Social Virtual Reality Experiences for Hospitalized Older Adult Trauma Patients to Reduce Pain

老年人(即65岁及以上的老年人)占美国所有医院创伤的25%以上 入院，主要是由于跌倒和碰撞。鉴于美国人口老龄化，到2050年，大约 据估计，40%的创伤患者年龄在65岁以上。创伤患者经历了高比率的 疼痛。阿片类药物通常用于治疗创伤相关的疼痛，但会导致过量 发病率，包括上瘾、精神错乱、便秘和跌倒的风险。此外，不良事件 阿片类药物的使用增加了住院时间、总成本、感染风险和门诊延误 康复。多个权威机构呼吁开发和测试非药理性疼痛 在这一群体中，缓解方法很少，但使用的很少。为了解决这一差距，我们建议评估一个 在一项分两步进行的研究中，对老年创伤患者进行了一项新的疼痛治疗--社交虚拟现实(SVR) 患者、他们的朋友和家人的可行性、可用性和可接受性，作为次要措施， 参与病人护理的临床医生。我们将向10-15名患者展示现有版本的SVR，采访 并根据他们的反馈进行迭代求精。在这项研究的第二部分，我们将 对25-30名老年住院患者进行非受控试点研究，以确定其可行性、可用性、 以及数据收集协议和数据可用性以捕捉不同痛苦的可接受性， 焦虑和情绪。患者将确定他们愿意与之共事的“伴侣”、家人或密友 体验SVR，研究助理(RA)将提供耳机和密集的技术支持 既有耐心也有伴侣。我们将通过成功的招聘评估可行性、可用性和可接受性 和完成研究方案，以及通过使用可用性和可用性的标准措施进行调查 两组均可接受：患者和伴侣。我们还将检查患者在疼痛、焦虑、 和情绪，通过调查和使用一种方法来衡量干预前后的结果 基于耳机中的调查和跟踪用户数据的生态瞬时评估。

Older adults (i.e., those 65 years of age and older) account for more than 25% of all US hospital trauma admissions, primarily due to falls and collisions. Given the aging population of the US, by 2050, approximately 40% of all trauma patients are estimated to be over the age of 65. Trauma patients experience high rates of pain. Opioid medications are commonly used to manage trauma-related pain, but contribute to excess morbidity, including risk of addiction, delirium occurrence, constipation, and falls. In addition, adverse events resulting from opioid use increase hospital length-of stay, overall costs, risk of infection, and delays outpatient rehabilitation. Multiple authorities have called for the development and testing of nonpharmacologic pain mitigation approaches in this population, but few are in use. To address this gap, we propose to evaluate a novel pain treatment, social virtual reality (SVR), in older adult trauma patients, in a two-step study to examine feasibility, usability, and acceptability for patients, their friends and family, and, as a secondary measure, clinicians who are involved in patient care. We will present existing versions of SVR to 10-15 patients, interview them, and make iterative refinements according to their feedback. In the second part of this study, we will conduct an uncontrolled pilot study with 25-30 older hospitalized patients, to establish the feasibility, usability, and acceptability of SVR, and of data collection protocols and data availability to capture differences pain, anxiety and mood. Patients will identify a “partner,” a family member or close friend, with whom they would like to experience SVR, and a research assistant (RA) will provide headsets and intensive technical support for both patient and partner. We will assess feasibility, usability and acceptability through successful recruitment and completion of the study protocol, as well as through surveys using standard measures of usability and acceptability for both groups: patients and partner. We will also examine differences in patient pain, anxiety, and mood, measuring these outcomes pre- and post-intervention by survey as well as using a method of ecological momentary assessment based on surveys in the headset and tracking user data.