A virtual reality home-based training for the management of stress and anxiety among healthcare workers during the COVID-19 pandemic: study protocol for a randomized controlled trial.

BACKGROUND: Healthcare workers represent one of the most affected categories by the adverse effects of the COVID-19 pandemic on mental health. Excessive stress and anxiety are critical factors that could compromise work performance. Besides, high levels of stress and anxiety may have long-term physical and psychological consequences. Recent studies investigated virtual reality to reduce stress and anxiety among healthcare workers during the COVID-19 pandemic. However, the proposed virtual reality interventions have important limitations related to their location (i.e., research lab and hospitals) and content (i.e., virtual experiences only for relaxation). Within this context, this randomized controlled trial aims to investigate the efficacy and acceptability of a brief home-based virtual reality training for managing stress and anxiety during the COVID-19 crisis in a sample of Italian healthcare workers. METHODS: The study is a randomized controlled trial. It includes two groups of 30 individuals recruited from healthcare workers: (1) the experimental group and (2) the control group. Participants in the experimental group will receive a training consisting of three home sessions performed in a week. In each session, participants will try through an immersive virtual reality standalone system (i.e., Oculus Quest 2) a virtual psychoeducation experience on stress and anxiety (i.e., MIND-VR). Subsequently, they will try the virtual relaxation content (i.e., The Secret Garden). The control group will receive no training and will be reassessed one week and one month after the initial evaluation. DISCUSSION: If the proposed brief home-based virtual reality training will result helpful and easy to use, it could become an empirically assessed viable option for protecting healthcare workers' mental health both during the COVID-19 pandemic and once it will be over. Furthermore, the intervention might be easily adapted for other categories of people who need support in managing stress and anxiety. TRIAL REGISTRATION: ClinicalTrials.gov NCT04611399 .

Effects of direct laryngoscopy versus Glidescope videolaryngoscopy on subjective and objective measures of cognitive workload: an in-vivo randomized trial.

BACKGROUND: Laryngoscopy and tracheal intubation are associated with high operators' workload, which potentially causes lower performance and risk of errors. Measuring anesthesiologists' mental workload during instrumental procedures allows to test the usability of the devices and, by managing operators' workload, improve clinical decision making. The aim of this study was to investigate the differences in subjective and objective cognitive workload between videolaryngoscopy with hyperangulated blade (Glidescope) vs. direct laryngoscopy in a real clinical setting. METHODS: Fourteen anesthesiologists were enrolled and performed three intubations for each device, a Glidescope videolaryngoscope (Verathon Inc., Schiltigheim, France) and a Macintosh (Apple Inc., Cupertino, CA, USA) direct laryngoscope, in a random order. The subjective workload was assessed with the NASA Task Load Index questionnaire right after intubation and reaction times to a secondary task were recorded during laryngoscopy and intubation as an objective measure of workload. RESULTS: The overall perceived workload (P<0.001) and the subscales of physical demand (P<0.001) and effort (P<0.001) were lower during Glidescope than during Macintosh laryngoscopy. Reaction times were faster during Glidescope than during Macintosh laryngoscopy (P<0.014). A significant positive correlation was found between reaction times and the overall perceived workload (P<0.001). CONCLUSIONS: A videolaryngoscope with hyperangluated blade used in a real clinical scenario of elective surgery significantly reduced both subjective and objective workload compared to a direct laryngoscope. Physical demand and effort were the key components in reducing operators' mental workload. Therefore, the expert use of a videolaryngoscope with hyperangulated blade constitutes an ergonomic option that could limit operators' workload and improve patients' safety and operators' well-being.