduate School of Communication, University of Amsterdam, Amsterdam, Netherlands
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3
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Khalid UB, Naeem M, Stasolla F, Syed MH, Abbas M, Coronato A. Impact of AI-Powered Solutions in Rehabilitation Process: Recent Improvements and Future Trends. Int J Gen Med 2024; 17:943-969. [PMID: 38495919 PMCID: PMC10944308 DOI: 10.2147/ijgm.s453903] [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: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
Rehabilitation is an important and necessary part of local and global healthcare services along with treatment and palliative care, prevention of disease, and promotion of good health. The rehabilitation process helps older and young adults even children to become as independent as possible in activities of daily life and enables participation in useful living activities, recreation, work, and education. The technology of Artificial Intelligence (AI) has evolved significantly in recent years. Many activities related to rehabilitation have been getting benefits from using AI techniques. The objective of this review study is to explore the advantages of AI for rehabilitation and how AI is impacting the rehabilitation process. This study aims at the most critical aspects of the rehabilitation process that could potentially take advantage of AI techniques including personalized rehabilitation apps, rehabilitation through assistance, rehabilitation for neurological disorders, rehabilitation for developmental disorders, virtual reality rehabilitation, rehabilitation of neurodegenerative diseases and Telerehabilitation of Cardiovascular. We presented a survey on the newest empirical studies available in the literature including the AI-based technology helpful in the Rehabilitation process. The novelty feature included but was not limited to an overview of the technological solutions useful in rehabilitation. Seven different categories were identified. Illustrative examples of practical applications were detailed. Implications of the findings for both research and practice were critically discussed. Most of the AI applications in these rehabilitation types are in their infancy and continue to grow while exploring new opportunities. Therefore, we investigate the role of AI technology in rehabilitation processes. In addition, we do statistical analysis of the selected studies to highlight the significance of this review work. In the end, we also present a discussion on some challenges, and future research directions.
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Affiliation(s)
- Umamah bint Khalid
- Department of Electronics, Quaid-I-Azam University, Islamabad, 44000, Pakistan
| | - Muddasar Naeem
- Research Center on ICT Technologies for Healthcare and Wellbeing, Università Telematica “Giustino Fortunato”, Benevento, 82100, Italy
| | - Fabrizio Stasolla
- Research Center on ICT Technologies for Healthcare and Wellbeing, Università Telematica “Giustino Fortunato”, Benevento, 82100, Italy
| | - Madiha Haider Syed
- Department of Electronics, Quaid-I-Azam University, Islamabad, 44000, Pakistan
- Institute of Information Technology, Quaid-i-Azam University, Islamabad, 44000, Pakistan
| | - Musarat Abbas
- Department of Electronics, Quaid-I-Azam University, Islamabad, 44000, Pakistan
| | - Antonio Coronato
- Research Center on ICT Technologies for Healthcare and Wellbeing, Università Telematica “Giustino Fortunato”, Benevento, 82100, Italy
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Huang Y, Benford S, Spence J, Blake H. Exploring Effects of a Nostalgic Storytelling Virtual Reality Experience Beyond Hedonism. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024; 27:221-226. [PMID: 38153373 DOI: 10.1089/cyber.2023.0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
In this study, we tested the effect of a nostalgic storytelling virtual reality (VR) experience (vs. a text-reading neutral VR experience as the comparison condition) on state-level eudaimonic well-being and explored the underlying mediating mechanisms. In a within-subject experimental design, all 31 participants experienced both versions of the VR in pseudorandomized and counterbalanced order. Compared with the text-reading VR experience, the nostalgic storytelling VR resulted in significantly higher hedonic and eudaimonic entertainment media gratifications (aka. media enjoyment and media appreciation, respectively), social connectedness, and state-level well-being. Moreover, the relationship between VR and well-being was serially mediated by the level of state nostalgia and eudaimonic media gratifications. That is, the nostalgic storytelling VR was found to evoke state nostalgia, which led to a greater appreciation of the VR experience; this appreciation, in turn, contributed to increased state-level well-being. Implications of the study findings for future research and practice are discussed.
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Affiliation(s)
- Yitong Huang
- School of Media and Communication, Shanghai Jiaotong University, Shanghai, China
| | - Steve Benford
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Jocelyn Spence
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
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5
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Žilinský T, Halamová J. The Effects of Virtual Reality on Enhancement of Self-Compassion and Self-Protection, and Reduction of Self-Criticism: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2592. [PMID: 36767956 PMCID: PMC9915010 DOI: 10.3390/ijerph20032592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Virtual reality used for the treatment of mental health disorders is showing promising potential in clinical practice. Increasing self-compassion and self-protections and decreasing self-criticism have been identified as trans-diagnostic mechanisms helping to build a resilient self. The goal of this systematic review was to provide an overview of research studies about virtual reality while exploring its effectiveness in increasing self-compassion and self-protection and decreasing self-criticism. METHODS On 6 December 2022, titles, abstracts, and, where available, keywords were searched in the following databases: PubMed, Scopus, and Web of Science. The inclusion criteria were: empirical study; quantitative methodology; outcomes measured, including self-compassion and/or self-protection, and/or self-criticism; pre/post and/or control group intervention measures of selected outcomes; participants aged 18 and above; application of virtual reality technology as part of the intervention; full study availability; and English language. Exclusion criteria were: ruminations related only to physical pain; self-protection in the context of physical survival; VR used to increase ruminations. RESULTS Selection criteria were met by 19 studies (two randomized controlled trials, 16 longitudinal studies, and one case study) with an overall number of 672 participants. Results suggest that VR interventions targeting self-criticism, self-compassion, and self-protection might be effective for non-clinical (self-compassion) as well as clinical (self-criticism and self-protection) samples. DISCUSSION The present systematic review partially supports the effectiveness of VR interventions on self-criticism, self-protection, and self-compassion. To properly answer the question of its effectiveness, more randomized control trials with larger samples from different populations are needed. The results are also limited by the variability of intervention protocols and the amount of exposure to VR. Other: This work was supported by the Vedecká grantová agentúra VEGA under Grant 1/0075/19. This systematic review has not been pre-registered.
