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Journal of Burn Care & Research :... Oct 2019Burns patients often suffer severe pain during interventions such as dressing changes, even with analgesia. Virtual Reality (VR) can be used to distract patients and...
Burns patients often suffer severe pain during interventions such as dressing changes, even with analgesia. Virtual Reality (VR) can be used to distract patients and reduce pain. However, more evidence is needed from the patients and staff using the technology about its use in clinical practice and the impact of different VR strategies. This small-scale qualitative study explored patient and staff perceptions of the impact and usability of active and passive VR during painful dressing changes. Five patients took part in three observed dressing changes-one with an active VR scenario developed for the study, one with passive VR, and one with no VR-following which they were interviewed about their experiences. Three nurses who performed the dressing changes participated in a focus group. Thematic analysis of the resulting data generated four themes: "Caution replaced by contentment," "Distraction and implications for pain and wound care," "Anxiety, control and enjoyment," and "Preparation and communication concerns." Results suggested that user-informed active VR was acceptable to burn patients, helped manage their perceived pain, and was both usable and desirable within the clinical environment. Further testing with larger samples is now required.
Topics: Adult; Aged; Anxiety; Attitude of Health Personnel; Bandages; Burns; Female; Humans; Male; Middle Aged; Nursing Staff, Hospital; Pain; Pain Management; Virtual Reality; Young Adult
PubMed: 31190052
DOI: 10.1093/jbcr/irz106 -
Current Neurology and Neuroscience... Feb 2023Neuro-ophthalmologists rapidly adopted telehealth during the COVID-19 pandemic to minimize disruption to patient care. This article reviews recent research on... (Review)
Review
PURPOSE OF THE REVIEW
Neuro-ophthalmologists rapidly adopted telehealth during the COVID-19 pandemic to minimize disruption to patient care. This article reviews recent research on tele-neuro-ophthalmology adoption, current limitations, and potential use beyond the pandemic. The review considers how digital transformation, including machine learning and augmented reality, may be applied to future iterations of tele-neuro-ophthalmology.
RECENT FINDINGS
Telehealth utilization has been sustained among neuro-ophthalmologists throughout the pandemic. Adoption of tele-neuro-ophthalmology may provide solutions to subspecialty workforce shortage, patient access, physician wellness, and trainee educational needs within the field of neuro-ophthalmology. Digital transformation technologies have the potential to augment tele-neuro-ophthalmology care delivery by providing automated workflow solutions, home-based visual testing and therapies, and trainee education via simulators. Tele-neuro-ophthalmology use has and will continue beyond the COVID-19 pandemic. Digital transformation technologies, when applied to telehealth, will drive and revolutionize the next phase of tele-neuro-ophthalmology adoption and use in the years to come.
Topics: Humans; COVID-19; Pandemics; Ophthalmology; Telemedicine; Neurology
PubMed: 36609726
DOI: 10.1007/s11910-022-01248-w -
PloS One 2019Chronic pain, such as low-back pain, can be a highly disabling condition degrading people's quality of life (QoL). Not every patient responds to pharmacological... (Clinical Trial)
Clinical Trial
Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome.
OBJECTIVES
Chronic pain, such as low-back pain, can be a highly disabling condition degrading people's quality of life (QoL). Not every patient responds to pharmacological therapies, thus alternative treatments have to be developed. The chronicity of pain can lead to a somatic dysperception, meaning a mismatch between patients' own body perception and its actual physical state. Since clinical evaluation of pain relies on patients' subjective reports, a body image disruption can be associated with an incorrect pain rating inducing incorrect treatment and a possible risk of drug abuse. Our aim was to reduce chronic low-back pain through a multimodal neurorehabilitative strategy using innovative technologies to help patients regain a correct body image.
METHODS
Twenty patients with chronic low-back pain were included. Before and after treatment, patients underwent: a neurological exam; a neuro-psychological evaluation testing cognitive functions (memory, attention, executive functions) and personality traits, QoL and mood; pain ratings; sensorimotor functional abilities' testing. Patients underwent a 6 week-neurorehabilitative treatment (total 12 sessions) using virtual reality (VRRS system, Khymeia, Italy). Treatment consisted on teaching patients to execute correct movements with the painful body parts to regain a correct body image, based on the augmented multisensory feedback (auditory, visual) provided by the VRRS.
RESULTS
Our data showed significant reductions in all pain rating scale scores (p<0.05); significant improvements of QoL in the domains of physical functioning, physical role functioning, bodily pain, vitality, and social role functioning; improvements in cognitive functions (p<0.05); improvements in functional scales (p<0.05) and mood (p = 0.04).
