Virtual reality interventions and the outcome measures of adult patients in acute care settings undergoing surgical procedures: An integrative review.

Abstract

To evaluate the different types of virtual reality (VR) therapy received by adult patients undergoing surgical procedures in acute care settings and the outcome measures, as well as to highlight the acceptability and feasibility of VR approaches among patients and healthcare workers. Whittemore and Knafl's integrative review method guided the analysis. Searches were conducted in ScienceDirect, ProQuest, Wiley Online Library, Medline, PsycINFO and PubMed and Google Scholar from 2000 to June 2021. A systematic searchon articles published in English was carried out with electronic databases and hand search references. Keywords searched included primary qualitative and quantitative studies that utilized VR therapy in surgical care settings. Eighteen articles were reviewed, which reported the use of two main strategies: guided and interactive imagery therapy. The findings identified: (i) patient-clinical outcome measures including the use of analgesics, vital signs, functional capacity and length of hospital stay; and (ii) patient-reported experience measures including pain, anxiety and satisfaction level. Comfort, age, knowledge and attitude were key factors influencing the acceptability of VR among the patients, whereas cost-effectiveness and infection control were two main factors affecting the feasibility of use among the health care workers. VR therapy demonstrated potential improvements in both the patient-clinical outcomes and patient-reported experiences of those undergoing surgical procedures. However, the findings were inconsistent, which required further research to explore and establish the effectiveness of using VR in the context of acute care settings. VR distraction has been increasingly used as a non-pharmacological method in managing pain, easing anxiety and optimizing other associated outcomes in patients undergoing surgical procedures. It is essential to examine the effectiveness of VR therapy on the adult patients' outcomes in acute care settings with surgical procedures, as well as its acceptability and feasibility of use.