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Affiliation(s)
| | - Júlia Halamová
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University in Bratislava, Mlynské luhy 4, 821 05 Bratislava, Slovakia
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Mohamed ES, Naqishbandi TA, Veronese G. Metaverse! INTERNATIONAL JOURNAL OF E-ADOPTION 2023. [DOI: 10.4018/ijea.316537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study aimed to synthesize the literature on Metaverse to highlight its current research, opportunities, and applications in e-healthcare and education to reduce inequalities and for delivering fair and equal opportunities and solutions. The authors employed preferred reporting items for systematic reviews and meta-analyses (PRISMA) to rapidly map the field of a metaverse in health and education. Two major application domains emerged in the literature from the 88 research publications, which include (1) Metaverse in healthcare and (2) Metaverse in education. This study will act as a road map to help academics who desire to continue their research work in the Metaverse for various healthcare and educational services. However, its implementation is required in the future to improve mental healthcare and the effectiveness of mental health services, particularly in low and medium-income (LMIC) and conflict-affected areas.
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Affiliation(s)
- E. Syed Mohamed
- B.S. Abdur Rahman Crescent Institute of Science and Technology, India
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Huang YC, Li LN, Lee HY, Browning MH, Yu CP. Surfing in virtual reality: An application of extended technology acceptance model with flow theory. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2022. [DOI: 10.1016/j.chbr.2022.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Malighetti C, Sansoni M, Gaudio S, Matamala-Gomez M, Di Lernia D, Serino S, Riva G. From Virtual Reality to Regenerative Virtual Therapy: Some Insights from a Systematic Review Exploring Inner Body Perception in Anorexia and Bulimia Nervosa. J Clin Med 2022; 11:jcm11237134. [PMID: 36498708 PMCID: PMC9737310 DOI: 10.3390/jcm11237134] [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: 09/09/2022] [Revised: 11/10/2022] [Accepted: 11/20/2022] [Indexed: 12/02/2022] Open
Abstract
Despite advances in our understanding of the behavioral and molecular factors that underlie the onset and maintenance of Eating Disorders (EDs), it is still necessary to optimize treatment strategies and establish their efficacy. In this context, over the past 25 years, Virtual Reality (VR) has provided creative treatments for a variety of ED symptoms, including body dissatisfaction, craving, and negative emotions. Recently, different researchers suggested that EDs may reflect a broader impairment in multisensory body integration, and a particular VR technique-VR body swapping-has been used to repair it, but with limited clinical results. In this paper, we use the results of a systematic review employing PRISMA guidelines that explore inner body perception in EDs (21 studies included), with the ultimate goal to analyze the features of multisensory impairment associated with this clinical condition and provide possible solutions. Deficits in interoception, proprioception, and vestibular signals were observed across Anorexia and Bulimia Nervosa, suggesting that: (a) alteration of inner body perception might be a crucial feature of EDs, even if further research is needed and; (b) VR, to be effective with these patients, has to simulate/modify both the external and the internal body. Following this outcome, we introduce a new therapeutic approach-Regenerative Virtual Therapy-that integrates VR with different technologies and clinical strategies to regenerate a faulty bodily experience by stimulating the multisensory brain mechanisms and promoting self-regenerative processes within the brain itself.
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Affiliation(s)
- Clelia Malighetti
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Maria Sansoni
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
- Correspondence: ; Tel.: +39-02-72-343-863
| | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Husargatan 3, 75237 Uppsala, Sweden
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Montpellier 1, 00133 Rome, Italy
| | - Marta Matamala-Gomez
- Department of Psychology, Mind and Behavior Technological Center, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
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Cerasa A, Gaggioli A, Marino F, Riva G, Pioggia G. The promise of the metaverse in mental health: the new era of MEDverse. Heliyon 2022; 8:e11762. [PMID: 36458297 PMCID: PMC9706139 DOI: 10.1016/j.heliyon.2022.e11762] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/11/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022] Open
Abstract
Since Mark Zuckerberg's announcement about the development of new three-dimensional virtual worlds for social communication, a great debate has been raised about the promise of such a technology. The metaverse, a term formed by combining meta and universe, could open a new era in mental health, mainly in psychological disorders, where the creation of a full-body illusion via digital avatar could promote healthcare and personal well-being. Patients affected by body dysmorphism symptoms (i.e., eating disorders), social deficits (i.e. autism) could greatly benefit from this kind of technology. However, it is not clear which advantage the metaverse would have in treating psychological disorders with respect to the well-known and effective virtual reality (VR) exposure therapy. Indeed, in the last twenty years, a plethora of studies have demonstrated the effectiveness of VR technology in reducing symptoms of pain, anxiety, stress, as well as, in improving cognitive and social skills. We hypothesize that the metaverse will offer more opportunities, such as a more complex, virtual realm where sensory inputs, and recurrent feedback, mediated by a "federation" of multiple technologies - e.g., artificial intelligence, tangible interfaces, Internet of Things and blockchain, can be reinterpreted for facilitating a new kind of communication overcoming self-body representation. However, nowadays a clear starting point does not exist. For this reason, it is worth defining a theoretical framework for applying this new kind of technology in a social neuroscience context for developing accurate solutions to mental health in the future.
