Effect of an Immersive Preoperative Virtual Reality Experience on Patient Reported Outcomes A Randomized Controlled Trial
Effect of an Immersive Preoperative Virtual Reality Experience on Patient Reported Outcomes A Randomized Controlled Trial
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DOI：
10.1097/sla.0000000000002094
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发表时间：
2017-06-01
影响因子：
9
通讯作者：
Kakoulides, George
中科院分区：
文献类型：
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作者：
Bekelis, Kimon;Calnan, Daniel;Kakoulides, George
目的：探讨手术前暴露于虚拟现实(VR)环境对患者报告的手术结果的影响。背景：针对患者满意度的质量改进举措尚不多见。方法：我们在一个三级转诊中心对接受颅脑和脊柱手术的患者进行了随机对照试验。患者接受1：1随机分为沉浸式的术前VR体验或根据手术类型分层的标准术前体验。主要观察指标为L麻醉综合评分(EVAN-G)和阿姆斯特丹术前焦虑与信息评分(APAIS)，作为患者手术经历的标志。结果：在研究期间，共有127名患者(平均年龄55.3岁，女性41.9%)接受了随机分组。VR后的平均Evan-G评分为84.3(标准差，SD，6.4)，标准术前体验后的平均Evan-G评分为64.3(SD，11.7)(差值为20.0；95%可信区间，CI为16.6-23.3)。身临其境的VR体验也导致了更高的APAIS评分(差异，29.9；95%CI，24.5-35.2)。此外，VR导致较低的术前VAS压力评分(差异，-41.7；95%CI，-33.1~-50.2)，较高的术前VAS准备(差异，32.4；95%CI，24.9~39.8)和VAS满意度(差异，33.2；95%CI，25.4~41.0)。未发现与VAS压力评分相关(差值为-1.6；95%可信区间为-13.4至10.2)。结论：在一项随机对照试验中，我们证明了术前接触VR的患者在手术中有更高的满意度。利用这项技术的力量，医院可以创造一个身临其境的环境，将压力降至最低，并增强围手术期体验。
Objective: To investigate the effect of exposure to a virtual reality (VR) environment preoperatively on patient-reported outcomes for surgical operations.Background: There is a scarcity of well-developed quality improvement initiatives targeting patient satisfaction.Methods: We performed a randomized controlled trial of patients undergoing cranial and spinal operations in a tertiary referral center. Patients underwent a 1:1 randomization to an immersive preoperative VR experience or standard preoperative experience stratified on type of operation. The primary outcome measures were the Evaluation du Vecu de l'Anesthesie Generale (EVAN-G) score and the Amsterdam Preoperative Anxiety and Information (APAIS) score, as markers of the patient's experience during the surgical encounter.Results: During the study period, a total of 127 patients (mean age 55.3 years, 41.9% females) underwent randomization. The average EVAN-G score was 84.3 (standard deviation, SD, 6.4) after VR, and 64.3 (SD, 11.7) after standard preoperative experience (difference, 20.0; 95% confidence interval, CI, 16.6-23.3). Exposure to an immersive VR experience also led to higher APAIS score (difference, 29.9; 95% CI, 24.5-35.2). In addition, VR led to lower preoperative VAS stress score (difference, -41.7; 95% CI, -33.1 to -50.2), and higher preoperative VAS preparedness (difference, 32.4; 95% CI, 24.9-39.8), and VAS satisfaction (difference, 33.2; 95% CI, 25.4-41.0) scores. No association was identified with VAS stress score (difference, -1.6; 95% CI, -13.4 to 10.2).Conclusions: In a randomized controlled trial, we demonstrated that patients exposed to preoperative VR had increased satisfaction during the surgical encounter. Harnessing the power of this technology, hospitals can create an immersive environment that minimizes stress, and enhances the perioperative experience.