CONCLUSION
This non-pharmacological approach was able to act on the multi-dimensional aspects of pain and improved patients' QoL, pain intensity, mood and patient's functional abilities.
Topics: Activities of Daily Living; Adult; Affect; Aged; Body Image; Chronic Pain; Exercise Movement Techniques; Female; Humans; Italy; Low Back Pain; Male; Middle Aged; Neurological Rehabilitation; Quality of Life; Virtual Reality
PubMed: 31120892
DOI: 10.1371/journal.pone.0216858 -
Frontiers in Psychology 2020New computer technologies, like virtual reality (VR), have created opportunities to study human behavior and train skills in novel ways. VR holds significant promise for... (Review)
Review
New computer technologies, like virtual reality (VR), have created opportunities to study human behavior and train skills in novel ways. VR holds significant promise for maximizing the efficiency and effectiveness of skill learning in a variety of settings (e.g., sport, medicine, safety-critical industries) through immersive learning and augmentation of existing training methods. In many cases the adoption of VR for training has, however, preceded rigorous testing and validation of the simulation tool. In order for VR to be implemented successfully for both training and psychological experimentation it is necessary to first establish whether the simulation captures fundamental features of the real task and environment, and elicits realistic behaviors. Unfortunately evaluation of VR environments too often confuses presentation and function, and relies on superficial visual features that are not the key determinants of successful training outcomes. Therefore evidence-based methods of establishing the fidelity and validity of VR environments are required. To this end, we outline a taxonomy of the subtypes of fidelity and validity, and propose a variety of practical methods for testing and validating VR training simulations. Ultimately, a successful VR environment is one that enables transfer of learning to the real-world. We propose that key elements of psychological, affective and ergonomic fidelity, are the real determinants of successful transfer. By adopting an evidence-based approach to VR simulation design and testing it is possible to develop valid environments that allow the potential of VR training to be maximized.
PubMed: 32296379
DOI: 10.3389/fpsyg.2020.00605 -
International Journal of Environmental... Apr 2022Shinrin-yoku, forest bathing, may provide relief from chronic and breakthrough pain in patients with axial spondyloarthritis and improve immune function through...
Shinrin-yoku, forest bathing, may provide relief from chronic and breakthrough pain in patients with axial spondyloarthritis and improve immune function through increasing NK cell numbers and activity and their downstream effectors, perforin and granulysin, after chemo- or radiation therapy in breast and prostate cancer patients. The aim of this paper is to describe the study protocol for a simulated forest immersion therapy using virtual reality and atomized phytoncides, volatile organic compounds found in forested areas designed to effect positive change for these two patient populations. The setting, including the room set up and samples with inclusion/exclusion specific to this type of intervention, is outlined. Measures and calibration procedures pertinent to determining the feasibility of simulated forest immersion therapy are presented and include: ambient and surface room temperatures and relative humidity in real time, ambient ultrafine particulate matter, ambient droplet measurement that coincides with volatile organic compounds, specific phytoncides, and virtual reality and atomization of phytoncide set up. Particular lessons learned while training and setting up the equipment are presented. Simulated forest immersion therapy is possible with attention to detail during this early phase when development of methods, equipment testing, and feasibility in deploying the intervention become operational. The expected outcome of the development of the methods for this study is the creation of a standardized approach to simulating forest therapy in a controlled laboratory space.
Topics: Forests; Humans; Male; Monoterpenes; Volatile Organic Compounds
PubMed: 35564767
DOI: 10.3390/ijerph19095373 -
Cold Spring Harbor Perspectives in... Jul 2020Cardiovascular genetic counselors provide guidance to people facing the reality or prospect of inherited cardiovascular conditions. Key activities in this role include... (Review)
Review
Cardiovascular genetic counselors provide guidance to people facing the reality or prospect of inherited cardiovascular conditions. Key activities in this role include discussing clinical cardiac screening for at-risk family members and offering genetic testing. Psychological factors often influence whether patients choose to have genetic testing and how they understand and communicate the results to at-risk relatives, so psychological counseling increases the impact of genetic education and medical recommendations. This work reviews the literature on the factors that influence patient decisions about cardiovascular genetic testing and the psychological impact of results on people who opt to test. It also models use of a psychological framework to apply themes from the literature to routine cardiovascular genetic counseling practice. Modifications of the framework are provided to show how it can be adapted to serve the needs of both new and experienced genetic counselors.
