scholarly journals A Virtual Reality Video to Improve Information Provision and Reduce Anxiety Before Cesarean Delivery: Randomized Controlled Trial

10.2196/15872 ◽  
2019 ◽  
Vol 6 (12) ◽  
pp. e15872 ◽  
Author(s):  
Lore Noben ◽  
Simone Maria Theresia Anna Goossens ◽  
Sophie Eva Marieke Truijens ◽  
Marijn Marthe Georgine van Berckel ◽  
Christel Wilhelmina Perquin ◽  
...  

Background Anxiety levels before cesarean delivery (CD) can lead to a negative birth experience, which may influence several aspects of the woman’s life in the long term. Improving preoperative information may lower preoperative anxiety and lead to a more positive birth experience. Objective This study aimed to determine whether a virtual reality (VR) video in addition to standard preoperative information decreases anxiety levels before a planned CD. Methods Women scheduled to undergo term elective CD were recruited from the outpatient clinic. They were randomized and stratified based on history of emergency CD (yes or no). All participants received standard preoperative information (folder leaflets and counseling by the obstetrician); the VR group additionally watched the VR video showing all aspects of CD such as the ward admission, operating theater, spinal analgesia, and moment of birth. The primary outcome measure was a change in score on the Visual Analogue Scale for Anxiety (ΔVAS-A) measured at admission for CD, compared with the baseline VAS-A score. Results A total of 97 women were included for analysis. The baseline characteristics were similar in both groups, except for a significantly higher level of education in the control group. There was no significant decrease in the VAS-A score of the women in the VR group (n=49) compared with those in the control group (n=48; ΔVAS-A=1.0; P=.08; 95% CI −0.1 to 2.0). Subgroup analysis for the group of women with a history of emergency CD showed a trend toward decreased preoperative anxiety, despite the small sample size of this subgroup (n=17; P=.06). Of the 26 participants who provided completed questionnaires, 22 (85%) in the VR group reported feeling more prepared after seeing the VR video; of the 24 participants’ partners who completed the questionnaires, 19 (79%) agreed with the participants. No discomfort or motion sickness was reported. Conclusions A VR video may help patients and their partners feel better prepared when planning a CD. This study showed that VR does not lead to a decrease in preoperative anxiety. However, subgroups such as women with a history of emergency CD may benefit from VR videos. Trial Registration International Standard Randomised Controlled Trial Number (ISRCTN) 74794447; http://www.isrctn.com/ISRCTN74794447 (retrospectively registered)

2018 ◽  
Vol 7 (9) ◽  
pp. 284 ◽  
Author(s):  
Jung-Hee Ryu ◽  
Jin-Woo Park ◽  
Francis Nahm ◽  
Young-Tae Jeon ◽  
Ah-Young Oh ◽  
...  

The use of gamification in healthcare has been gaining popularity. This prospective, randomized, clinical trial was designed to evaluate whether gamification of the preoperative process—via virtual reality (VR) gaming that provides a vivid, immersive and realistic experience—could reduce preoperative anxiety in children. Seventy children scheduled for elective surgery under general anesthesia were randomly divided into either the control or gamification group. Children in the control group received conventional education regarding the preoperative process, whereas those in the gamification group played a 5 min VR game experiencing the preoperative experience. Preoperative anxiety, induction compliance checklist (ICC), and procedural behavior rating scale (PBRS) were measured. Sixty-nine children were included in the final analysis (control group = 35, gamification = 34). Preoperative anxiety (28.3 [23.3–36.7] vs. 46.7 [31.7–51.7]; p < 0.001) and intraoperative compliance measured using ICC (p = 0.038) were lower in the gamification group than in the control group. However, PBRS (p = 0.092) and parent/guardian satisfaction (p = 0.268) were comparable between the two groups. VR experience of the preoperative process could reduce preoperative anxiety and improve compliance during anesthetic induction in children undergoing elective surgery and general anesthesia.


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Farokh Saljughi ◽  
Mitra Savabi-Esfahani ◽  
Shahnaz Kohan ◽  
Soheila Ehsanpour

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.


