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Omisore OM, Odenigbo I, Orji J, Beltran AIH, Meier S, Baghaei N, Orji R. Extended Reality for Mental Health Evaluation: Scoping Review. JMIR Serious Games 2024; 12:e38413. [PMID: 39047289 DOI: 10.2196/38413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/05/2022] [Accepted: 03/24/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Mental health disorders are the leading cause of health-related problems worldwide. It is projected that mental health disorders will be the leading cause of morbidity among adults as the incidence rates of anxiety and depression grow worldwide. Recently, "extended reality" (XR), a general term covering virtual reality (VR), augmented reality (AR), and mixed reality (MR), is paving the way for the delivery of mental health care. OBJECTIVE We aimed to investigate the adoption and implementation of XR technology used in interventions for mental disorders and to provide statistical analyses of the design, usage, and effectiveness of XR technology for mental health interventions with a worldwide demographic focus. METHODS In this paper, we conducted a scoping review of the development and application of XR in the area of mental disorders. We performed a database search to identify relevant studies indexed in Google Scholar, PubMed, and the ACM Digital Library. A search period between August 2016 and December 2023 was defined to select papers related to the usage of VR, AR, and MR in a mental health context. The database search was performed with predefined queries, and a total of 831 papers were identified. Ten papers were identified through professional recommendation. Inclusion and exclusion criteria were designed and applied to ensure that only relevant studies were included in the literature review. RESULTS We identified a total of 85 studies from 27 countries worldwide that used different types of VR, AR, and MR techniques for managing 14 types of mental disorders. By performing data analysis, we found that most of the studies focused on high-income countries, such as the United States (n=14, 16.47%) and Germany (n=12, 14.12%). None of the studies were for African countries. The majority of papers reported that XR techniques lead to a significant reduction in symptoms of anxiety or depression. The majority of studies were published in 2021 (n=26, 30.59%). This could indicate that mental disorder intervention received higher attention when COVID-19 emerged. Most studies (n=65, 76.47%) focused on a population in the age range of 18-65 years, while few studies (n=2, 3.35%) focused on teenagers (ie, subjects in the age range of 10-19 years). In addition, more studies were conducted experimentally (n=67, 78.82%) rather than by using analytical and modeling approaches (n=8, 9.41%). This shows that there is a rapid development of XR technology for mental health care. Furthermore, these studies showed that XR technology can effectively be used for evaluating mental disorders in a similar or better way that conventional approaches. CONCLUSIONS In this scoping review, we studied the adoption and implementation of XR technology for mental disorder care. Our review shows that XR treatment yields high patient satisfaction, and follow-up assessments show significant improvement with large effect sizes. Moreover, the studies adopted unique designs that were set up to record and analyze the symptoms reported by their participants. This review may aid future research and development of various XR mechanisms for differentiated mental disorder procedures.
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Affiliation(s)
- Olatunji Mumini Omisore
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Ifeanyi Odenigbo
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Joseph Orji
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | | | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Nilufar Baghaei
- School of Electrical Engineering and Computer Science, University of Queensland, St Lucia, Australia
| | - Rita Orji
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
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El-Gabalawy R, Sommer JL, Hebbard P, Reynolds K, Logan GS, Smith MSD, Mutter TC, Mutch WA, Mota N, Proulx C, Gagnon Shaigetz V, Maples-Keller JL, Arora RC, Perrin D, Benedictson J, Jacobsohn E. An Immersive Virtual Reality Intervention for Preoperative Anxiety and Distress Among Adults Undergoing Oncological Surgery: Protocol for a 3-Phase Development and Feasibility Trial. JMIR Res Protoc 2024; 13:e55692. [PMID: 38743939 PMCID: PMC11134251 DOI: 10.2196/55692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Preoperative state anxiety (PSA) is distress and anxiety directly associated with perioperative events. PSA is associated with negative postoperative outcomes such as longer hospital length of stay, increased pain and opioid use, and higher rates of rehospitalization. Psychological prehabilitation, such as education, exposure to hospital environments, and relaxation strategies, has been shown to mitigate PSA; however, there are limited skilled personnel to deliver such interventions in clinical practice. Immersive virtual reality (VR) has the potential for greater accessibility and enhanced integration into an immersive and interactive experience. VR is rarely used in the preoperative setting, but similar forms of stress inoculation training involving exposure to stressful events have improved psychological preparation in contexts such as military deployment. OBJECTIVE This study seeks to develop and investigate a targeted PSA intervention in patients undergoing oncological surgery using a single preoperative VR exposure. The primary objectives are to (1) develop a novel VR program for patients undergoing oncological surgery with general anesthesia; (2) assess the feasibility, including