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Moll B, Sykes E. Optimized virtual reality-based Method of Loci memorization techniques through increased immersion and effective memory palace designs: a feasibility study. VIRTUAL REALITY 2022; 27:941-966. [PMID: 36248722 PMCID: PMC9540171 DOI: 10.1007/s10055-022-00700-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 08/18/2022] [Indexed: 06/05/2023]
Abstract
For most, an improvement in memory would always be desirable, whether from the point of view of an aging individual with declining memory, or from the perspective of someone seeking to memorize large amounts of information in the shortest period of time. One way for people to improve upon their memory performance is by using the Method of Loci (MoL), a famously complex, ancient memorization technique for non-spatial information recall. With the use of virtual reality technology, this technique can finally be easily taught to individuals for use in their daily lives. In this paper, we present an exploration into this avenue of using MoL in virtual reality and report on the design and evaluation of our new virtual memory palace that aims to prove the feasibility of improving upon designs from other studies to optimize memory recall performance. An experiment was conducted to evaluate our VR MoL environment. The results from week 1 on the pre-test (M = 62.55, SD = 24.01) and post-test (M = 82.91, SD = 15.99) memory task showed an increase in the number of words remembered was statistically significant, t(20) = -2.34, p = 0.014 where participants were able to remember approximately 20.4% more non-spatial information, when compared to traditional memorization techniques. After a second use, participants improved, remembering 22.2% more non-spatial information on the pre-test (M = 63.44, SD = 26.64) and post-test (M = 85.67, SD = 16.10) memory task, indicating that the increase in number of words remembered was statistically significant, t(16) = -2.142, p = 0.024. The results suggest that the virtual memory palace experience could be optimized to help participants learn the MoL technique with very little training time and potentially produce significant improvements in recall performance as a result.
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Affiliation(s)
- Brigham Moll
- Sheridan College, 1430 Trafalgar Road, Ontario, ON Canada
| | - Ed Sykes
- Sheridan College, 1430 Trafalgar Road, Ontario, ON Canada
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11
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He D, Cao S, Le Y, Wang M, Chen Y, Qian B. Virtual Reality Technology in Cognitive Rehabilitation Application: A Bibliometric Analysis (Preprint). JMIR Serious Games 2022; 10:e38315. [PMID: 36260388 PMCID: PMC9631168 DOI: 10.2196/38315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/30/2022] [Accepted: 09/02/2022] [Indexed: 12/04/2022] Open
Abstract
Background In recent years, with the development of computer science and medical science, virtual reality (VR) technology has become a promising tool for improving cognitive function. Research on VR-based cognitive training has garnered increasing attention. Objective This study aimed to investigate the application status, research hot spots, and emerging trends of VR in cognitive rehabilitation over the past 20 years. Methods Articles on VR-based cognitive rehabilitation from 2001 to 2021 were retrieved from the Web of Science Core Collection. CiteSpace software was used for the visual analysis of authors and countries or regions, and Scimago Graphica software was used for the geographic visualization of published countries or regions. Keywords were clustered using the gCLUTO software. Results A total of 1259 papers were included. In recent years, research on the application of VR in cognitive rehabilitation has been widely conducted, and the annual publication of relevant literature has shown a positive trend. The main research areas include neuroscience and neurology, psychology, computer science, and rehabilitation. The United States ranked first with 328 papers, and Italy ranked second with 140 papers. Giuseppe Riva, an Italian academic, was the most prolific author with 29 publications. The most frequently cited reference was “Using Reality to Characterize Episodic Memory Profiles in Amnestic Mild Cognitive Impairment and Alzheimer’s Disease: Influence of Active and Passive Encoding.” The most common keywords used by researchers include “virtual reality,” “cognition,” “rehabilitation,” “performance,” and “older adult.” The largest source of research funding is from the public sector in the United States. Conclusions The bibliometric analysis provided an overview of the application of VR in cognitive rehabilitation. VR-based cognitive rehabilitation can be integrated into multiple disciplines. We conclude that, in the context of the COVID-19 pandemic, the development of VR-based telerehabilitation is crucial, and there are still many problems that need to be addressed, such as the lack of consensus on treatment methods and the existence of safety hazards.
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Affiliation(s)
- Danni He
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Shihua Cao
- Nursing Department, Hangzhou Normal University Qianjiang College, Hangzhou, China
| | - Yuchao Le
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Mengxin Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Yanfei Chen
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Beiying Qian
- School of Nursing, Hangzhou Normal University, Hangzhou, China
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Ong T, Wilczewski H, Soni H, Nisbet Q, Paige SR, Barrera JF, Welch BM, Bunnell BE. The Symbiosis of Virtual Reality Exposure Therapy and Telemental Health: A Review. FRONTIERS IN VIRTUAL REALITY 2022; 3:848066. [PMID: 37483657 PMCID: PMC10361704 DOI: 10.3389/frvir.2022.848066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Phobias and related anxiety are common and costly mental health disorders. Experts anticipate the prevalence of phobias will increase due to the COVID-19 pandemic. Exposure therapies have been established as effective and reliable treatments for anxiety, including recent innovations in virtual reality-based exposure therapy (VRET). With the recent advent of telemental health (TMH), VRET is poised to become mainstream. The combination of VRET and TMH has the potential to extend provider treatment options and improve patient care experiences. In this narrative review, we describe how recent events have accelerated VRET + TMH, identify barriers to VRET + TMH implementation, and discuss strategies to navigate those barriers.
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Affiliation(s)
- Triton Ong
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Hiral Soni
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | - Quinn Nisbet
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Janelle F. Barrera
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
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13
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Virtual Reality Aided Therapy towards Health 4.0: A Two-Decade Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031525. [PMID: 35162546 PMCID: PMC8834834 DOI: 10.3390/ijerph19031525] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 12/12/2022]
Abstract
Health 4.0 aligns with Industry 4.0 and encourages the application of the latest technologies to healthcare. Virtual reality (VR) is a potentially significant component of the Health 4.0 vision. Though VR in health care is a popular topic, there is little knowledge of VR-aided therapy from a macro perspective. Therefore, this paper was aimed to explore the research of VR in aiding therapy, thus providing a potential guideline for futures application of therapeutic VR in healthcare towards Health 4.0. A mixed research method was adopted for this research, which comprised the use of a bibliometric analysis (a quantitative method) to conduct a macro overview of VR-aided therapy, the identification of significant research structures and topics, and a qualitative review of the literature to reveal deeper insights. Four major research areas of VR-aided therapy were identified and investigated, i.e., post-traumatic stress disorder (PTSD), anxiety and fear related disorder (A&F), diseases of the nervous system (DNS), and pain management, including related medical conditions, therapies, methods, and outcomes. This study is the first to use VOSviewer, a commonly used software tool for constructing and visualizing bibliometric networks and developed by Center for Science and Technology Studies, Leiden University, the Netherlands, to conduct bibliometric analyses on VR-aided therapy from the perspective of Web of Science core collection (WoSc), which objectively and visually shows research structures and topics, therefore offering instructive insights for health care stakeholders (particularly researchers and service providers) such as including integrating more innovative therapies, emphasizing psychological benefits, using game elements, and introducing design research. The results of this paper facilitate with achieving the vision of Health 4.0 and illustrating a two-decade (2000 to year 2020) map of pre-life of the Health Metaverse.