2016 ◽  
Vol 5 (1) ◽  
pp. 1-6
Author(s):  
Wenny Savitri ◽  
Nani Fidayanti ◽  
Paulus Subiyanto

Background: Surgery is one of medical interventions which can cause fear, anxiety, and stressed because of its effects toward the integrity of body and soul. Nurses have significant roles in any preoperative care which is helping patients to decrease preoperative anxiety by using complementary therapy. The use of music therapy as one of the complementary therapies is not common in Indonesia. Therefore, scientific studies to prove the role of this therapy to decrease the level of anxiety of pre-operative patients is needed. Objective: To investigate the effects of music therapy in reducing anxiety levels of preoperative patients. Methods: A quasy experimental study with pre-test and post-test design with control group was applied to 50 respondents from medical ward in Panembahan Senopati Hospital of Yogyakarta who met the inclusion criteria.Dara were then analyzed by using t-test statistical analysis. Results: The control group showed the increased value of anxiety level of0.8 without music intervention (t= - 1503, df = 24, p<.05), whereas the intervention group showed the decreased value of anxiety level of -5.52 (t=5.081, df=24, p<.05). Meanwhile the independent t-test results for both groups showed a significant difference between group (t= 3,373, df=48, p<.05). Conclusion: Music therapy has significant effect in reducing preoperative anxiety levels of patients. Keywords: anxiety, preoperative, music therapy


OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2097502
Author(s):  
Joseph Chang ◽  
Sen Ninan ◽  
Katherine Liu ◽  
Alfred Marc Iloreta ◽  
Diana Kirke ◽  
...  

Objectives Virtual reality (VR) has been used as nonpharmacologic anxiolysis benefiting patients undergoing office-based procedures. There is little research on VR use in laryngology. This study aims to determine the efficacy of VR as anxiolysis for patients undergoing in-office laryngotracheal procedures. Study Design Randomized controlled trial. Setting Tertiary care center. Methods Adult patients undergoing office-based larynx and trachea injections, biopsy, or laser ablation were recruited and randomized to receive standard care with local anesthesia only or local anesthesia with adjunctive VR. Primary end point was procedural anxiety measured by the Subjective Units of Distress Scale (SUDS). Subjective pain, measured using a visual analog scale, satisfaction scores, and procedure time, and baseline anxiety, measured using the Hospital Anxiety and Depression Scale (HADS), were also collected. Results Eight patients were randomized to the control group and 8 to the VR group. SUDS scores were lower in the VR group than in the control group with mean values of 26.25 and 53.13, respectively ( P = .037). Baseline HADS scores did not differ between groups. There were no statistically significant differences in pain, satisfaction, or procedure time. Average satisfaction scores in VR and control groups were 6.44 and 6.25, respectively ( P = .770). Average pain scores were 3.53 and 2.64, respectively ( P = .434). Conclusion This pilot study suggests that VR distraction may be used as an adjunctive measure to decrease patient anxiety during office-based laryngology procedures. Procedures performed using standard local anesthesia resulted in low pain scores and high satisfaction scores even without adjunctive VR analgesia. Level of Evidence 1


2020 ◽  
Vol 9 (10) ◽  
pp. 3151
Author(s):  
Chang-Hoon Koo ◽  
Jin-Woo Park ◽  
Jung-Hee Ryu ◽  
Sung-Hee Han

Virtual reality (VR), a technology that provides a stimulated sensory experience, has recently been implemented in various fields of medicine. Several studies have investigated the efficacy of VR on preoperative anxiety. The purpose of this meta-analysis was to validate whether VR could relieve preoperative anxiety in patients undergoing surgery. Electronic databases were searched to identify all randomized controlled trials (RCTs) investigating the effect of VR on preoperative anxiety. The primary outcome was defined as the preoperative anxiety scores. We estimated the effect size using the standard mean difference (SMD) with a 95% confidence interval (CI) using a random effect model. Ultimately, 10 RCTs, with a total of 813 patients, were included in the final analysis. Preoperative anxiety was significantly lower in the VR group than in the control group (SMD −0.64, 95% CI −1.08 to −0.20, p = 0.004). In a subgroup analysis, the preoperative anxiety scores were lower in the VR group than in the control group in pediatric patients (SMD −0.71, 95% CI −1.14 to −0.27, p = 0.002), whereas a significant difference was not observed between the two groups in adult patients (p = 0.226). The results of this meta-analysis indicated that VR could decrease preoperative anxiety, especially in pediatric patients.