acceptability, of a single exposure to this intervention; (3) assess the feasibility, including acceptability, of outcome measures of PSA; and (4) use these results to refine the VR content and outcome measures for a larger trial. A secondary objective is to preliminarily assess the clinical utility of the intervention for PSA. METHODS This study comprises 3 phases. Phase 1 (completed) involved the development of a VR prototype targeting PSA, using multidisciplinary iterative input. Phase 2 (data collection completed) involves examining the feasibility aspects of the VR intervention. This randomized feasibility trial involves assessing the novel VR preoperative intervention compared to a VR control (ie, nature trek) condition and a treatment-as-usual group among patients undergoing breast cancer surgery. Phase 3 will involve refining the prototype based on feasibility findings and input from people with lived experience for a future clinical trial, using focus groups with participants from phase 2. RESULTS This study was funded in March 2019. Phase 1 was completed in April 2020. Phase 2 data collection was completed in January 2024 and data analysis is ongoing. Focus groups were completed in February 2024. Both the feasibility study and focus groups will contribute to further refinement of the initial VR prototype (phase 3), with the final simulation to be completed by mid-2024. CONCLUSIONS The findings from this work will contribute to the limited body of research examining feasible and broadly accessible interventions for PSA. Knowledge gained from this research will contribute to the final development of a novel VR intervention to be tested in a large population of patients with cancer before surgery in a randomized clinical trial. TRIAL REGISTRATION ClinicalTrials.gov NCT04544618; https://www.clinicaltrials.gov/study/NCT04544618. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55692.
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Affiliation(s)
- Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Hebbard
- CancerCare Manitoba, Winnipeg, MB, Canada
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Gabrielle S Logan
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Thomas C Mutter
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - W Alan Mutch
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Rakesh C Arora
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States
| | - David Perrin
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Surgery, Section of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada
| | - Jada Benedictson
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Eric Jacobsohn
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
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3
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Sommer JL, Reynolds K, Hebbard P, Smith MSD, Mota N, Mutch WAC, Maples-Keller J, Roos L, El-Gabalawy R. Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study. JMIR Form Res 2024; 8:e46367. [PMID: 38231570 PMCID: PMC10831694 DOI: 10.2196/46367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Clinically elevated preoperative distress and anxiety are common among patients undergoing cancer surgery. Preoperative interventions have been developed to mitigate this distress and anxiety but are inconsistent in efficacy and feasibility for broad implementation. OBJECTIVE This preliminary pilot study aims to assess the feasibility and utility of a newly developed virtual reality (VR) intervention to expose patients awaiting breast cancer surgery to the operating room environment and a simulation of anesthetic induction. METHODS Patients undergoing breast cancer surgery (N=7) were assigned to the VR intervention or control (treatment as usual) group and completed self-report measures of distress and anxiety before surgery, on the day of surgery, and after surgery (5 and 30 d postoperatively). Those in the intervention group trialed the VR simulation 1 to 2 weeks preoperatively and provided qualitative and quantitative feedback. We assessed the feasibility of recruitment capability and study design and evaluated participants' impressions of the intervention using self-report rating scales and open-ended questions. We also descriptively examined distress and anxiety levels throughout the duration of the study. RESULTS Recruitment occurred between December 2021 and December 2022 and progressed slowly (rate: 1 participant/7 wk on average; some hesitancy because of stress and being overwhelmed). All participants who consented to participate completed the entire study. All participants were female and aged 56 (SD 10.56) years on average. In total, 57% (4/7) of the participants were assigned to the intervention group. On average, intervention participants spent 12 minutes engaged in the VR simulation. In general, the intervention was rated favorably (eg, clear information, enjoyable, and attractive presentation; mean% agreement 95.00-96.25, SD 4.79-10.00) and as helpful (mean% agreement 87.50, SD 25.00). Participants described the intervention as realistic (eg, "It was realistic to my past surgical experiences"), impacting their degree of preparedness and expectations for surgery (eg, "The sounds and sights and procedures give you a test run; they prepare you for the actual day"), and having a calming or relaxing effect (eg, "You feel more relaxed for the surgery"). CONCLUSIONS This preoperative VR intervention demonstrated preliminary feasibility among a sample of patients undergoing breast cancer surgery. Results and participant feedback will inform modifications to the VR intervention and the study design of a large-scale randomized controlled trial to examine the efficacy of this intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT04544618; https://clinicaltrials.gov/study/NCT04544618.