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Rowland DP, Casey LM, Ganapathy A, Cassimatis M, Clough BA. A Decade in Review: A Systematic Review of Virtual Reality Interventions for Emotional Disorders. PSYCHOSOCIAL INTERVENTION = INTERVENCION PSICOSOCIAL 2022; 31:1-20. [PMID: 37362616 PMCID: PMC10268557 DOI: 10.5093/pi2021a8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/22/2021] [Indexed: 06/28/2023]
Abstract
Research is increasingly demonstrating the therapeutic benefits of virtual reality interventions for various mental health conditions, though these rarely translate from research to application in clinical settings. This systematic review aims to examine the efficacy of current virtual reality interventions for emotional disorders, with a focus on clinical and technological features that influence translation of treatments from research to clinical practice. A comprehensive systematic literature search was conducted following PRISMA guidelines, for studies including the application of a virtual reality intervention to a clinical population of adults with an emotional disorder. Thirty-seven eligible studies were identified, appraised, and assessed for bias. Treatment effects were typically large across studies, with virtual reality being considered an efficacious treatment modality for various anxiety disorders and post-traumatic stress disorder. Virtual reality interventions were typically used for delivering exposure in cognitive behavioural therapy approaches. Considerable variability was seen in cost, technological specifications, degree of therapist involvement, delivery format, dosage, duration, and frequency of treatment. Suboptimal methodological rigour was identified in some studies. Remote use of virtual reality was rare, despite increasing options for in home use. Virtual reality interventions have the potential to overcome barriers to care and better meet the needs of consumers. Future research should examine the efficacy of virtual reality for treatment of depressive disorders and obsesive compulsive disorder. Improved methodological reporting and development of transdiagnostic and remotely delivered virtual reality interventions, will likely increase the translation of this treatment modality.
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Affiliation(s)
- Dale P. Rowland
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Leanne M. Casey
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Aarthi Ganapathy
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Mandy Cassimatis
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Bonnie A. Clough
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
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15
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Development and Feasibility Test of a Mouth Contactless Breathing Exercise Solution Using Virtual Reality: A Randomized Crossover Trial. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:345-352. [PMID: 34920173 DOI: 10.1016/j.anr.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this study was to develop a novel mouth contactless breathing exercise solution based on virtual reality (VR), and to test its feasibility. METHODS We developed the Virtual Reality-based Breathing Exercise System (VR-BRES), a self-regulating biofeedback breathing exercise with gaming characteristics and a soft stretch sensor. The feasibility and efficacy of the VR-BRES prototype were investigated through a randomized crossover trial. Fifty healthy adults participated in the trial, and their respiratory parameters and user evaluation of the VR-BRES were compared with conventional deep breathing (CDB) exercises. RESULTS The respiratory parameters, forced vital capacity (Z = 4.82, 4.95, p < .001), forced expiratory volume in one second (t = 6.02, 6.26, p < .001), and peak expiratory flow (t = 5.35, 5.68, p < .001) were significantly higher during breathing exercises using the VR-BRES. User evaluation was also significantly higher for the VR-BRES in terms of efficiency (Z = 3.86, p < .001), entertainingness (Z = 5.00, p < .001), and intention to use (Z = 3.22, p = .001) compared to CDB. However, there was no difference in convenience between the two methods (Z = -0.90, p = .369). CONCLUSION The VR-BRES has the potential to be an efficient breathing exercise solution. We recommend a clinical study that evaluates the effects of the VR-BRES for a certain period of time for people who need breathing exercises.
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16
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Riva G, Serino S, Di Lernia D, Pagnini F. Regenerative Virtual Therapy: The Use of Multisensory Technologies and Mindful Attention for Updating the Altered Representations of the Bodily Self. Front Syst Neurosci 2021; 15:749268. [PMID: 34803617 PMCID: PMC8595209 DOI: 10.3389/fnsys.2021.749268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/04/2021] [Indexed: 12/25/2022] Open
Abstract
The term “regenerative medicine” (RM) indicates an emerging trend in biomedical sciences that aims at replacing, engineering, or regenerating human cells, tissues, or organs to restore or establish normal function. So far, the focus of RM has been the physical body. Neuroscience, however, is now suggesting that mental disorders can be broadly characterized by a dysfunction in the way the brain computes and integrates the representations of the inner and outer body across time [bodily self-consciousness (BSC)]. In this perspective, we proposed a new kind of clinical intervention, i.e., “Regenerative Virtual Therapy” (RVT), which integrates knowledge from different disciplines, from neuroscience to computational psychiatry, to regenerate a distorted or faulty BSC. The main goal of RVT was to use technology-based somatic modification techniques to restructure the maladaptive bodily representations behind a pathological condition. Specifically, starting from a Bayesian model of our BSC (i.e., body matrix), we suggested the use of mindful attention, cognitive reappraisal, and brain stimulation techniques merged with high-rewarding and novel synthetic multisensory bodily experience (i.e., a virtual reality full-body illusion in sync with a low predictabIlity interoceptive modulation) to rewrite a faulty experience of the body and to regenerate the wellbeing of an individual. The use of RVT will also offer an unprecedented experimental overview of the dynamics of our bodily representations, allowing the reverse-engineering of their functioning for hacking them using advanced technologies.