2020 ◽  
Vol 4 (2) ◽  
pp. 69-71
Author(s):  
Bilqees Akhtar Malik ◽  
Ambreen Shabbir ◽  
Zeb-Un-Nisa ◽  
Asma Ambreen

Objective: In our part of the world poverty and illiteracy has adversely affected our core objective of pregnancy i.e. healthy mother and healthy child. Exploring the role of a routinely used drug in reducing the duration of labor could be a breakthrough. Present study was planned accordingly to evaluate the effect of phloroglucinol (PHL). Materials and Methods: It was a Randomized controlled trial conducted at Department of Obstetrics & Gynecology, Combined Military Hospital, Bahawalpur from January 2019 to June 2019. This study included 60 cases of age 18 to 40 years, having singleton pregnancy and in active first stage of uncomplicated labor. Patients with history of multiple pregnancies, obstetrical and surgical complications and cardiorespiratory diseases were excluded. The cases were placed randomly into Group A & Group B and given intravenous PHL and a placebo respectively. After this, duration of the first stage of labor was recorded in minutes from when there was 3-4 cm cervical dilatation with regular uterine contractions to complete cervical dilation i.e. 10 cm and descent of the presenting fetal part. Results: Mean duration of active first stage of labor in experimental group A (230.20 ± 52.96 minutes) was significantly higher than that of control group B (345.30 ± 50.57 minutes). Conclusion: This study concluded that intravenous PHL has efficiently reduced the duration of active first stage of labor in these randomly selected nulliparous and multiparous women. PHL is a useful drug serving the purpose of a spasmolytic, analgesic and labor augmentation at the same time.


2020 ◽  
Author(s):  
Leila Jahangiry ◽  
Maryam Khazaee-Pool ◽  
Towhid Babazadeh ◽  
Parvin Sarbakhsh ◽  
Koen Ponnet

Abstract Background: Brucellosis is one of the most frequently occurring zoonotic diseases of veterinary and a public health problem in developing countries. It affects human and animal health and has measurable effects on the productive and reproductive performance of livestock. Therefore, the main purpose of this study was to develop a community-based intervention program for brucellosis prevention and control. A two-arm parallel cluster randomized controlled trial investigated the effectiveness of the program over six months in a rural population in Ahar, East Azerbaijan, Iran. A total of 16 village health houses were randomly allocated to the intervention and the control groups (eight per arm), and 400 participants were recruited via household health records in the health houses. The PRECEDE model, which is an acronym for Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation, was used to design, implement, and evaluate the brucellosis prevention and control program. Knowledge, attitudes, self-efficacy, social support, environmental enabling, and behavioral factors were measured at the baseline and the six-month follow-up. A generalized mixed effects model was used to analyze data. Results: The mean ages (SD) of the intervention and control group respondents were 35.9 (11.87) and 37.28 (11.04) years, respectively. After the six-month intervention, significant between-group differences were found on all PRECEDE variables, adjusted for education, history of brucellosis, and family history of brucellosis. Conclusion: There is a need to consolidate collaborative health and veterinary sector efforts, as well as increase regular vaccination practices and financial resources to support farmers willing to slaughter animals and/or offer slaughter facilities. The present study was able to demonstrate which educational and ecological factors influence behaviors and environments related to brucellosis and, as such, provide evidence of the effectiveness of interventions based on the PROCEDE model.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e048270
Author(s):  
Pablo Kappen ◽  
Johannes Jeekel ◽  
Clemens M F Dirven ◽  
M Klimek ◽  
Steven Kushner ◽  
...  