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Affiliation(s)
- Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Hebbard
- Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
| | | | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - W Alan C Mutch
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jessica Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Leslie Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
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Benchimol-Elkaim B, Khoury B, Tsimicalis A. Nature-based mindfulness programs using virtual reality to reduce pediatric perioperative anxiety: a narrative review. Front Pediatr 2024; 12:1334221. [PMID: 38283632 PMCID: PMC10820709 DOI: 10.3389/fped.2024.1334221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Over 75% of pediatric surgery patients experience preoperative anxiety, which can lead to complicated recoveries. Current interventions are less effective for children over 12 years old. New interventions, like mindfulness-based ones (MBIs), are needed to address this issue. MBIs work well for reducing mental health symptoms in youth, but they can be challenging for beginners. Virtual reality (VR) nature settings can help bridge this gap, providing an engaging 3-D practice environment that minimizes distractions and enhances presence. However, no study has investigated the combined effects of mindfulness training in natural VR settings for pediatric surgery patients, creating a significant gap for a novel intervention. This paper aims to fill that gap by presenting a narrative review exploring the potential of a nature-based mindfulness program using VR to reduce pediatric preoperative anxiety. It begins by addressing the risks of anxiety in children undergoing surgery, emphasizing its impact on physical recovery, and supporting the use of VR for anxiety reduction in hospitals. The review then delves into VR's role in nature and mindfulness, discussing theoretical concepts, clinical applications, and effectiveness. It also examines how the combination of mindfulness, nature, and VR can create an effective intervention, supported by relevant literature. Finally, it synthesizes the existing literature's limitations, findings, gaps, and contradictions, concluding with research and clinical implications.
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Affiliation(s)
| | - Bassam Khoury
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Shriners Hospital for Children, Montreal, QC, Canada
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Can virtual reality reduce pain and anxiety in pediatric emergency care and promote positive response of parents of children? A quasi-experimental study. Int Emerg Nurs 2023. [DOI: 10.1016/j.ienj.2023.101268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Alcaraz Garcia-Tejedor G, Le M, Tackey T, Watkins J, Caldeira-Kulbakas M, Matava C. Experiences of Parental Presence in the Induction of Anesthesia in a Canadian Tertiary Pediatric Hospital: A Cross-Sectional Study. Cureus 2023; 15:e36246. [PMID: 36937125 PMCID: PMC10019788 DOI: 10.7759/cureus.36246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/18/2023] Open
Abstract
Background Parental presence at induction of anesthesia remains controversial and has been reported to provide mixed results. As such, parental presence at induction of anesthesia is not practiced routinely everywhere. There are currently limited data describing the practice of parental presence at induction of anesthesia or the experiences and perceptions of parents in Canada. Objectives We sought to investigate (1) the frequency of parental presence at induction of anesthesia and (2) the experiences and perceptions of parents accompanying their child into the operating room compared to those who did not at a tertiary Canadian pediatric hospital. Methods Institutional quality improvement approval was obtained. This study was a cross-sectional survey. Parents waiting in the parent surgical waiting room during the procedure were invited to complete a web-based survey. Consent was implied via completing the survey. The cross-sectional survey elicited the prevalence of parental presence during induction of anesthesia as well as their experience and perceptions. We also investigated the parents' preferences for preoperative education. Results Of the 448 parents approached, 403 completed the survey between May and June 2017. Sixty-eight (16.9% [13.4-20.9]) parents accompanied their child into the operating room (parental presence at induction of anesthesia), while 335/403 (83.1% [79.1-86.7]) did not (no-parental presence at induction of anesthesia). Reasons for not accompanying their child into the operating room included "not being aware they could" (158/335, 47.2% [41.9-52.5]), "I didn't think my child needed me" (107/335, 31.9% [27.2-37.1]), "my child was coping well" (46/335, 13.4% [10.5-17.8]), and "I was anxious" (47/335, 14.0% [10.7-18.2]). Most of the parents in the parental presence at induction of anesthesia cohort (66/67, 98.5% [95.6-101.2]) reported that they believed their child benefited/would have benefited from their presence during induction of anesthesia compared to those in the no-parental presence at induction of anesthesia cohort (137/335, 40.9% [35.8-46.2]), P < 0.001. Overall, 51/335 (14.7%) parents in the no-parental presence at induction of anesthesia cohort and 3/67 (4.5%) of those in the parental presence at induction of anesthesia cohort felt that offering parental presence at induction of anesthesia should depend on factors including child's age as well as the level of coping and anxiety. More patients in the no-parental presence at induction of anesthesia cohort felt that parental presence at induction of anesthesia should also depend on the child's age and whether the child was coping. Parents felt that face-to-face discussions with clinicians are most effective for discussing future parental presence at induction of anesthesia. Conclusions We have shown that most parents at our institution do not undergo parental presence at induction of anesthesia and are for the most part comfortable with their child going unaccompanied into the operating room. Administrators and clinicians seeking to implement parental presence policies should consider navigating parental presence at induction of anesthesia with evidence-based approaches tailored to each parent and their child.