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Affiliation(s)
- Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Silvia Serino
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Harvard University, Cambridge, MA, United States
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17
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Ma L, Mor S, Anderson PL, Baños RM, Botella C, Bouchard S, Cárdenas-López G, Donker T, Fernández-Álvarez J, Lindner P, Mühlberger A, Powers MB, Quero S, Rothbaum B, Wiederhold BK, Carlbring P. Integrating virtual realities and psychotherapy: SWOT analysis on VR and MR based treatments of anxiety and stress-related disorders. Cogn Behav Ther 2021; 50:509-526. [PMID: 34342251 DOI: 10.1080/16506073.2021.1939410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments.Abbreviations: AR: Augmented Reality; MR: Mixed Reality; RCT: Randomised Controlled Trial; SWOT: Strengths, Weaknesses, Opportunities, and Threats; VR: Virtual Reality; VR-EBT: Virtual Reality Exposure-Based Therapy.
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Affiliation(s)
- Lichen Ma
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Sonia Mor
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Page L Anderson
- Department of Psychology, Georgia State University, Atlanta, USA
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Stephane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
| | | | - Tara Donker
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Albert-LudwigsUniversität Freiburg, Freiburg, Germany
| | - Javier Fernández-Álvarez
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Philip Lindner
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Healthcare Services, Sweden
| | | | | | - Soledad Quero
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Barbara Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, USA
| | | | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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18
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Ong T, Wilczewski H, Paige SR, Soni H, Welch BM, Bunnell BE. Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint. JMIR Serious Games 2021; 9:e26520. [PMID: 34227992 PMCID: PMC8315161 DOI: 10.2196/26520] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic caused widespread challenges and revealed vulnerabilities across global health care systems. In response, many health care providers turned to telehealth solutions, which have been widely embraced and are likely to become standard for modern care. Immersive extended reality (XR) technologies have the potential to enhance telehealth with greater acceptability, engagement, and presence. However, numerous technical, logistic, and clinical barriers remain to the incorporation of XR technology into telehealth practice. COVID-19 may accelerate the union of XR and telehealth as researchers explore novel solutions to close social distances. In this viewpoint, we highlight research demonstrations of XR telehealth during the COVID-19 pandemic and discuss future directions to make XR the next evolution of remote health care.
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Affiliation(s)
- Triton Ong
- Doxy.me, LLC, Rochester, NY, United States
| | | | | | - Hiral Soni
- Doxy.me, LLC, Rochester, NY, United States
| | - Brandon M Welch
- Doxy.me, LLC, Rochester, NY, United States
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me, LLC, Rochester, NY, United States
- Department of Psychiatry, University of South Florida, Tampa, FL, United States
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19
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Rimer E, Husby LV, Solem S. Virtual Reality Exposure Therapy for Fear of Heights: Clinicians' Attitudes Become More Positive After Trying VRET. Front Psychol 2021; 12:671871. [PMID: 34335386 PMCID: PMC8319686 DOI: 10.3389/fpsyg.2021.671871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/23/2021] [Indexed: 12/24/2022] Open
Abstract
Background Virtual reality exposure therapy (VRET) has the potential to solve logistic challenges when treating specific phobias. However, VRET has yet to see a large-scale implementation in clinical settings despite positive findings in treatment trials. This may partly be due to attitudes and lack of experience among clinicians, but also because of expensive and stationary VR solutions. Objective This study tested whether modern, wireless, commercially available VR equipment with controller-free hand tracking could induce and reduce discomfort using scenarios designed for fear of heights. Also, the study tested if clinicians’ attitudes toward using VR in therapy changed after trying it themselves. Method Attitudes to using VR in therapy and discomfort ratings were assessed for 74 clinicians before and after completing two VR scenarios. In addition, 54 non-clinicians completed the same scenarios. Participants were not diagnosed with acrophobia. Results The VR scenarios induced discomfort comparable to participants’ reported fear of heights in real life. Repeated training reduced discomfort. Positive attitudes toward use of VR in therapy was predicted by previous experience with VR, as well as positive attitudes toward novel technology and exposure therapy. Clinicians’ attitudes became more favorable after trying VRET themselves. Clinicians reported a range of possible advantages and disadvantages of using VR in therapy. Conclusion VRET for fear of heights was able to induce and reduce discomfort in clinicians and non-clinicians, and clinicians’ attitudes toward using VRET become more positive after trying VRET for themselves. The latest generation of VR solutions has potential to improve clinical availability and treatment options. Future research should explore how VRET can be implemented in clinical settings.
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Affiliation(s)
- Elise Rimer
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Vågsholm Husby
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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20
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Zhai K, Dilawar A, Yousef MS, Holroyd S, El-Hammali H, Abdelmonem M. Virtual Reality Therapy for Depression and Mood in Long-Term Care Facilities. Geriatrics (Basel) 2021; 6:58. [PMID: 34199801 PMCID: PMC8293126 DOI: 10.3390/geriatrics6020058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022] Open
Abstract
Virtual reality (VR) describes a family of technologies which immerse users in sensorily-stimulating virtual environments. Such technologies have increasingly found applications in the treatment of neurological and mental health disorders. Depression, anxiety, and other mood abnormalities are of concern in the growing older population-especially those who reside in long-term care facilities (LTCFs). The transition from the familiar home environment to the foreign LTCF introduces a number of stressors that can precipitate depression. However, recent studies reveal that VR therapy (VRT) can promote positive emotionality and improve cognitive abilities in older people, both at home and in LTCFs. VR thus holds potential in allowing older individuals to gradually adapt to their new environments-thereby mitigating the detrimental effects of place attachment and social exclusion. Nevertheless, while the current psychological literature is promising, the implementation of VR in LTCFs faces many challenges. LTCF residents must gain trust in VR technologies, care providers require training to maximize the positive effects of VRT, and decision makers must evaluate both the opportunities and obstacles in adopting VR. In this review article, we concisely discuss the implications of depression related to place attachment in LTCFs, and explore the potential therapeutic applications of VR.
