Abstract：
OBJECTIVE: Virtual reality (VR) can enhance engagement in outpatient physical therapy (PT) through distraction and gamification of movement. This study assessed barriers and facilitators to VR-enhanced PT.
METHODS: Data were collected during a feasibility trial of VR-enhanced PT for youth with chronic musculoskeletal pain. Semistructured and informal interviews were conducted with youth participants, their caregivers, and collaborating physical therapists. To analyze transcriptions, content analysis was employed in multiple rounds. Barriers and facilitators to VR implementation were coded using a deductive approach, then an inductive approach was used to identify emergent themes within each deductive code category.
RESULTS: We completed interviews with youth participants (n = 9), caregivers (n = 7), and clinician stakeholders (n = 5). Coded barriers included: (1) participant identity and self-narrative inconsistent with the intervention, (2) system-level, structural constraints of healthcare, (3) lack of guidance and leadership from clinicians around VR use, (4) research burnout, (5) expectation violation and disappointment, and (6) missing the optimal treatment window. Coded facilitators included: (1) viewing VR as a bridge to achieving treatment goals, (2) having access to resources, (3) sustained positive experience and immersion in the game, (4) alignment between identity and the intervention, and (5) champion-level collaborations.
CONCLUSIONS: This study highlights the importance of considering the VR technology, person using the VR, and the context in which VR is being implemented to optimize uptake and acceptability. Adopting an implementation science lens to the field of VR for chronic pain will enhance the applicability and scale of impact.
METHODS: Data were collected during a feasibility trial of VR-enhanced PT for youth with chronic musculoskeletal pain. Semistructured and informal interviews were conducted with youth participants, their caregivers, and collaborating physical therapists. To analyze transcriptions, content analysis was employed in multiple rounds. Barriers and facilitators to VR implementation were coded using a deductive approach, then an inductive approach was used to identify emergent themes within each deductive code category.
RESULTS: We completed interviews with youth participants (n = 9), caregivers (n = 7), and clinician stakeholders (n = 5). Coded barriers included: (1) participant identity and self-narrative inconsistent with the intervention, (2) system-level, structural constraints of healthcare, (3) lack of guidance and leadership from clinicians around VR use, (4) research burnout, (5) expectation violation and disappointment, and (6) missing the optimal treatment window. Coded facilitators included: (1) viewing VR as a bridge to achieving treatment goals, (2) having access to resources, (3) sustained positive experience and immersion in the game, (4) alignment between identity and the intervention, and (5) champion-level collaborations.
CONCLUSIONS: This study highlights the importance of considering the VR technology, person using the VR, and the context in which VR is being implemented to optimize uptake and acceptability. Adopting an implementation science lens to the field of VR for chronic pain will enhance the applicability and scale of impact.
摘要：
目的：虚拟现实（VR）可以通过分散注意力和运动游戏化来增强门诊物理治疗（PT）的参与度。这项研究评估了VR增强PT的障碍和促进因素。
方法：在VR增强PT治疗青年慢性肌肉骨骼疼痛的可行性试验中收集数据。对青年参与者进行了半结构化和非正式的访谈，他们的照顾者，和合作的物理治疗师。要分析转录，在多轮中采用了内容分析.VR实施的障碍和促进者使用演绎方法进行编码，然后使用归纳法来识别每个演绎代码类别中的紧急主题。
结果：我们完成了对青年参与者的访谈（n=9），护理人员（n=7），和临床医生利益相关者(n=5)。编码障碍包括：(1)参与者身份和自我叙事与干预不一致，(2)系统级,医疗保健的结构性约束，(3)缺乏临床医生对VR使用的指导和领导,(4)研究倦怠,（5）期望违背和失望，和(6)缺少最佳处理窗口。编码的促进者包括：（1）将VR视为实现治疗目标的桥梁，(2)获得资源；（3）持续的积极体验和沉浸在游戏中，(4)身份认同与介入之间的一致性，和（5）冠军级合作。
结论：这项研究强调了考虑VR技术的重要性，使用VR的人，以及正在实施VR以优化摄取和可接受性的背景。将实施科学镜头应用于VR领域的慢性疼痛将增强影响的适用性和规模。
方法：在VR增强PT治疗青年慢性肌肉骨骼疼痛的可行性试验中收集数据。对青年参与者进行了半结构化和非正式的访谈，他们的照顾者，和合作的物理治疗师。要分析转录，在多轮中采用了内容分析.VR实施的障碍和促进者使用演绎方法进行编码，然后使用归纳法来识别每个演绎代码类别中的紧急主题。
结果：我们完成了对青年参与者的访谈（n=9），护理人员（n=7），和临床医生利益相关者(n=5)。编码障碍包括：(1)参与者身份和自我叙事与干预不一致，(2)系统级,医疗保健的结构性约束，(3)缺乏临床医生对VR使用的指导和领导,(4)研究倦怠,（5）期望违背和失望，和(6)缺少最佳处理窗口。编码的促进者包括：（1）将VR视为实现治疗目标的桥梁，(2)获得资源；（3）持续的积极体验和沉浸在游戏中，(4)身份认同与介入之间的一致性，和（5）冠军级合作。
结论：这项研究强调了考虑VR技术的重要性，使用VR的人，以及正在实施VR以优化摄取和可接受性的背景。将实施科学镜头应用于VR领域的慢性疼痛将增强影响的适用性和规模。
