The goal of this study is to explore if Virtual Reality helps patients in the cardiothoracic ICU move more and feel better. Participants will be asked to answer a survey about anxiety, depression, and loneliness. The study team will teach participants how to use the VR device and how to play the game. Participants will play the game at least once per day, but can play as much as they want. Study activities include nurse facilitated patient use of VR applications that involve upper body movement (e.g., using arms and hands to dance or hit objects in a virtual reality environment).
Patients who survive critical illness and prolonged intensive care unit (ICU) stays are at risk for debilitating physical (deconditioning, skin injury, and infection), and mental health impairment (depression, anxiety and PTSD). Early mobility improves these deleterious outcomes but is challenging to implement in patients on prolonged bedrest. The purpose of this study is to compare a nurse-led implementation of a Virtual Reality (VR) experience in the Cardio-Thoracic Intensive Care Unit (CT-ICU) to standard of care to improve mobility for patients on prolonged bedrest. The investigators hypothesize that nurse-led implementation of VR experiences in the CT-ICU, in combination with engineering-led patient-centered customization of the VR applications, will improve both the physical and psychological function of ICU patients on prolonged bedrest.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
30
Commercially-based VR experience used to help move upper extremities to music, similar to dancing or Tai-Chi.
Duke University Hospital
Durham, North Carolina, United States
RECRUITINGFeasibility as measured by nursing time required
For each participant, the total nursing time spent (in minutes) setting up and delivering the intervention will be recorded.
Time frame: up to 6 months
Usability as measured by patient-reported ease of playing the game
Usability: Using a 5-point Likert scale (0- very difficult to 5- very easy; higher is better outcome), participants will be surveyed after the intervention period to assess ease of playing the game.
Time frame: up to 6 months
Usability as measured by patient-reported ease of hand controller use
Usability: Using a 5-point Likert scale (0- very difficult to 5- very easy; higher is better outcome), participants will be surveyed after the intervention period to assess ease of hand controller use.
Time frame: up to 6 months
Usability as measured by patient-reported wearability of headset
Usability: Using a 5-point Likert scale (0- very difficult to 5- very easy; higher is better outcome), participants will be surveyed after the intervention period to assess wearability of headset.
Time frame: up to 6 months
Usability as measured by patient-reported comfort of headset
Usability: Using a 5-point Likert scale (0- very difficult to 5- very easy; higher is better outcome), participants will be surveyed after the intervention period to assess comfort of headset.
Time frame: up to 6 months
Number of participants who find the intervention acceptable
Acceptability: Participants will be asked if they would recommend this game to a friend or loved one, yes or no.
Time frame: up to 6 months
Change in mobility activity frequency
To determine if a VR intervention increases mobility for patients on prolonged bedrest, the frequency of VR sessions is recorded. Frequency will be reported as counts.
Time frame: Baseline, 6 months
Change in mobility activity time
To determine if a VR intervention increases mobility for patients on prolonged bedrest, the duration of each VR session is recorded. Activity will be reported as total minutes.
Time frame: Baseline, 6 months
Change in Hospital Anxiety and Depression Scale (HADS) - anxiety
The Hospital Anxiety and Depression Scale (HADS) is a self-report scale used to measure the severity of depression and anxiety in patients with comorbid medical conditions. The total score for anxiety ranges from 0 to 21, where a higher score indicates greater anxiety.
Time frame: Baseline to day 10 or ICU transfer, whichever comes first
Change in Hospital Anxiety and Depression Scale (HADS) - depression
The Hospital Anxiety and Depression Scale (HADS) is a self-report scale used to measure the severity of depression and anxiety in patients with comorbid medical conditions. The total score for depression ranges from 0 to 21, where a lower score indicates greater depression.
Time frame: Baseline to day 10 or ICU transfer, whichever comes first
Change in UCLA 3-item Loneliness Scale
This scale comprises 3 questions that measure three dimensions of loneliness: relational connectedness, social connectedness and self-perceived isolation. The total score ranges from 0 to 9, where a higher score indicates greater loneliness.
Time frame: Baseline to day 10 or ICU transfer, whichever comes first
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