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Affiliation(s)
- Kevin Zhai
- Premedical Unit, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar; (K.Z.); (A.D.); (M.S.Y.)
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar;
| | - Azwa Dilawar
- Premedical Unit, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar; (K.Z.); (A.D.); (M.S.Y.)
| | - Mohammad S. Yousef
- Premedical Unit, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar; (K.Z.); (A.D.); (M.S.Y.)
| | - Sean Holroyd
- Department of Physiology and Biophysics, Weill Cornell Medicine-Qatar, Cornell University, Doha P.O. Box 24144, Qatar;
| | - Haithem El-Hammali
- VCU School of the Arts in Qatar, Virginia Commonwealth University, Doha P.O. Box 8095, Qatar
| | - Marwa Abdelmonem
- VCU School of the Arts in Qatar, Virginia Commonwealth University, Doha P.O. Box 8095, Qatar
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21
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Lal S, Siafa L, Lee H, Adair CE. Priority Given to Technology in Government-Based Mental Health and Addictions Vision and Strategy Documents: Systematic Policy Review. J Med Internet Res 2021; 23:e25547. [PMID: 33949955 PMCID: PMC8135019 DOI: 10.2196/25547] [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: 11/10/2020] [Revised: 03/01/2021] [Accepted: 04/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background The use of information and communication technologies (ICTs) to deliver mental health and addictions (MHA) services is a global priority, especially considering the urgent shift towards virtual delivery of care in response to the COVID-19 pandemic. It is important to monitor the evolving role of technology in MHA services. Given that MHA policy documents represent the highest level of priorities for a government’s vision and strategy for mental health care, one starting point is to measure the frequency with which technology is mentioned and the terms used to describe its use in MHA policy documents (before, during, and after COVID-19). Yet, to our knowledge, no such review of the extent to which ICTs are referred to in Canadian MHA policy documents exists to date. Objective The objective of this systematic policy review was to examine the extent to which technology is addressed in Canadian government–based MHA policy documents prior to the COVID-19 pandemic to establish a baseline for documenting change. Methods We reviewed 22 government-based MHA policy documents, published between 2011 and 2019 by 13 Canadian provinces and territories. We conducted content analysis to synthesize the policy priorities addressed in these documents into key themes, and then systematically searched for and tabulated the use of 39 technology-related keywords (in English and French) to describe and compare jurisdictions. Results Technology was addressed in every document, however, to a varying degree. Of the 39 searched keywords, we identified 22 categories of keywords pertaining to the use of technology to deliver MHA services and information. The 6 most common categories were tele (n=16/22), phone (n=12/22), tech (n=11/22), online (n=10/22), line (n=10/22), and web (n=10/22), with n being the number of policy documents in which the category was mentioned out of 22 documents. The use of terms referring to advanced technologies, such as virtual (n=6/22) and app (n= 4/22), were less frequent. Additionally, policy documents from some provinces and territories (eg, Alberta and Newfoundland and Labrador) mentioned a diverse range of ICTs, whereas others described only 1 form of ICT. Conclusions This review indicates that technology has been given limited strategic attention in Canadian MHA policy. Policy makers may have limited knowledge on the evidence and potential of using technology in this field, highlighting the value for knowledge translation and collaborative initiatives among policy makers and researchers. The development of a pan-Canadian framework for action addressing the integration and coordination of technology in mental health services can also guide initiatives in this field. Our findings provide a prepandemic baseline and replicable methods to monitor how the use of technology-supported services and innovations emerge relative to other priorities in MHA policy during and after the COVID-19 pandemic.
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Affiliation(s)
- Shalini Lal
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.,Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada.,Prevention and Early Intervention Program for Psychosis and ACCESS Open Minds, Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Lyna Siafa
- Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada.,Department of Medicine, McGill University, Montréal, QC, Canada
| | - Hajin Lee
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.,Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada
| | - Carol E Adair
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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22
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Reeves R, Curran D, Gleeson A, Hanna D. A Meta-Analysis of the Efficacy of Virtual Reality and In Vivo Exposure Therapy as Psychological Interventions for Public Speaking Anxiety. Behav Modif 2021; 46:937-965. [PMID: 33533265 PMCID: PMC9158252 DOI: 10.1177/0145445521991102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Public speaking anxiety (PSA) is a prevalent condition with disabling occupational, educational, and social consequences. Exposure therapy is a commonly utilized approach for treating PSA. Traditionally, this intervention has been delivered as in vivo exposure therapy (IVET). Limitations inherent to in vivo as a mode of delivery have been identified and studies have increasingly explored the use of Virtual Reality Exposure Therapy (VRET) as an alternative. Understanding the efficacy of both VRET and IVET as psychological interventions for PSA is important. A systematic search identified 11 studies with 508 participants. Meta-analysis yielded a large significant effect wherein VRET resulted in significant reductions in PSA versus control of -1.39 (Z = 3.96, p < .001) and a similar large significant effect wherein IVET resulted in significant reductions in PSA versus control of -1.41 (Z = 7.51, p < .001). Although IVET was marginally superior to VRET, both interventions proved efficacious. Given the advantages of utilizing VRET over IVET future research and clinical practice could explore VRET as a treatment option for PSA.
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Affiliation(s)
- Rachel Reeves
- School of Psychology, Queens University, Belfast, UK
| | - David Curran
- School of Psychology, Queens University, Belfast, UK
| | | | - Donncha Hanna
- School of Psychology, Queens University, Belfast, UK
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23
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Head-Mounted Display-Based Application for Cognitive Training. SENSORS 2020; 20:s20226552. [PMID: 33212748 PMCID: PMC7696435 DOI: 10.3390/s20226552] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 12/20/2022]
Abstract
Virtual Reality (VR) has had significant advances in rehabilitation, due to the gamification of cognitive activities that facilitate treatment. On the other hand, Immersive Virtual Reality (IVR) produces outstanding results due to the interactive features with the user. This work introduces a VR application for memory rehabilitation by walking through a maze and using the Oculus Go head-mounted display (HMD) technology. The mechanics of the game require memorizing geometric shapes while the player progresses in two modes, autonomous or manual, with two levels of difficulty depending on the number of elements to remember. The application is developed in the Unity 3D video game engine considering the optimization of computational resources to improve the performance in the processing and maintaining adequate benefits for the user, while the generated data is stored and sent to a remote server. The maze task was assessed with 29 subjects in a controlled environment. The obtained results show a significant correlation between participants’ response accuracy in both the maze task and a face–pair test. Thus, the proposed task is able to perform memory assessments.
