背景:虚拟现实(VR)越来越被认为是痴呆症患者的有价值的治疗工具。然而,仍然需要严格的研究来评估其对痴呆症的行为和心理症状(BPSD)以及护理环境中的生活质量(QoL)的影响.
目的:本研究的主要目的是评估VR疗法对管理BPSD的影响,falls,逗留时间,住院痴呆症患者的QoL和QoL被送往急性护理医院。次要目的是在可接受性方面评估干预措施的可行性,安全,和病人的经验。
方法:前瞻性,开放标签,混合方法,随机对照临床试验于2019年4月至2020年3月期间进行.共有69名参与者(年龄≥65岁,诊断为痴呆症且不符合排除标准)被随机分配到对照组(n=35,51%)或VR组(n=34,49%)。研究人员拜访了实验(VR)手臂的参与者,并在头戴式显示器上观看了360°VR电影,每1至3天观看20分钟,而对照组的个体接受标准治疗.从护士的每日笔记中收集每日BPSD和跌倒的实例。QoL是通过半结构化访谈和晚期痴呆症量表中的生活质量来测量的。结构化观察和半结构化访谈用于衡量治疗可行性。根据意向治疗方法,以95%的显著性水平分析主要结果。
结果:VR疗法对降低侵袭性具有统计学上的显着影响(即,身体攻击性和大声叫喊;P=.01)。VR治疗对其他BPSD没有发现实质性影响(例如,冷漠),falls,逗留时间,或使用晚期痴呆症生活质量量表测量的QoL。平均VR治疗疗程持续6.8(SD6.6;范围0-20)分钟,对于参与者来说,干预措施总体上是一种可接受且令人愉快的体验.VR治疗没有发生不良事件。
结论:沉浸式VR疗法似乎对急性护理痴呆患者的攻击行为有影响。尽管由于COVID-19的限制,随机对照试验在达到预期样本量之前就停止了,结果的趋势是有希望的。我们建议用更大的样本进行未来的试验,在某些情况下,更敏感的数据收集工具。
背景:ClinicalTrials.govNCT03941119;https://clinicaltrials.gov/study/NCT03941119。
■RR2-10.2196/22406。
BACKGROUND: Virtual reality (VR) is increasingly considered a valuable therapeutic tool for people with dementia. However, rigorous studies are still needed to evaluate its impact on behavioral and psychological symptoms of dementia (BPSDs) and quality of life (QoL) across care settings.
OBJECTIVE: The primary aim of this
study was to evaluate the impact of VR therapy on managing BPSDs, falls, length of stay, and QoL in inpatients with dementia admitted to an acute care hospital. The secondary aim was to evaluate the intervention\'s feasibility in terms of acceptability, safety, and patient experience.
METHODS: A prospective, open-label, mixed methods, randomized controlled clinical
trial was conducted between April 2019 and March 2020. A total of 69 participants (aged ≥65 years with a diagnosis of dementia and who did not meet the exclusion criteria) were randomly assigned to either the control (n=35, 51%) or VR (n=34, 49%) arm. Participants in the experimental (VR) arm were visited by a researcher and watched 360° VR films on a head-mounted display for up to 20 minutes every 1 to 3 days, whereas individuals in the control arm received standard of care. Instances of daily BPSDs and falls were collected from nurses\' daily notes. QoL was measured through semistructured interviews and the Quality of Life in Late-Stage Dementia scale. Structured observations and semistructured interviews were used to measure treatment feasibility. The primary outcomes were analyzed at a 95% significance level based on the intention-to-treat method.
RESULTS: VR therapy had a statistically significant effect on reducing aggressiveness (ie, physical aggression and loud vociferation; P=.01). Substantial impact of VR therapy was not found for other BPSDs (eg, apathy), falls, length of stay, or QoL as measured using the Quality of Life in Late-Stage Dementia scale. The average VR therapy session lasted 6.8 (SD 6.6; range 0-20) minutes, and the intervention was overall an acceptable and enjoyable experience for participants. No adverse events occurred as a result of VR therapy.
CONCLUSIONS: Immersive VR therapy appears to have an effect on aggressive behaviors in patients with dementia in acute care. Although the randomized controlled
trial was stopped before reaching the intended sample size owing to COVID-19 restrictions, trends in the results are promising. We suggest conducting future trials with larger samples and, in some cases, more sensitive data collection instruments.
BACKGROUND: ClinicalTrials.gov NCT03941119; https://clinicaltrials.gov/
study/NCT03941119.
UNASSIGNED: RR2-10.2196/22406.