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      The effect of virtual reality on anxiety, stress, and hemodynamic parameters during cesarean section : A randomized controlled clinical trial

      research-article
      , PhD, , PhD , , PhD, , BSc
      Saudi Medical Journal
      Saudi Medical Journal
      anxiety, caesarian section, hemodynamic, stress

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          Abstract

          Objectives:

          To investigate the effect of virtual reality (VR) on anxiety, stress, and hemodynamic parameters during cesarean section (CS).

          Methods:

          This is a randomized controlled clinical trial conducted at the operating theatre / Maternal and Children Hospital, Najran, Saudi Arabia from February to October 2021. The study comprised a random sample of 351(176 study and 175 control) low-risk pregnant women undergoing elective CS with regional anesthesia. Data collection was carried out using 5 instruments. Basic and clinical data sheet, maternal hemodynamic parameters assessment sheet, brief measure of preoperative emotional stress, a novel visual facial anxiety scale, and maternal satisfaction scale. Virtual reality group exposed to 3D natural videos associated with calm Quran or music voices via phone using VR glasses immediately after anesthesia until completion of skin suture. The control group left for routine hospital care.

          Results:

          The VR group showed significantly lower stress and anxiety levels immediately after skin suture and 2h postoperative ( p=0.000). Maternal satisfaction 2 hours after CS showed that 58% of the VR group were completely satisfied compared to 11.3% of the control group (FET=135.359 p=0.000). Virtual reality have an impact on hemodynamic parameters at some time points while peripheral oxygen saturation did not differ significantly ( p>0.05).

          Conclusion:

          Virtual reality significantly reduced anxiety and stress among women undergoing CS under regional anesthesia. Virtual reality may be added to the routine intraoperative techniques that help induce patient relaxation and increase satisfaction.

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          Most cited references39

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          The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders

          Virtual reality, or VR, allows users to experience a sense of presence in a computer-generated three-dimensional environment. Sensory information is delivered through a head mounted display and specialized interface devices. These devices track head movements so that the movements and images change in a natural way with head motion, allowing for a sense of immersion. VR allows for controlled delivery of sensory stimulation via the therapist and is a convenient and cost-effective treatment. The primary focus of this article is to review the available literature regarding the effectiveness of incorporating VR within the psychiatric treatment of a wide range of psychiatric disorders, with a specific focus on exposure-based intervention for anxiety disorders. A systematic literature search was conducted in order to identify studies implementing VR based treatment for anxiety or other psychiatric disorders. This review will provide an overview of the history of the development of VR based technology and its use within psychiatric treatment, an overview of the empirical evidence for VR based treatment, the benefits for using VR for psychiatric research and treatment, recommendations for how to incorporate VR into psychiatric care, and future directions for VR based treatment and clinical research.
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            What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies

            In 1985, WHO stated that there was no justification for caesarean section (CS) rates higher than 10–15 % at population-level. While the CS rates worldwide have continued to increase in an unprecedented manner over the subsequent three decades, concern has been raised about the validity of the 1985 landmark statement. We conducted a systematic review to identify, critically appraise and synthesize the analyses of the ecologic association between CS rates and maternal, neonatal and infant outcomes. Four electronic databases were searched for ecologic studies published between 2000 and 2014 that analysed the possible association between CS rates and maternal, neonatal or infant mortality or morbidity. Two reviewers performed study selection, data extraction and quality assessment independently. We identified 11,832 unique citations and eight studies were included in the review. Seven studies correlated CS rates with maternal mortality, five with neonatal mortality, four with infant mortality, two with LBW and one with stillbirths. Except for one, all studies were cross-sectional in design and five were global analyses of national-level CS rates versus mortality outcomes. Although the overall quality of the studies was acceptable; only two studies controlled for socio-economic factors and none controlled for clinical or demographic characteristics of the population. In unadjusted analyses, authors found a strong inverse relationship between CS rates and the mortality outcomes so that maternal, neonatal and infant mortality decrease as CS rates increase up to a certain threshold. In the eight studies included in this review, this threshold was at CS rates between 9 and 16 %. However, in the two studies that adjusted for socio-economic factors, this relationship was either weakened or disappeared after controlling for these confounders. CS rates above the threshold of 9–16 % were not associated with decreases in mortality outcomes regardless of adjustments. Our findings could be interpreted to mean that at CS rates below this threshold, socio-economic development may be driving the ecologic association between CS rates and mortality. On the other hand, at rates higher than this threshold, there is no association between CS and mortality outcomes regardless of adjustment. The ecological association between CS rates and relevant morbidity outcomes needs to be evaluated before drawing more definite conclusions at population level. Electronic supplementary material The online version of this article (doi:10.1186/s12978-015-0043-6) contains supplementary material, which is available to authorized users.
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              Is Virtual Reality Ready for Prime Time in the Medical Space? A Randomized Control Trial of Pediatric Virtual Reality for Acute Procedural Pain Management

              To conduct a randomized control trial to evaluate the feasibility and efficacy of virtual reality (VR) compared with standard of care (SOC) for reducing pain, anxiety, and improving satisfaction associated with blood draw in children ages 10-21 years.
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                Author and article information

                Journal
                Saudi Med J
                Saudi Med J
                smj
                SAMJDI
                Saudi Medical Journal
                Saudi Medical Journal
                0379-5284
                1658-3175
                April 2022
                : 43
                : 4
                : 360-369
                Affiliations
                From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim), Nursing College Najran University; and from the Department of Obstetrics and Gynecology (Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
                Author notes
                Address correspondence and reprint request to: Dr. Wafaa T. Elgzar, Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran, Kingdom of Saudi Arabia. E-mail: wafaa.elgzar@ 123456nur.dmu.edu.eg ORCID ID: https://orcid.org/0000-0002-2866-3119
                Article
                SaudiMedJ-43-360
                10.15537/smj.2022.43.4.20210921
                9998068
                35414614
                9d7f75c5-0910-44c1-b883-9519f104f003
                Copyright: © Saudi Medical Journal

                This is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work.

                History
                : 23 December 2021
                : 21 March 2022
                Categories
                Original Article

                anxiety,caesarian section,hemodynamic,stress
                anxiety, caesarian section, hemodynamic, stress

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