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Affiliation(s)
| | - Matthew Le
- Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, CAN
| | - Theophilus Tackey
- Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, CAN
| | - Jessica Watkins
- Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, CAN
| | | | - Clyde Matava
- Anesthesiology and Pain Medicine, University of Toronto, Toronto, CAN
- Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, CAN
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Demblon MC, Bicknell C, Aufegger L. Systematic review of the development and effectiveness of digital health information interventions, compared with usual care, in supporting patient preparation for paediatric hospital care, and the impact on their health outcomes. FRONTIERS IN HEALTH SERVICES 2023; 3:1103624. [PMID: 37089454 PMCID: PMC10117991 DOI: 10.3389/frhs.2023.1103624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/14/2023] [Indexed: 04/25/2023]
Abstract
Background and aim Elective surgery can be overwhelming for children, leading to pre-operative anxiety, which is associated with adverse clinical and behavioural outcomes. Evidence shows that paediatric preparation digital health interventions (DHIs) can contribute to reduced pre-operative anxiety and negative behavioural changes. However, this evidence does not consider their design and development in the context of behavioural science. This systematic review used the Theoretical Domains Framework (TDF) to evaluate the design and development of DHIs used to support children up to 14 years of age and their parents, prepare for hospital procedures, and determine any correlation to health outcomes. It also considered whether any behavioural frameworks and co-production were utilised in their design. Methods A search of the MEDLINE, EMBASE, PsycINFO, and HMIC databases was carried out, looking for original, empirical research using digital paediatric preparation technologies to reduce pre-operative anxiety and behavioural changes. Limitations for the period (2000-2022), English language, and age applied. Results Seventeen studies were included, sixteen randomised control trials and one before and after evaluation study. The results suggest that paediatric preparation DHIs that score highly against the TDF are (1) associated with improved health outcomes, (2) incorporate the use of co-production and behavioural science in their design, (3) are interactive, and (4) are used at home in advance of the planned procedure. Conclusion Paediatric preparation DHIs that are co-produced and designed in the context of behavioural science are associated with reduced pre-operative anxiety and improved health outcomes and may be more cost-effective than other interventions. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022274182.
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Suleiman‐Martos N, García‐Lara RA, Membrive‐Jiménez MJ, Pradas‐Hernández L, Romero‐Béjar JL, Dominguez‐Vías G, Gómez‐Urquiza JL. Effect of a game-based intervention on preoperative pain and anxiety in children: A systematic review and meta-analysis. J Clin Nurs 2022; 31:3350-3367. [PMID: 35075716 PMCID: PMC9787560 DOI: 10.1111/jocn.16227] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/27/2021] [Accepted: 01/02/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non-invasive and non-pharmacological. AIMS To determine whether a game-based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients. METHODS A systematic review with meta-analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication. RESULTS 26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of -10.62 (95% CI -13.85, -7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game-based intervention, was recorded. CONCLUSIONS Game-based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients. RELEVANCE TO CLINICAL PRACTICE In children, preoperative management is a challenging task for healthcare professionals, and game-based strategies could enhance results, improving patients' emotional health and boosting post-surgery recovery. Distractive games-based procedures should be considered for incorporation in the pre-surgery clinical workflow in order to optimise healthcare.
