Patients in intensive care units experience significant physiological and psychological stress due to life-threatening conditions and invasive treatments. This randomized controlled study aims to examine the effects of virtual art therapy on physiological parameters, delirium risk, anger, anxiety, and mental-spiritual recovery in 62 patients in the coronary ICU of Malatya Training and Research Hospital. Data will be collected using validated scales and analyzed with appropriate parametric or non-parametric tests. The study seeks to evaluate the effectiveness and applicability of virtual art therapy as a technology-based complementary intervention in intensive care settings.
Patients treated in intensive care units are under both physiological and psychological stress due to life-threatening illnesses, invasive procedures, prolonged stays in isolated environments, and a process full of uncertainty. In coping with this process, alternative and complementary approaches are emerging alongside medical treatment. Virtual art therapy, which has emerged as a result of adapting traditional art therapy practices to digital and virtual environments with technology, is being investigated as a new treatment method to help patients relax and support their physical and mental recovery. The aim of this research is to examine the effect of virtual art therapy on physiological parameters, delirium risk, anger, anxiety levels, and mental and spiritual recovery in intensive care patients. The research will be conducted in the coronary intensive care unit of Malatya Training and Research Hospital. The research population will consist of patients followed in the aforementioned unit. The sample will consist of 62 patients determined by power analysis. After the patients are randomized and assigned to their groups, the experimental group will be asked to paint using virtual reality glasses. The research data will be collected through the Personal Introduction and Monitoring Form, the Nursing Delirium Screening Scale, the State Anger Scale, the Integrated Anxiety Scale, and the Mental and Spiritual Recovery Assessment Scale Short Form. Descriptive statistics, Independent Samples t-test/Mann Whitney U test, and Dependent Samples T-test/Wilcoxon test for comparing repeated measures within groups will be used in the evaluation of the data. The research aims to reveal the potential of virtual art therapy to accelerate the mental and emotional recovery of patients beyond traditional treatment methods. It also aims to test the applicability of technology-based alternative treatment methods in intensive care settings where the application area of this therapy is limited. The results of this research, which will show that alternative treatment methods such as art therapy and virtual reality can be used as an effective tool, especially in intensive care units, can make a significant contribution to the fields of nursing and medical treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
62
The Vermillion - VR Painting application will be used to have the patient paint. This application is a sophisticated tool that simulates the traditional oil painting experience in a virtual reality environment. Users can create original works starting from a completely blank canvas; the application primarily supports the artistic creation process by using digital reproductions of real physical painting materials rather than offering ready-made templates. In addition, reference images and basic composition guides are available for educational purposes. The duration of a painting activity can vary significantly depending on the user's experience level, the complexity of the work, and the level of detail targeted; a simple sketch or study may take 15-30 minutes, while a complex composition or portrait may require several hours, or even multiple sessions for experienced users. The writing areas can be extended as needed.
Nursing Delirium Screening Scale (Nu-DESC)
The Nursing Delirium Screening Scale (Nu-DESC) was developed by Gaudreau et al. in 2005. The Turkish adaptation of the scale was conducted by Karataş and Bağlama (2021). Nu-DESC is a rapid and practical screening tool that can be easily implemented in routine nursing practice. The scale consists of five items assessed based on nurses' clinical observations: disorientation, inappropriate behavior, inappropriate communication, illusions/hallucinations, and psychomotor retardation. Each item is scored from 0 (absent) to 2 (severe), with a maximum possible total score of 10. The evaluation is based on observations accumulated over a 12-hour period. A total score of 2 or higher is considered positive for delirium. The internal consistency coefficient of the scale was reported as 0.74 (Karataş \& Samancıoğlu, 2023).
Time frame: 3 day
State Anger Scale
The State Anger Scale, developed by Spielberger (1999), is a unidimensional instrument designed to assess individuals' current level of anger. The Turkish adaptation was conducted by Cankardaş and Şalcıoğlu. The scale consists of 10 items, each rated on a 4-point Likert scale (1 = Not at all, 2 = Somewhat, 3 = Moderately, 4 = Very much). Total scores range from 10 to 40, with higher scores indicating higher levels of state anger. The internal consistency coefficient was reported as 0.94 (Cankardaş \& Şalcıoğlu, 2021).
Time frame: 3 days
Integrated Anxiety Scale:
The Integrated Anxiety Scale was developed by Ebadi (2020) and consists of 33 items. Each item is rated on a 5-point scale ranging from 0 (Never) to 4 (Always). The total score ranges from 0 to 132, with higher scores indicating higher levels of anxiety and stress. The internal consistency coefficient of the scale was reported as 0.96.
Time frame: 3 days
Mental and Spiritual Recovery Assessment Scale - Short Form
The Mental and Spiritual Recovery Assessment Scale - Short Form was developed by Barber et al. (2017) to evaluate individuals' levels of mental and spiritual recovery. The Turkish adaptation was conducted by Danış and Günaydın (2024). The scale consists of 15 items rated on a 5-point Likert scale (1 = Strongly disagree to 5 = Strongly agree). It includes three subdimensions: Existential Well-Being, Religious Well-Being, and Spiritual Distress. The total score ranges from 15 to 75, with higher scores indicating greater levels of mental and spiritual recovery. The internal consistency coefficient (Cronbach's alpha) of the Turkish version was reported as 0.864 for the total scale, with subscale coefficients ranging from 0.773 to 0.953. The Turkish validity and reliability study demonstrated adequate construct validity, linguistic validity, and item analysis results.
Time frame: 3 days
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