Use of virtual reality in preoperative education of cardiac surgery patients - A feasibility study.

OBJECTIVE: A Virtual Patient Tour (VPT) was developed to inform cardiac surgery patients about their hospitalization from the admission to their postoperative stay on the ward. The objective of our study was to assess the feasibility and acceptability of this VPT following the framework of the Virtual Reality Clinical Outcomes Research Experts Committee. METHODS: In this single-centre cross-sectional study, adult patients admitted to the hospital for elective cardiac surgery were included. Acceptability, usability, and tolerability were measured by the validated questionnaires Unified Theory of Acceptance and Use of Technology (acceptability), System Usability Scale (usability), and Virtual Reality Sickness Questionnaire (tolerability). Descriptive statistics were used for the analysis. RESULTS: Twenty-eight participants used the VPT. Results showed high acceptability (mean 16.7 ± 1.5), acceptable usability (mean 86.7 ± 9.3), and high tolerability (sickness score, median 7.1 % [0-17.1 %]). CONCLUSION: The use of the VPT is a feasible and promising technique. The next step is to optimize the content and technique of the VPT based on the suggestions of the participants. PRACTICE IMPLICATIONS: We recommend incorporating the VPT into preoperative patient education in addition to the routine information in cardiac surgery patients.

The association of resilience with self-care and quality of life in people with chronic obstructive pulmonary disease: A cross-sectional study.

AIM: To investigate the association of resilience with self-care and quality of life in people with chronic obstructive pulmonary disease. DESIGN: Cross-sectional study. METHODS: Data were collected between February and May 2021. Self-care was measured with the self-care of chronic illness inventory, quality of life was measured with the clinical chronic obstructive pulmonary disease questionnaire and resilience was measured with the resilience evaluation scale. Possible confounders were included (sex, age, smoking, time since diagnosis of chronic obstructive pulmonary disease, educational level, social support and pulmonary function). Multiple regression analysis was performed among the determinants, confounders and both outcomes. RESULTS: Participants scored fairly well on resilience (mean 22.5). Self-care scored reasonably well (mean maintenance 65.9, mean monitoring 70.9, mean management 59.9 and mean confidence 71.5). Quality of life scored mediocre (mean 2.6). The results of the linear multiple regression were resilience, which is associated with self-care confidence and quality of life when adjusted for possible confounders. This means people with chronic obstructive pulmonary disease with higher resilience have better self-care confidence and higher quality of life. The outcome contributes to strengthening nursing care and further developing nurses' knowledge. The results can contribute to increasing awareness for healthcare professionals that resilience can potentially increase self-care and quality of life.

The use of virtual reality in patient education related to medical somatic treatment: A scoping review.

OBJECTIVE: To map the available evidence on the context, content and outcome of VR in patient education in situations related to preparation for medical somatic treatment. METHODS: A Scoping review. In October 2020, the Embase, CINAHL, MEDLINE and PsycINFO databases were searched with the terms 'Virtual Reality' and 'Patient Education'. The literature was synthesised and mapped with a narrative approach. RESULTS: 17 studies published between 2015 and 2020 were included in the qualitative synthesis. VR was applied in (paediatric) surgery and radiation therapy treatment. VR interventions were heterogeneous regarding technical applications, context of implementation, guidance by healthcare professionals and integration in education sessions. Anxiety reduction was demonstrated significantly in some studies. Patients experienced VR education useful; it enhanced understanding, improved communication with healthcare professionals and encouraged treatment compliance. CONCLUSIONS: The application of VR in patient education is a promising technology. Patients are highly satisfied and experience enhanced understanding. VR education was not effective in reducing all anxiety, pain and stress and improving preparedness for treatment. Practice implications It is important to develop VR interventions profoundly. The application of a methodological framework for VR development is recommended. Involve patients, educationalists and technology professionals in the development of technology interventions.

Patients' voices in the development of pre-surgical patient education using virtual reality: A qualitative study.

Objective: To identify the information needs and perceptions of patients regarding the application of virtual reality in pre-surgical patient education. Methods: A qualitative study was conducted between March and July 2020. The study population consisted of a purposive sample of patients scheduled for cardiac surgery from a single institution. Semi-structured individual interviews (n=19) were conducted and analysed using thematic analysis. Results: Patient perceptions regarding virtual reality and information needs related to hospitalisation and surgery could be categorised into three themes: Creating familiarity, contents to explore and challenges and preconditions. Conclusions: Virtual reality technology is a promising tool that can enhance conventional patient education to improve understanding and to potentially reduce concerns and anxieties. The virtual reality environment creates an opportunity for patients to be in control of the timing, quantity, depth and frequency of patient education. A virtual reality education tool should not be a substitute for personal contact with the physician. Innovation: Patient information needs were identified profoundly to the further development of a virtual reality intervention. This intervention aims to educate patients prior to elective cardiac surgery.