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Croke L. Complementary Care Interventions to Reduce. AORN J 2022; 115:P9-P11. [PMID: 35616468 DOI: 10.1002/aorn.13703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Espinoza JC, Chin SW, Shah P, Tut M, Raymond JK. Proposing a Practical, Simplified Framework for Implementing Integrated Diabetes Data and Technology Solutions. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:867284. [PMID: 36992736 PMCID: PMC10012144 DOI: 10.3389/fcdhc.2022.867284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022]
Abstract
Diabetes is a uniquely quantifiable disease, and as technology and data have proliferated over the past two decades, so have the tools to manage diabetes. Patients and providers have at their disposal devices, applications, and data platforms that generate immense amounts of data, provide critical insights into a patient’s disease, and allow for personalization of treatment plans. However, the proliferation of options also comes with new burdens for providers: selecting the right tool, getting buy-in from leadership, defining the business case, implementation, and maintenance of the new technology. The complexity of these steps can be overwhelming and sometimes lead to inaction, depriving providers and patients of the advantages of technology-assisted diabetes care. Conceptually, the adoption of digital health solutions can be thought of as occurring in five interconnected phases: Needs Assessment, Solution Identification, Integration, Implementation, and Evaluation. There are a number of existing frameworks to help guide much of this process, but relatively little attention has been focused on integration. Integration is a critical phase for a number of contractual, compliance, financial, and technical processes. Missing a step or doing them out of order can lead to significant delays and potentially wasted resources. To address this gap, we have developed a practical, simplified framework for integrating diabetes data and technology solutions that can guide clinicians and clinical leaders on the critical steps in adopting and implementing a new technology.
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Affiliation(s)
- Juan C. Espinoza
- Division of General Pediatrics, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, United States
- Translational Informatics, Information Services Department, Children’s Hospital Los Angeles, Los Angeles, CA, United States
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Juan C. Espinoza,
| | - Steven W. Chin
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Division of Neonatology, Department of Pediatrics, Fetal and Neonatal Institute, Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - Payal Shah
- Division of General Pediatrics, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - Maurice Tut
- Translational Informatics, Information Services Department, Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - Jennifer K. Raymond
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Division of Endocrinology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, United States
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Ryu JH, Ko D, Han JW, Park JW, Shin A, Han SH, Kim HY. The proper timing of virtual reality experience for reducing preoperative anxiety of pediatric patients: A randomized clinical trial. Front Pediatr 2022; 10:899152. [PMID: 36177450 PMCID: PMC9514542 DOI: 10.3389/fped.2022.899152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/09/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The virtual reality (VR) experience of an operation room (OR) prior to anesthesia and surgery has been known to reduce the anxiety and distress of pediatric patients. However, the proper timing needed for this is unknown. This randomized clinical study aimed to evaluate the proper timing of a VR tour of an OR (a few days before vs. immediately before anesthesia) to reduce the anxiety in a pediatric patient undergoing elective surgery. METHODS The children from the ages of 4-10 years old were randomly divided into three groups. The control group received standard verbal information about the process of anesthesia and surgery 10 min before anesthesia. The VR A group experienced a VR tour at the outpatient clinic a few days before anesthesia, whereas the VR B group experienced the tour 10 min before anesthesia at the reception area of the OR. The 4-min VR video used in this study showed the experience of Pororo, an animation character, entering the OR and undergoing anesthesia. We evaluated the anxiety of children using the modified Yale preoperative anxiety scale (m-YPAS), the anxiety of caregivers using Beck anxiety inventory (BAI), and caregivers' satisfaction. RESULTS The m-YPAS of the VR B group was significantly lower than that of the control and VR A groups (p = 0.001), whereas there was no statistically significant difference in BAI (p = 0.605) among the 3 groups. The score of caregivers' satisfaction with the overall process of anesthesia and surgery was higher in VR A group than in the control and VR B groups (p = 0.054). CONCLUSION The VR experience of an OR immediately before anesthesia was more effective than standard verbal information or a VR tour at the outpatient clinic a few days before anesthesia in reducing the anxiety and distress of children prior to surgery. CLINICAL TRIAL REGISTRATION [https://cris.nih.go.kr/cris/search/detailSearch.do/20773], identifier [KCT0006845].
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Affiliation(s)
- Jung-Hee Ryu
- Medical Virtual Reality Research Group, Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dayoung Ko
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, South Korea
| | - Ji-Won Han
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, South Korea
| | - Jin-Woo Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Sung-Hee Han
- Medical Virtual Reality Research Group, Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, South Korea.,Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
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