An Immersive Virtual Reality Intervention for Preoperative Anxiety and Distress Among Adults Undergoing Oncological Surgery: Protocol for a 3-Phase Development and Feasibility Trial.

Autor:	El-Gabalawy R; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada.; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada.; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.; CancerCare Manitoba, Winnipeg, MB, Canada.; Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada., Sommer JL; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada.; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada., Hebbard P; CancerCare Manitoba, Winnipeg, MB, Canada.; Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States., Reynolds K; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.; Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada., Logan GS; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada., Smith MSD; National Research Council of Canada, Winnipeg, MB, Canada., Mutter TC; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada., Mutch WA; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada., Mota N; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada.; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.; Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada., Proulx C; National Research Council of Canada, Winnipeg, MB, Canada., Gagnon Shaigetz V; National Research Council of Canada, Winnipeg, MB, Canada., Maples-Keller JL; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States., Arora RC; Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States., Perrin D; CancerCare Manitoba, Winnipeg, MB, Canada.; Department of Surgery, Section of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada., Benedictson J; Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada.; Department of Psychology, University of Manitoba, Winnipeg, MB, Canada., Jacobsohn E; Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada.
Jazyk:	angličtina
Zdroj:	JMIR research protocols [JMIR Res Protoc] 2024 May 14; Vol. 13, pp. e55692. Date of Electronic Publication: 2024 May 14.
DOI:	10.2196/55692
Abstrakt:	Background: Preoperative state anxiety (PSA) is distress and anxiety directly associated with perioperative events. PSA is associated with negative postoperative outcomes such as longer hospital length of stay, increased pain and opioid use, and higher rates of rehospitalization. Psychological prehabilitation, such as education, exposure to hospital environments, and relaxation strategies, has been shown to mitigate PSA; however, there are limited skilled personnel to deliver such interventions in clinical practice. Immersive virtual reality (VR) has the potential for greater accessibility and enhanced integration into an immersive and interactive experience. VR is rarely used in the preoperative setting, but similar forms of stress inoculation training involving exposure to stressful events have improved psychological preparation in contexts such as military deployment. Objective: This study seeks to develop and investigate a targeted PSA intervention in patients undergoing oncological surgery using a single preoperative VR exposure. The primary objectives are to (1) develop a novel VR program for patients undergoing oncological surgery with general anesthesia; (2) assess the feasibility, including acceptability, of a single exposure to this intervention; (3) assess the feasibility, including acceptability, of outcome measures of PSA; and (4) use these results to refine the VR content and outcome measures for a larger trial. A secondary objective is to preliminarily assess the clinical utility of the intervention for PSA. Methods: This study comprises 3 phases. Phase 1 (completed) involved the development of a VR prototype targeting PSA, using multidisciplinary iterative input. Phase 2 (data collection completed) involves examining the feasibility aspects of the VR intervention. This randomized feasibility trial involves assessing the novel VR preoperative intervention compared to a VR control (ie, nature trek) condition and a treatment-as-usual group among patients undergoing breast cancer surgery. Phase 3 will involve refining the prototype based on feasibility findings and input from people with lived experience for a future clinical trial, using focus groups with participants from phase 2. Results: This study was funded in March 2019. Phase 1 was completed in April 2020. Phase 2 data collection was completed in January 2024 and data analysis is ongoing. Focus groups were completed in February 2024. Both the feasibility study and focus groups will contribute to further refinement of the initial VR prototype (phase 3), with the final simulation to be completed by mid-2024. Conclusions: The findings from this work will contribute to the limited body of research examining feasible and broadly accessible interventions for PSA. Knowledge gained from this research will contribute to the final development of a novel VR intervention to be tested in a large population of patients with cancer before surgery in a randomized clinical trial. Trial Registration: ClinicalTrials.gov NCT04544618; https://www.clinicaltrials.gov/study/NCT04544618. International Registered Report Identifier (irrid): DERR1-10.2196/55692. (©Renée El-Gabalawy, Jordana L Sommer, Pamela Hebbard, Kristin Reynolds, Gabrielle S Logan, Michael S D Smith, Thomas C Mutter, W Alan Mutch, Natalie Mota, Catherine Proulx, Vincent Gagnon Shaigetz, Jessica L Maples-Keller, Rakesh C Arora, David Perrin, Jada Benedictson, Eric Jacobsohn. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 14.05.2024.)
Databáze:	MEDLINE
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