Background: Surgery is an essential treatment for early-stage breast cancer. However, various side effects of breast cancer surgery, such as arm dysfunction and lymphedema, remain causes for concern. Rehabilitation exercises to prevent such side effects should be initiated within 24 hours after surgery. Virtual reality (VR) can assist the process of rehabilitation; however, the feasibility of applying VR for rehabilitation must be explored, in addition to experiences of this application.
Objective: This study explored patients' attitudes toward and experiences of using VR for their rehabilitation to determine the feasibility of such VR use and to identify potential barriers.
Methods: A phenomenological qualitative study was conducted from September to December 2021. A total of 18 patients with breast cancer who had undergone surgical treatment were interviewed using open-ended questions. The Colaizzi 7-step procedure for phenomenological analysis was used for data analysis. To ensure high study reliability, this study followed previously reported quality criteria for trustworthiness.
Results: Three themes were identified: (1) VR was powerful in facilitating rehabilitation, (2) early and repetitive upper limb movements were an advantage of VR rehabilitation, and (3) extensive VR use had challenges to be overcome. Most of the interviewed patients reported positive experiences of using VR for rehabilitation. Specifically, VR helped these patients identify appropriate motion and angle limits while exercising; in other words, knowledge gained through VR can play a key role in the rehabilitation process. In addition, the patients reported that the use of VR provided them company, similar to when a physiotherapist is present. Finally, the gamified nature of the VR system seemed to make VR-based rehabilitation more engaging than traditional rehabilitation, particularly with respect to early rehabilitation; however, the high cost of VR equipment made VR-based rehabilitation difficult to implement at home.
Conclusions: The interviewed patients with breast cancer had positive experiences in using VR for rehabilitation. The high cost of both VR equipment and software development presents a challenge for applying VR-based rehabilitation.
Background: In addition to illness, inactivity is a risk factor for high mortality in nursing homes. Using innovative technology, such as virtual reality (VR), for meaningful group activities could provide new opportunities for solving this problem. VR interventions have already been approved as a promising method for enhancing the health of older adults.
Objective: In this study, we examined whether VR-based group activities can have a positive impact on activity level and group interaction among older adults living in nursing homes.
Methods: We conducted a longitudinal study and provided VR interventions as a group activity once a week for 4 consecutive weeks in nursing homes. Participants were recruited based on the experience of the nursing staff members and the natural decisions of the older adults. Within a virtual cottage, designed according to the needs of the target group, older adults were able to perform daily tasks that they were no longer able to do in real life, such as gardening and making pizza. Overall, 2 psychologists measured the psychosocial capacities, activities of daily life, and well-being before and after the interventions using standardized instruments.
Results: The results focus on a total of 84 older adults from 14 nursing homes who completed at least 3 VR interventions. The results indicate that several psychosocial capacities among the older adults improved, including adherence to regulations (P<.001; η²=0.122), flexibility (P<.001; η²=0.109), and group integration (P<.001; η²=0.141). Problems related to competence also showed a slight decrease (P=.04; η²=0.039). In addition, the VR intervention promoted their proactivity (P<.001; η²=0.104) and mobility (P=.04; η²=0.039). During the VR group intervention, older adults' well-being could be maintained at a high level. The results highlight the beneficial effects of VR intervention as a meaningful activity in nursing homes, showcasing the potential of VR applications in this setting.
Conclusions: This study provides a novel and naturalistic perspective, offering new insights into the use of VR in nursing homes. The VR intervention was well accepted and fulfilled the aim of enhancing capacity and well-being. It could be a meaningful group activity in nursing homes to improve social group interaction. To provide stronger evidence, randomized controlled trials are necessary.
Background: A frequent rehabilitation goal for children with gait disorders is to practice daily-life walking activities. Unfortunately, these are often difficult to practice in a conventional therapeutic setting. Virtual reality (VR) with head-mounted displays (HMDs) could be a promising approach in neurorehabilitation to train such activities in a safe environment. First, however, we must know whether obstacles in VR are indeed mastered as obstacles.
Objective: This study aimed to provide information on whether VR is feasible and motivating to induce and practice movements needed to master real obstacles in children and adolescents with gait disorders. Furthermore, this project aims to evaluate which kinds of everyday walking activities are appropriate to be practiced in VR.
Methods: In this cross-sectional study, participants stepped over a bar, crossed a gap, balanced over a beam, and circumvented stationary obstructions arranged in a course under real physical and virtual conditions wearing a VR HMD. We recorded the respective primary outcomes (step height, step length, step width, and minimal shoulder-obstacle distance) with motion capture. We then calculated the mean differences and 95% CI of the spatiotemporal parameters between the VR and physical setup and later compared them using noninferiority analysis with margins defined a priori by a clinical expert panel. Additionally, the participants responded to a standardized questionnaire while the therapists observed and evaluated their movement performance.
Results: We recruited 20 participants (mean age 12.0, range 6.6-17.8 years) with various diagnoses affecting their walking ability. At 3.77 (95% CI 1.28 to 6.26) cm, the mean difference in step height of the leading foot in the overstepping task did not exceed the predefined margin of -2 cm, thus signifying noninferiority of the VR condition compared to mastering the physical obstacles. The same was true for step length (-1.75, 95% CI -4.91 to 1.41 cm; margin -10 cm), step width (1.05, 95% CI 0.20 to -1.90 cm; margin 3 cm), and the minimal shoulder-obstacle distance (0.25, 95% CI -0.85 to 0.35 cm; margin -2 cm) in the other tasks. Only the trailing foot in the overstepping task yielded inconclusive results.
