Do Extended Reality Interventions Benefit Patients Undergoing Elective Cardiac Surgical and Interventional Procedures? A Systematic Review and Meta-analysis.

IF 3.2 3区医学 Q1 NURSING Journal of Clinical Nursing Pub Date : 2024-12-12 DOI:10.1111/jocn.17578

Emma Harris, Steven Fenton, John Stephenson, Fiona Ewart, Salime Goharinezhad, Hyunkook Lee, Felicity Astin

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Abstract

Background: Extended reality (XR) interventions have the potential to benefit patients undergoing elective cardiac surgical and interventional procedures. However, there are no systematic reviews with meta-analyses to guide clinical care.

Aim: To critically evaluate the evidence on the effectiveness of XR interventions on patient anxiety and pain and other associated outcomes.

Design: Systematic review and meta-analysis following the PRISMA 2020 statement.

Data sources: A systematic search of five databases (CENTRAL, CINAHL, MEDLINE, PsycInfo, Scopus) from inception to July 2023.

Methods: Screening and data extraction was conducted independently by multiple reviewers. Stata (Version 17) was used to conduct meta-analyses for patient anxiety and pain. Secondary patient outcomes were summarised in a synthesis. The Cochrane Risk of Bias (Version 2) tool was applied to trials and the NHLBI Study Quality Assessment tools to all other study designs.

Results: Of the 3372 records identified, 22 were included, 10 of which were eligible for inclusion in the meta-analyses. Fifty-seven percent of randomised trials were rated as high risk of bias. Virtual reality (VR) was the only XR technology evaluated. VR significantly reduced pre-procedural anxiety (standardised mean difference: -1.29; 95% confidence interval - 1.96, -0.62, p < 0.001), and peri-procedural anxiety (standardised mean difference: -0.50; 95% confidence interval - 0.83, -0.18, p < 0.003) but did not reduce pain levels, compared with usual care. VR increased pre-procedural knowledge and postsurgical physical and pulmonary function. VR interventions may also improve emotional wellbeing, care delivery and physiological outcomes, but evidence was inconsistent.

Conclusions: XR potentially benefits cardiac patients undergoing elective invasive procedures and surgery by reducing pre- and peri-procedural anxiety and increasing procedural knowledge and physical function.

Relevance to clinical practice: Cardiac nurses' role can be supported by VR interventions to improve the patient experience and several aspects of patient care.

Patient or public contribution: Not applicable as this is a systematic review.

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扩展现实干预是否有益于接受择期心脏手术和介入手术的患者？系统回顾与元分析》。

背景：扩展现实（XR）干预有可能使接受选择性心脏手术和介入性手术的患者受益。然而，没有系统的荟萃分析来指导临床护理。目的：批判性地评估XR干预对患者焦虑、疼痛和其他相关结果的有效性证据。设计：根据PRISMA 2020声明进行系统评价和荟萃分析。数据来源：系统检索5个数据库（CENTRAL， CINAHL， MEDLINE, PsycInfo, Scopus）自成立至2023年7月。方法：由多位审稿人独立进行筛选和资料提取。采用Stata （Version 17）对患者的焦虑和疼痛进行meta分析。患者的次要结局在综合中总结。Cochrane偏倚风险（版本2）工具应用于试验，NHLBI研究质量评估工具应用于所有其他研究设计。结果：在确定的3372条记录中，22条被纳入，其中10条符合纳入meta分析的条件。57%的随机试验被评为高风险偏倚。虚拟现实（VR）是唯一被评估的XR技术。VR显著降低手术前焦虑(标准化平均差异：-1.29；结论：XR通过减少术前和术中焦虑，增加手术知识和身体功能，对接受选择性侵入性手术和手术的心脏病患者有潜在的益处。与临床实践的相关性：心脏护士的角色可以通过VR干预来改善患者体验和患者护理的几个方面。患者或公众贡献：不适用，因为这是一个系统评价。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.