IntroductionDelirium is a neurocognitive disorder characterised by an acute and temporary decline of mental status affecting attention, awareness, cognition, language and visuospatial ability. The underlying pathophysiology is driven by neuroinflammation and cellular oxidative stress.Delirium is a serious complication following neurosurgical procedures with a reported incidence varying between 4% and 44% and has been associated with increased length of hospital stay, increased amount of reoperations, increased costs and mortality.Perioperative music has been reported to reduce preoperative anxiety, postoperative pain and opioid usage, and attenuates stress response caused by surgery. We hypothesize that this beneficial effect of music on a combination of delirium eliciting factors might reduce delirium incidence following neurosurgery and subsequently improve clinical outcomes.MethodsThis protocol concerns a single-centred prospective randomised controlled trial with 6 months follow-up. All adult patients undergoing a craniotomy at the Erasmus Medical Center in Rotterdam are eligible. The music group will receive recorded music through an overear headphone before, during and after surgery until postoperative day 3. Patients can choose from music playlists, offered based on music importance questionnaires administered at baseline. The control group will receive standard of clinical careDelirium is assessed by the Delirium Observation Scale and confirmed by a delirium-expert psychiatrist according to the DSM-5 criteria. Risk factors correlated with the onset of delirium, such as cognitive function at baseline, preoperative anxiety, perioperative medication use, depth of anaesthesia and postoperative pain, and delirium-related health outcomes such as length of stay, daily function, quality of life (ie, EQ-5D, EORTC questionnaires), costs and cost-effectiveness are collected.Ethics and disseminationThis study is being conducted in accordance with the Declaration of Helsinki. The Medical Ethics Review Board of Erasmus University Medical Center Rotterdam, The Netherlands, approved this protocol. Results will be disseminated via peer-reviewed scientific journals and conference presentations.Trial registration numbersNL8503 and NCT04649450.


Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1437
Author(s):  
SukKyong Kim ◽  
HyeonCheol Jeong

This study aimed to analyze the influence of patient-selected music listening on the pain and anxiety levels of hemodialysis patients after undergoing a vascular access operation. Methods: Sixty five patients were randomly assigned to the experimental group (n = 32) or the control group (n = 33). The experimental group was instructed to listen to their favorite music using headphones during their operations at the center. The control group underwent the operations without listening to any music. The pain measurement during vascular access operation was measured by subjective pain and objective pain behavior; anxiety was measured by subjective anxiety and anxiety states. Results: The experimental group reported significantly lower subjective pain levels than the control group (t = 9.36, p = 0.003). Regarding objective pain behaviors, the experimental group had a significantly lower score than the control group (t = 4.59, p = 0.036). The experimental group had significantly lowered subjective anxiety compared to the control group (F = 10.10, p = 0.002). Regarding anxiety states, the experimental group had significantly lower scores than the control group (F = 23.34, p < 0.001). Conclusion: The results suggest that patient-selected music listening reduced hemodialysis patients’ pain and anxiety levels during vascular access operations. Therefore, music medicine can be included as a new clinical intervention.


2020 ◽  
Vol 14 (6) ◽  
pp. 574-580
Author(s):  
Bejaan A. Jivraj ◽  
Emily Schaeffer ◽  
Jeffrey N. Bone ◽  
Chelsea Stunden ◽  
Eva Habib ◽  
...  

Purpose While virtual reality (VR) has been shown to be an effective distractor in children across a range of procedures, no studies have looked at its use within paediatric orthopaedics. The purpose of this study was to look at the use of VR in reducing anxiety levels in children during cast removal. In addition, the study aimed to find ways to enhance the efficiency of future VR trials in paediatrics. Methods A non-blinded randomized control trial took place in children aged four to 18 years. Intraprocedural anxiety was measured using the Children’s Emotional Manifestation Scale (CEMS), while pre- and post-procedural anxiety was measured using the Short State Anxiety Inventory Scale. Additional data was collected on trait anxiety, nausea levels, desire for future VR use and areas of improvement for future VR studies. Results A total of 90 subjects were included in the study (control n = 45, intervention n = 45) with a mean age of 10.25 years (sd 3.35). Post-procedural anxiety and intraprocedural anxiety were 18% (p = 0.03) and 24% (p = 0.01) lower in the VR group, respectively, with the CEMS facial component showing a 31% (p < 0.001) reduction in the VR group. In all, 99% (n = 89) of subjects experienced no nausea, with one patient experiencing mild nausea that may have been present prior to VR use. Finally, 90% (n = 81) of subjects said they would like to use VR again, 1% (n = 1) said ‘no’ and 9% (n = 8) said ‘maybe’. Conclusion VR appears to be an effective distraction technique in reducing anxiety levels in children during cast removal.


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