Virtual Reality in Clinical Practice and Research: Viewpoint on Novel Applications for Nursing

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Abstract

Virtual reality is a novel technology that provides users with an immersive experience in 3D virtual environments. The use of virtual reality is expanding in the medical and nursing settings to support treatment and promote wellness. Nursing has primarily used virtual reality for nursing education, but nurses might incorporate this technology into clinical practice to enhance treatment experience of patients and caregivers. Thus, it is important for nurses to understand what virtual reality and its features are, how this technology has been used in the health care field, and what future efforts are needed in practice and research for this technology to benefit nursing. In this article, we provide a brief orientation to virtual reality, describe the current application of this technology in multiple clinical scenarios, and present implications for future clinical practice and research in nursing.

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Dennis C Turk, Hilary D Wilson, Alex Cahana (2011)

Chronic pain is a pervasive problem that affects the patient, their significant others, and society in many ways. The past decade has seen advances in our understanding of the mechanisms underlying pain and in the availability of technically advanced diagnostic procedures; however, the most notable therapeutic changes have not been the development of novel evidenced-based methods, but rather changing trends in applications and practices within the available clinical armamentarium. We provide a general overview of empirical evidence for the most commonly used interventions in the management of chronic non-cancer pain, including pharmacological, interventional, physical, psychological, rehabilitative, and alternative modalities. Overall, currently available treatments provide modest improvements in pain and minimum improvements in physical and emotional functioning. The quality of evidence is mediocre and has not improved substantially during the past decade. There is a crucial need for assessment of combination treatments, identification of indicators of treatment response, and assessment of the benefit of matching of treatments to patient characteristics. Copyright © 2011 Elsevier Ltd. All rights reserved.

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Factors Associated With Virtual Reality Sickness in Head-Mounted Displays: A Systematic Review and Meta-Analysis

Dimitrios Saredakis, Ancret Szpak, Brandon J. Birckhead … (2020)

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate, however, VR content also plays a significant role. The primary objective of this systematic review and meta-analysis was to examine the literature on HMDs that report Simulator Sickness Questionnaire (SSQ) scores to determine the impact of content. User factors associated with VR sickness were also examined. A systematic search was conducted according to PRISMA guidelines. Fifty-five articles met inclusion criteria, representing 3,016 participants (mean age range 19.5–80; 41% female). Findings show gaming content recorded the highest total SSQ mean 34.26 (95%CI 29.57–38.95). VR sickness profiles were also influenced by visual stimulation, locomotion and exposure times. Older samples (mean age ≥35 years) scored significantly lower total SSQ means than younger samples, however, these findings are based on a small evidence base as a limited number of studies included older users. No sex differences were found. Across all types of content, the pooled total SSQ mean was relatively high 28.00 (95%CI 24.66–31.35) compared with recommended SSQ cut-off scores. These findings are of relevance for informing future research and the application of VR in different contexts.

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Recommendations for Methodology of Virtual Reality Clinical Trials in Health Care by an International Working Group: Iterative Study

Brandon J. Birckhead, Carine Khalil, Xiaoyu Liu … (2019)

Background Therapeutic virtual reality (VR) has emerged as an efficacious treatment modality for a wide range of health conditions. However, despite encouraging outcomes from early stage research, a consensus for the best way to develop and evaluate VR treatments within a scientific framework is needed. Objective We aimed to develop a methodological framework with input from an international working group in order to guide the design, implementation, analysis, interpretation, and communication of trials that develop and test VR treatments. Methods A group of 21 international experts was recruited based on their contributions to the VR literature. The resulting Virtual Reality Clinical Outcomes Research Experts held iterative meetings to seek consensus on best practices for the development and testing of VR treatments. Results The interactions were transcribed, and key themes were identified to develop a scientific framework in order to support best practices in methodology of clinical VR trials. Using the Food and Drug Administration Phase I-III pharmacotherapy model as guidance, a framework emerged to support three phases of VR clinical study designs—VR1, VR2, and VR3. VR1 studies focus on content development by working with patients and providers through the principles of human-centered design. VR2 trials conduct early testing with a focus on feasibility, acceptability, tolerability, and initial clinical efficacy. VR3 trials are randomized, controlled studies that evaluate efficacy against a control condition. Best practice recommendations for each trial were provided. Conclusions Patients, providers, payers, and regulators should consider this best practice framework when assessing the validity of VR treatments.

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Author and article information

Contributors

Hyojin Son:

ORCID: https://orcid.org/0000-0002-3988-7492

Translational Biobehavioral and Health Disparities BranchNational Institutes of Health Clinical Center10 Center DriveBethesda, MD, 20892United States1 667 701 5768hyojin.son@nih.gov

Journal

Journal ID (nlm-ta): JMIR Nurs

Journal ID (iso-abbrev): JMIR Nurs

Journal ID (publisher-id): JN

Title: JMIR Nursing

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2562-7600

Publication date Collection: Jan-Dec 2022

Publication date (Electronic): 16 March 2022

Volume: 5

Issue: 1

Electronic Location Identifier: e34036

Affiliations

[1 ] Translational Biobehavioral and Health Disparities Branch National Institutes of Health Clinical Center Bethesda, MD United States

Author notes

Corresponding Author: Hyojin Son hyojin.son@ 123456nih.gov

Author information

Hyojin Son https://orcid.org/0000-0002-3988-7492

Alyson Ross https://orcid.org/0000-0003-1600-6645

Elizabeth Mendoza-Tirado https://orcid.org/0000-0002-9486-8411

Lena Jumin Lee https://orcid.org/0000-0002-2086-993X

Article

Publisher ID: v5i1e34036

DOI: 10.2196/34036

PMC ID: 8968556

PubMed ID: 35293870

SO-VID: d5b808e9-2698-472d-9c17-43f807c4b8c7

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Nursing, is properly cited. The complete bibliographic information, a link to the original publication on https://nursing.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 4 October 2021

Date revision requested : 30 November 2021

Date accepted : 10 December 2021

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