Topics: Adaptation, Psychological; Cardiovascular Diseases; Decision Making; Genetic Counseling; Genetic Testing; Humans; Patient-Centered Care
PubMed: 31570390
DOI: 10.1101/cshperspect.a036624 -
Acta Neurochirurgica May 2021Surgical treatment of tumors, epileptic foci or of vascular origin, requires a detailed individual pre-surgical workup and intra-operative surveillance of brain... (Review)
Review
Surgical treatment of tumors, epileptic foci or of vascular origin, requires a detailed individual pre-surgical workup and intra-operative surveillance of brain functions to minimize the risk of post-surgical neurological deficits and decline of quality of life. Most attention is attributed to language, motor functions, and perception. However, higher cognitive functions such as social cognition, personality, and the sense of self may be affected by brain surgery. To date, the precise localization and the network patterns of brain regions involved in such functions are not yet fully understood, making the assessment of risks of related post-surgical deficits difficult. It is in the interest of neurosurgeons to understand with which neural systems related to selfhood and personality they are interfering during surgery. Recent neuroscience research using virtual reality and clinical observations suggest that the insular cortex, medial prefrontal cortex, and temporo-parietal junction are important components of a neural system dedicated to self-consciousness based on multisensory bodily processing, including exteroceptive and interoceptive cues (bodily self-consciousness (BSC)). Here, we argue that combined extra- and intra-operative approaches using targeted cognitive testing, functional imaging and EEG, virtual reality, combined with multisensory stimulations, may contribute to the assessment of the BSC and related cognitive aspects. Although the usefulness of particular biomarkers, such as cardiac and respiratory signals linked to virtual reality, and of heartbeat evoked potentials as a surrogate marker for intactness of multisensory integration for intra-operative monitoring has to be proved, systemic and automatized testing of BSC in neurosurgical patients will improve future surgical outcome.
Topics: Body Image; Brain Mapping; Cognition; Evoked Potentials; Heart Rate; Humans; Neurosurgical Procedures; Self Concept
PubMed: 33686522
DOI: 10.1007/s00701-021-04778-3 -
Nutrients Sep 2020The use of Extended Reality (XR) (i.e. Virtual and Augmented Reality) for nutrition education and behavior change has not been comprehensively reviewed. This paper... (Review)
Review
The use of Extended Reality (XR) (i.e. Virtual and Augmented Reality) for nutrition education and behavior change has not been comprehensively reviewed. This paper presents findings from a scoping review of current published research. Articles ( = 92) were extracted from PubMed and Scopus using a structured search strategy and selection approach. Pertinent study information was extracted using a standardized data collection form. Each article was independently reviewed and coded by two members of the research team, who then met to resolve any coding discrepancies. There is an increasing trend in publication in this area, mostly regarding Virtual Reality. Most studies used developmental testing in a lab setting, employed descriptive or observational methods, and focused on momentary behavior change like food selection rather than education. The growth and diversity of XR studies suggest the potential of this approach. There is a need and opportunity for more XR technology focused on children and other foundational theoretical determinants of behavior change to be addressed within nutrition education. Our findings suggest that XR technology is a burgeoning approach in the field of nutrition, but important gaps remain, including inadequate methodological rigor, community application, and assessment of the impact on dietary behaviors.
Topics: Behavior Therapy; Diet; Food Preferences; Health Behavior; Health Education; Humans; Nutritional Sciences; Virtual Reality
PubMed: 32971972
DOI: 10.3390/nu12092899 -
Psychiatria Danubina Mar 2010
Comparative Study
Topics: Antipsychotic Agents; Bias; Clinical Trials as Topic; Humans; Mythology; Reality Testing; Schizophrenia; Treatment Outcome
PubMed: 20305584
DOI: No ID Found -
Archives of Medical Science : AMS Apr 2018Neurosurgery is a medical specialty that relies heavily on imaging. The use of computed tomography and magnetic resonance images during preoperative planning and...
Neurosurgery is a medical specialty that relies heavily on imaging. The use of computed tomography and magnetic resonance images during preoperative planning and intraoperative surgical navigation is vital to the success of the surgery and positive patient outcome. Augmented reality application in neurosurgery has the potential to revolutionize and change the way neurosurgeons plan and perform surgical procedures in the future. Augmented reality technology is currently commercially available for neurosurgery for simulation and training. However, the use of augmented reality in the clinical setting is still in its infancy. Researchers are now testing augmented reality system prototypes to determine and address the barriers and limitations of the technology before it can be widely accepted and used in the clinical setting.
PubMed: 29765445
DOI: 10.5114/aoms.2016.58690