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24
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Mantovani E, Zucchella C, Bottiroli S, Federico A, Giugno R, Sandrini G, Chiamulera C, Tamburin S. Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic. Front Neurol 2020; 11:926. [PMID: 33041963 PMCID: PMC7522345 DOI: 10.3389/fneur.2020.00926] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022] Open
Abstract
The current COVID-19 pandemic presents unprecedented new challenges to public health and medical care delivery. To control viral transmission, social distancing measures have been implemented all over the world, interrupting the access to routine medical care for many individuals with neurological diseases. Cognitive disorders are common in many neurological conditions, e.g., stroke, traumatic brain injury, Alzheimer's disease, and other types of dementia, Parkinson's disease and parkinsonian syndromes, and multiple sclerosis, and should be addressed by cognitive rehabilitation interventions. To be effective, cognitive rehabilitation programs must be intensive and prolonged over time; however, the current virus containment measures are hampering their implementation. Moreover, the reduced access to cognitive rehabilitation might worsen the relationship between the patient and the healthcare professional. Urgent measures to address issues connected to COVID-19 pandemic are, therefore, needed. Remote communication technologies are increasingly regarded as potential effective options to support health care interventions, including neurorehabilitation and cognitive rehabilitation. Among them, telemedicine, virtual reality, augmented reality, and serious games could be in the forefront of these efforts. We will briefly review current evidence-based recommendations on the efficacy of cognitive rehabilitation and offer a perspective on the role of tele- and virtual rehabilitation to achieve adequate cognitive stimulation in the era of social distancing related to COVID-19 pandemic. In particular, we will discuss issues related to their diffusion and propose a roadmap to address them. Methodological and technological improvements might lead to a paradigm shift to promote the delivery of cognitive rehabilitation to people with reduced mobility and in remote regions.
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Affiliation(s)
- Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Zucchella
- Section of Neurology, Department of Neurosciences, Verona University Hospital, Verona, Italy
| | - Sara Bottiroli
- Giustino Fortunato University, Benevento, Italy.,IRCCS Mondino Foundation, Pavia, Italy
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Rosalba Giugno
- Department of Computer Science, University of Verona, Verona, Italy
| | - Giorgio Sandrini
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristiano Chiamulera
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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25
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Dellazizzo L, Potvin S, Luigi M, Dumais A. Evidence on Virtual Reality-Based Therapies for Psychiatric Disorders: Meta-Review of Meta-Analyses. J Med Internet Res 2020; 22:e20889. [PMID: 32812889 PMCID: PMC7468638 DOI: 10.2196/20889] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022] Open
Abstract
Background Among all diseases globally, mental illnesses are one of the major causes of burden. As many people are resistant to conventional evidence-based treatments, there is an unmet need for the implementation of novel mental health treatments. Efforts to increase the effectiveness and benefits of evidence-based psychotherapy in psychiatry have led to the emergence of virtual reality (VR)–based interventions. These interventions have shown a wide range of advantages over conventional psychotherapies. Currently, VR-based interventions have been developed mainly for anxiety-related disorders; however, they are also used for developmental disorders, severe mental disorders, and neurocognitive disorders. Objective This meta-review aims to summarize the current state of evidence on the efficacy of VR-based interventions for various psychiatric disorders by evaluating the quality of evidence provided by meta-analytical studies. Methods A systematic search was performed using the following electronic databases: PubMed, PsycINFO, Web of Science, and Google Scholar (any time until February 2020). Meta-analyses were included as long as they quantitatively examined the efficacy of VR-based interventions for symptoms of a psychiatric disorder. To avoid overlap among meta-analyses, for each subanalysis included within this meta-review, only one analysis provided from one meta-analysis was selected based on the best quality of evidence. Results The search retrieved 11 eligible meta-analyses. The quality of evidence varied from very low to moderate quality. Several reasons account for the lower quality evidence, such as a limited number of randomized controlled trials, lack of follow-up analysis or control group, and the presence of heterogeneity and publication bias. Nonetheless, evidence has shown that VR-based interventions for anxiety-related disorders display overall medium-to-large effects when compared with inactive controls but no significant difference when compared with standard evidence-based approaches. Preliminary data have highlighted that such effects appear to be sustained in time, and subjects may fare better than active controls. Neurocognitive disorders also appear to improve with VR-based approaches, with small effects being found for various clinical outcomes (eg, cognition, emotion). Finally, there are insufficient data to classify VR-based interventions as an evidence-based practice for social skills training in neurodevelopmental disorders and compliance among patients with schizophrenia. Conclusions VR provides unlimited opportunities by tailoring approaches to specific complex problems and individualizing the intervention. However, VR-based interventions have not shown superiority compared with usual evidence-based treatments. Future VR-based interventions should focus on developing innovative approaches for complex and treatment-resistant symptoms that are difficult to address with traditional treatments. Future research should also aim to gain a better understanding of the potential factors that may mediate VR outcomes to improve treatment.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada
| | - Mimosa Luigi
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada.,Institut national de psychiatrie légale Philippe-Pinel, Montreal, QC, Canada
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26
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The Use of a Virtual Reality Platform for the Assessment of the Memory Decline and the Hippocampal Neural Injury in Subjects with Mild Cognitive Impairment: The Validity of Smart Aging Serious Game (SASG). J Clin Med 2020; 9:jcm9051355. [PMID: 32384591 PMCID: PMC7290592 DOI: 10.3390/jcm9051355] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 12/11/2022] Open
Abstract
Due to the lack of pharmacological treatment for dementia, timely detection of subjects at risk can be of seminal importance for preemptive rehabilitation interventions. The aim of the study was to determine the usability of the smart aging serious game (SASG), a virtual reality platform, in assessing the cognitive profile of an amnestic mild cognitive impairment (aMCI) population, its validity in discriminating aMCI from healthy controls (HC), and in detecting hippocampal degeneration, a biomarker of clinical progression towards dementia. Thirty-six aMCI and 107 HC subjects were recruited and administered the SASG together with a neuropsychological evaluation. All aMCI and 30 HC subjects performed also an MRI for hippocampal volume measurement. Results showed good usability of the SASG despite the low familiarity with technology in both groups. ROC curve analyses showed similar discriminating abilities for SASG and gold standard tests, and a greater discrimination ability compared to non-specific neuropsychological tests. Finally, linear regression analysis revealed that the SASG outperformed the Montreal cognitive assessment test (MoCA) in the ability to detect neuronal degeneration in the hippocampus on the right side. These data show that SASG is an ecological task, that can be considered a digital biomarker providing objective and clinically meaningful data about the cognitive profile of aMCI subjects.
