Exploring the feasibility of virtual reality to support falls awareness education in care homes

每年有三分之一的65岁以上的老年人跌倒，导致受伤、死亡和医疗服务费用。由于合并症、多种药物、行动问题和认知障碍，这在护理院环境中进一步增加。重要的是要支持老年人在福尔斯意识和预防护理院，以减少进一步和潜在的后续生理和心理影响的福尔斯。这可以通过对护理之家工作人员的教育来支持;因为他们负责居民的健康，安全和福祉，以及协助他们的许多日常生活活动（ADL）。虽然虚拟现实已被用于教育，但它主要用于医疗或手术模拟，而不是针对社会护理。此外，福尔斯预防VR侧重于跑步机训练/运动康复。进行的范围界定审查表明，缺乏资源，包括缺乏培训，以及个别工作人员对福尔斯风险因素的了解，影响了福尔斯预防和管理策略的实施。Sentireal通过智能手机应用程序上的虚拟/增强现实提供个性化的医疗保健指导/培训。有可能开发软件d被用作一个从事培训工具的护理人员，可以提供支持自我管理的福尔斯风险老年人。Objectives：要建立是否是可行的头戴式显示器虚拟现实被用作交互式培训工具的护理人员。与护理人员共同设计自我管理和培训VR应用程序-测试应用程序的可接受性和可行性。方法：进行了一个多阶段项目，与护理人员共同设计和测试VR概念验证。探索性定性阶段，探索和建立VR的设计，功能和内容以及当前的证据基础。根据I期研究结果，进行了Sentireal开发阶段。一项并行的混合方法可行性研究探讨了大曼彻斯特地区护理院VR概念验证（福尔斯意识体验）的可行性。使用经验证的评估工具评估干预措施的潜在影响，并进行定性访谈，以确定使用该技术的经验，并为界面/应用程序功能的进一步设计提供信息。基于医学研究理事会关于复杂干预的开发和评价的指导（Skivington等人，这项工作将为未来试验的设计提供信息。在原型的开发阶段与Sentireal的合作已经发生，有可能与mHealth Technologies（从博洛尼亚大学分拆公司）联系，以了解运动检测和机器学习如何为应用程序开发提供信息。调查结果：参与，沉浸和享受是培训方法可接受性的关键因素。FAE适合护理人员的学习风格，VR被接受为一种培训方法。利用案例研究居民增加同理心的居民的经验。开发反馈包括额外的位置、场景和可交互项目。确定了可接受性和采用的障碍和促进因素。结论：确定一个复杂的干预培训的潜在有效的方法可能会影响创建未来的培训计划的护理院：以帮助增加护理人员的知识，保留信息，并将知识应用到实践中。这反过来又可以提高提供的护理质量和居民的成果。需要进行更多的研究，将概念验证发展成最低可行原型，并进一步测试可行性。

One in three older people over the age of 65 fall each year, leading to injury, death and health services costs. This increases further in care homes environments, due to comorbidities, polypharmacy, mobility issues and cognitive impairment. It is important to support older adults in falls awareness and prevention in care homes, to reduce further and potential subsequent physiological and psychological impact from falls. This can be supported through the education of care home staff; as they are responsible for the health, safety and wellbeing of residents, as well as assisting with many of their activiites of daily living (ADLs). Although virtual reality has been used in education, it is focused towards medical or surgical simulation, and not taregeted towards those in social care. In addition, falls prevention VR focuses on treadmill training/exercise rehabilitation. A scoping review conducted suggested that lack of resources including lack of training, and individual staff knowledge of falls risk factors impacted on the facilitation of falls prevention and management strategies. Sentireal provide personalised healthcare guidance/training through virtual/augmented reality on smartphone applications. There is the potential to develop software d be used as an engaging training tool for care staff which can provide support for self-management of falls risk to older people.Objectives: To establish whether it is feasible for head mounted display virtual reality to be used as interactive training tool for care staff.- Co-design a self-management and training VR application with care staff- Test the acceptability and feasibility of the application.Methods: A multi-phase project was conducted to co-design and test a VR proof of concept with care staff. An exploratory qualitative phase to explore and establish design, functionality and content of the VR alongside the current evidence base. A development phase with Sentireal was conducted, based on Phase I findings. A parallel mixed methods feasibility study explored the feasibility of the VR proof of concept (Falls Awareness Experience) across care homes in Greater Manchester. Validated assessment tools were used to assess the potential impact of the intervention and qualitative interviews were carried out to establish experiences of using the technology and to inform further design of the interfaces/App functionality. Based on Medical Research Council guidance for development and evaluation of complex interventions (Skivington et al., 2021) this work will inform the design of future trials. Collaboration with Sentireal during the development phase of the prototype has occured, with the potential to link with mHealth Technologies (spin off company from the University of Bologna) to understand how movement detection and machine learning can inform the app development.Findings: Engagement, immersion and enjoyment were key factors for acceptability of a training method. The FAE suited the learning styles of care staff, and VR was accepted as a training method. Utilisation of a case study resident increased empathy to the resident experience. Feedback for development included additional locations, scenarios, and interactable items. Barriers and facilitators of acceptability and adoption were identified. Conclusions: Identifying a potentially effective method of training for a complex intervention may influence the creation of future training programmes for care homes: to assist in increasing care staff knowledge, retention of information, and application of knowledge into practice. This in turn may improve the quality of care delivered and resident outcomes. Additional research is required to develop the proof-of-concept into a minimum viable prototype, and feasibility tested further.