Conclusions: Children with gait disorders perform everyday walking tasks like overstepping, crossing, balancing, or circumventing similarly in physical and VR environments, suggesting that VR could be a feasible therapeutic tool to practice everyday walking tasks.
Background: The COVID-19 pandemic has had a severe impact on students' mental health. Interventions are needed to promote their psychological well-being and prevent mental illnesses in the aftermath of this unprecedented situation. Digital escape games can be an effective tool to support students' mental health. A cocreation approach can improve the acceptability of these interventions by involving different stakeholders (eg, end users, game designers, and health professionals) to obtain audience-specific games.
Objective: This study aims to describe the process of testing and optimizing the game "EscapeCovid" on students' mental health, to serve as a model for the cocreation of future similar interventions.
Methods: The PRODUCES (Problem, Objective, Design, End Users, Cocreators, Evaluation, Scalability) framework was used. Cocreation steps (test and optimization) were detailed for replicability. A total of 45 students tested a pilot version of the game, with 10 undergoing a semistructured interview. Meetings with a group of stakeholders and brainwriting were organized to optimize the game.
Results: We produced a new version of the game incorporating the suggestions provided by student testers and following the stakeholders' guidelines. Improvements were made to both the content and the form of the new version of the pilot game. The storyline, including the protagonist and the scenes, was adapted to the student population.
Conclusions: Our results suggested that cocreation can contribute to the design of more widely accepted interventions aimed at promoting mental health and preventing psychological disorders. Results also suggest that an end user-centered approach can facilitate intervention tailoring. When conceiving a health-related escape game for students, we recommend using the cocreation approach to enhance players' experience, thus positively influencing their learning process and overall well-being.
Background: The construction field is highly concerned with the risk of work-related accidents, and training employees is difficult due to their small numbers in most companies.
Objective: This study aimed to study the impact of a virtual reality (VR) training tool following a periodic occupational health medical visit on the feeling of personal effectiveness in preventing occupational risks related to co-activity on a construction site.
Methods: We conducted a cross-sectional study with employees who had a periodic medical visit between April 1, 2022, and October 13, 2022, in a French occupational health service specializing in the construction field (Services Médicaux Interentreprises Bâtiment Travaux Publics [SMIBTP]). The employees were divided into 2 groups according to the training received: a medical visit alone or coupled with a session with a VR tool. We compared the scores for a "feeling of self-efficacy in occupational risk prevention" using the Fisher exact test.
Results: Of the 588 employees included, 210 had a medical visit alone, and 378 had a medical visit coupled with VR training. Training with the VR tool was associated with an increased "feeling of self-efficacy in occupational risk prevention." The employees who benefited from the training reported a willingness to apply the advice given on prevention to a greater extent than those who did not, and they believed that risks on the worksite could be reduced using this tool.
Conclusions: Using VR training as a complement to periodic medical visits in an occupational health service improves the feeling of personal effectiveness in occupational risk prevention at the end of the training. If this trend is confirmed over a longer period of time, it could be an easily accessible prevention lever for employees in the future.
Background: Implicit bias is as prevalent among health care professionals as among the wider population and is significantly associated with lower health care quality.
Objective: The study goal was to develop and evaluate the preliminary efficacy of an innovative mobile app, VARIAT (Virtual and Augmented Reality Implicit Association Training), to reduce implicit biases among Medicaid providers.
Methods: An interdisciplinary team developed 2 interactive case-based training modules for Medicaid providers focused on implicit bias related to race and socioeconomic status (SES) and sexual orientation and gender identity (SOGI), respectively. The simulations combine experiential learning, facilitated debriefing, and game-based educational strategies. Medicaid providers (n=18) participated in this pilot study. Outcomes were measured on 3 domains: training reactions, affective knowledge, and skill-based knowledge related to implicit biases in race/SES or SOGI.
Results: Participants reported high relevance of training to their job for both the race/SES module (mean score 4.75, SD 0.45) and SOGI module (mean score 4.67, SD 0.50). Significant improvement in skill-based knowledge for minimizing health disparities for lesbian, gay, bisexual, transgender, and queer patients was found after training (Cohen d=0.72; 95% CI -1.38 to -0.04).
Conclusions: This study developed an innovative smartphone-based implicit bias training program for Medicaid providers and conducted a pilot evaluation on the user experience and preliminary efficacy. Preliminary evidence showed positive satisfaction and preliminary efficacy of the intervention.
Background: Health education games make health-related tasks enjoyable and interactive, thereby encouraging user participation. Entrepreneurs and health educators can leverage online crowdfunding platforms, such as Kickstarter, to transform their innovative ideas into funded projects.
Objective: This research focuses on health education game initiatives on Kickstarter. Through an online user survey, it aims to understand user perceptions and evaluate the significance of 8 distinct components that may influence the success of such crowdfunding initiatives.
Methods: A total of 75 participants evaluated games using 8 dimensions: game rules, learning objectives, narrative, content organization, motivation, interactivity, skill building, and assessment and feedback. The survey data were analyzed using descriptive statistical analysis, exploratory factor analysis, the Wilcoxon-Mann-Whitney test, and multivariate analysis.
Results: Exploratory data analysis showed that, among the 8 dimensions, skill building, content organization, and interactivity were the top-ranking dimensions most closely associated with crowdfunding health education game. The 8 dimensions can be grouped into 3 categories from the exploratory factor analysis: game content-, instruction-, and game design-related components. Further statistical analysis confirmed the correlation between these dimensions with the successful crowdfunding of health education games.
Conclusions: This empirical analysis identified critical factors for game proposal design that can increase the likelihood of securing crowdfunding support.
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