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27
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Brown T, Nauman Vogel E, Adler S, Bohon C, Bullock K, Nameth K, Riva G, Safer DL, Runfola CD. Bringing Virtual Reality From Clinical Trials to Clinical Practice for the Treatment of Eating Disorders: An Example Using Virtual Reality Cue Exposure Therapy. J Med Internet Res 2020; 22:e16386. [PMID: 32324145 PMCID: PMC7206518 DOI: 10.2196/16386] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/07/2019] [Accepted: 12/15/2019] [Indexed: 12/11/2022] Open
Abstract
Novel treatment options for eating disorders (EDs) are critically needed to enhance treatment outcomes and reduce the rates of treatment dropouts. On average, only 50% of individuals receiving evidence-based care remit, whereas 24% drop out before treatment completion. One particularly promising direction involves integrating virtual reality (VR) with existing evidence-based treatments (EBTs) such as cue exposure therapy (CET). Across psychiatric disorders, VR-based interventions are demonstrating at least preliminary efficacy and noninferiority to traditional treatments. Furthermore, VR technology has become increasingly portable, resulting in improved acceptance, increased access, and reductions in cost. However, more efficient research processes may be needed to uncover the potential benefits of these rapid technological advances. This viewpoint paper reviews existing empirical support for integrating VR with EBTs (with a focus on its use with EDs) and proposes key next steps to more rapidly bring this innovative technology-based intervention into real-world clinic settings, as warranted. VR-CET for EDs is used to illustrate a suggested process for developing such treatment enhancements. We recommend following a deployment-focused model of intervention development and testing to enable rapid implementation of robust, practice-ready treatments. In addition, our review highlights the need for a comprehensive clinical protocol that supports clinicians and researchers in the implementation and testing of VR-CET and identifies key missing protocol components with rationale for their inclusion. Ultimately, this work may lead to a more complete understanding of the full potential of the applications and integrations of VR into mental health care globally.
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Affiliation(s)
- Theresa Brown
- PGSP-Stanford PsyD Consortium, Palo Alto, CA, United States
| | | | - Sarah Adler
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Kim Bullock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Katherine Nameth
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Centro Studi e Ricerche di Psicologia della Comunicazione, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Debra L Safer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Cristin D Runfola
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
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28
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Georgieva I, Georgiev GV. Redesign Me: Virtual Reality Experience of the Line of Life and Its Connection to a Healthier Self. Behav Sci (Basel) 2019; 9:bs9110111. [PMID: 31694177 PMCID: PMC6912767 DOI: 10.3390/bs9110111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 11/23/2022] Open
Abstract
Virtual Reality is used in various ways for creating a storytelling experience. It gives us the opportunity to imagine one’s life events as a story, and in settings that are intended to aid the self, such as treatment of trauma, anxiety, phobia, etc. This paper discusses the ways that challenging experiences change the way people perceive their life narratives and form their memories. This paper suggests that virtual reality (VR) can be used for the exploration of alternative scenarios in order to see one’s overall line of life in a new and healthier way. Considering the theoretical background of the narrative self, this research proposes a novel view of VR immersion as a medium for constructing a new storyline and attitude to the past. The approach would also influence attitudes regarding the present and future, and thus better shape the narrative of the self, which can lead to healthier life experiences.
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Affiliation(s)
- Iva Georgieva
- Department of History and Philosophy of Science, The University of Tokyo, Tokyo 153-8902, Japan;
- Institute for Advanced Study, Varna 9010, Bulgaria
| | - Georgi V. Georgiev
- Center for Ubiquitous Computing, University of Oulu, 90014 Oulu, Finland
- Correspondence:
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Joko S, Ohsuga M, Tada Y, Ishikawa J. Evaluation of a Mental Care System for Patients Recuperating in a Sterile Room after Hematopoietic Cell Transplantation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:1314-1317. [PMID: 31946134 DOI: 10.1109/embc.2019.8857157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We developed a mental healthcare system using 360° interactive video for hematopoietic cell transplant patients whose treatment is obligatory in a sterile room. This system uses projection mapping for video presentation. By using it, our aim was to allow patients to feel the spread of virtual space in aseptic rooms and to reduce anxiety and anger and to relieve stress. To assess the effectiveness of the developed system for mental care, especially in the presentation method, we executed an experiment comparing projection mapping and a monitor as a presentation tool. Twelve patients participated in the experiments. The changes in the state of patients before and after using the system were investigated. Physiological indices obtained from electrocardiography, respiration, skin conductance, scores of questionnaires, and answers in interviews were used for evaluation. Significant changes were observed between pre and post trials in the scores of STAI-Y1 and the anxiety score of VAS; however, there were no significant differences between the two presentation methods. The results of interview showed the advantage of projection mapping in the feeling of space spreading, presence, and preference to use.
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