Effects of Restorative Environment and Presence on Anxiety and Depression Based on Interactive Virtual Reality Scenarios

An evaluation of radiographers' extended practice in the detection of brain metastases on magnetic resonance images

INTRODUCTION

Patients who undergo magnetic resonance (MR) imaging to confirm or rule out metastatic brain disease are required to wait for image review by a radiologist before leaving the department at the institute where this study was carried out. The aim was to evaluate whether radiographers can review images and reduce waiting times in those patients without metastases.

METHODS

Prospective observational study of MR radiographers (n = 11) was undertaken. Radiographers commented on images to confirm whether the images showed evidence of metastatic disease, pathology but no metastases, or no pathology. Responses were compared to the radiological report (reference standard). Online questionnaires determined the views and opinions of radiographers (n = 8) and consultant radiologists (n = 6) towards radiographers expanding their scope of practice to include the confirmation or exclusion of brain metastases.

RESULTS

Despite a lack of formal training for image reviewing, overall level of agreement between the radiographer reviews and reference standard was 77.9 % (κ = 0.45). Pooled sensitivity and specificity were 88.6 % & 71.3 % respectively. Kendall's τ = -0.03 (bootstrap 95 % CI -0.73 to 0.61, p = 0.925). Positive predictive value (PPV) was 65.5 % (CI 59.2%-71.4 %) and negative predictive value (NPV) 91.1 % (CI 84.9%-94.9 %). Radiographers and radiologists surveyed demonstrated a willingness to engage with role expansion.

CONCLUSION

Based on our small study and interdisciplinary survey, local radiographers and radiologists agree, following a program of radiographer training, screening for brain metastases by radiographers could be implemented.

IMPLICATIONS FOR PRACTICE

With appropriate governance and training support, the introduction of formal radiographer screening for patients referred to exclude brain metastases could provide more efficient working practice.

A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression

This systematic review aims to assess the effectiveness of virtual reality (VR) and gamification interventions in addressing anxiety and depression. The review also seeks to identify gaps in the current VR treatment landscape and provide guidelines for future research and development. A systematic literature search was conducted using Scopus, Web of Science, and PubMed databases, focusing on studies that utilized VR and gamification technology to address anxiety and depression disorders. A total of 2,664 studies were initially identified, 15 of those studies fulfilled the inclusion criteria for this systematic review. The efficacy of VR in addressing anxiety and depression was evident across all included studies. However, the diversity among VR interventions highlights the need for further investigation. It is advised to incorporate more diverse participant samples and larger cohorts and explore a broader spectrum of therapeutic approaches within VR interventions for addressing anxiety and depression to enhance the credibility of future research. Additionally, conducting studies in varying socioeconomic contexts would contribute to a more comprehensive understanding of their real-world applicability.

Research on patient-centered design for post-stroke depression patients based on SEM and comprehensive evaluation

Introduction

Since COVID-19, medical resources have been tight, making it inconvenient to go offline for the sequelae of diseases such as post-stroke depression (PSD) that require long-term follow-up. As a new digital therapy, VRTL began to gain popularity.

Method

The research is divided into two parts: pre-test and post-test. In the pre-test, an evaluation method integrating reality-based interaction (RBI), structural equation model (SEM), analytic hierarchy process (AHP), and entropy weight method is proposed. In the post-test the patients' physiological indicators (Diastolic blood pressure, systolic blood pressure and heart rate) are measured to verify the effectiveness of RBI-SEM model using T-test method.

Results

In the pre-test, using SEM, it was confirmed that P_i physical awareness, B_i body awareness, E_i environmental awareness, and S_i social awareness were significantly correlated and positively affected VRTL satisfaction (p >> F 0.217; B >> F 0.130; E >> F 0.243; S >> F 0.122). The comprehensive weight ranking based on RBI-SEM considered light environment (0.665), vegetation diversity (0.667), accessible roaming space (0.550) et al. relatively of importance. And T-tset in the post-test experiment considered that the data of the two measurements before and after the VRTL experience, systolic blood pressure (p < 0.01), diastolic blood pressure (p < 0.01), and blood pressure (p < 0.01) were significantly decreased; one-way ANOVA concluded that there was no significant difference in the changes of blood pressure and heart rate among participants of different ages and genders (p > 0.01).

Conclusion

This research validated the effectiveness of RBI theory for VRTL design guidelines, established an RBI-SEM based VRTL evaluation model, and the output VRTL for PSD in the older adults was confirmed to have significant therapeutic benefits. This lays the foundation for designers to decompose design tasks and integrate VRTL into traditional clinical treatment systems.

Contribution from the public or patients

Four public health department employees helped to improve the research's content.