Virtual Group Research Articles

The Interweaving of Pain and Perfection: A Qualitative Inquiry about the Experiences of Pregnant Women during Pregnancy and Childbirth in the COVID-19 Pandemic in Iran

Background: The prevalence of the COVID-19 pandemic has made the pleasant experiences of pregnancy and childbirth for women a source of fear and anxiety. Objective: To explore the experiences of pregnant women during pregnancy and childbirth in the COVID-19 pandemic. Methods: This qualitative conventional content analysis was conducted in Tehran, Iran, in May and June 2020. The 15 participants were selected via purposeful sampling including: 12 pregnant women, 2 relatives, and one nurse. Data were collected using in-depth and semi-structured interviews and the analysis adopted by Graneheim and Lundman (2004). MAXQDA version 12 was used for data organization. Results: According to the findings, 12 sub-categories, 6 categories, and one theme were extracted. The main theme that was derived from the analysis of the data was " the interweaving of pain and perfection". The categories include "emotional disorders", "obsessive disorders", "psychological disorders", "strengthening the dimension of spirituality" "the need for more support resources", and "inadequacy in presenting the role of motherhood. Conclusion: According to the experiences of pregnant women during pregnancy and childbirth during the outbreak of COVID-19, social, psychological, and emotional support through family and healthcare providers is recommended, as is the formation of virtual counseling groups to answer the questions of pregnant women. Health policymakers and decision-makers can use the results of this research to plan for providing services for pregnant women during future pandemics.

Patient and care partner perspectives and preferences related to myasthenia gravis treatment: A qualitative study.

Due to the high symptom and treatment burden in myasthenia gravis (MG), understanding patient and care partner perspectives and preferences is crucial. This study used voice analysis and virtual focus groups to understand patient and care partner experiences with MG-related symptoms, treatments, and preferences. The voice analysis via social media listening used artificial intelligence-powered tools to gather and structure public digital conversations on MG. Focus groups included people living with MG and care partners who completed a questionnaire and participated in a 1-h virtual session facilitated using a semi-structured interview guide. Qualitative data were aggregated, transcribed, and thematically analyzed. The voice analysis examined 11,554 posts from 8321 individuals, discussing MG symptoms, treatments, and burden. Of 7563 symptom-related posts, 5902 (78%) conveyed negative, 1427 (19%) neutral, and 234 (3%) positive sentiment. The most frequently mentioned symptoms were categorized as dysarthria, muscle weakness, and dysphagia. MG treatment sentiment analysis identified 6667 posts (67%) as neutral, 2887 (29%) as negative, and 350 (4%) as positive. For the focus groups, 15 individuals (12 patients and 3 care partners) completed the questionnaire and 14 participated in the virtual focus group sessions. The 15 participants who completed the questionnaire prioritized treatment convenience, symptom control for improved quality of life, and preventing potential MG crises in their current treatment. New treatment expectations included increased effectiveness, less frequent dosing, faster onset, and fewer side effects. Participants were also receptive to wearable medication delivery systems placed on the body and valued direct involvement in treatment decisions. Patients and care partners are often negatively impacted by MG symptoms and value convenient and fast-acting treatments that control symptoms with minimal side effects. Considering patient preferences may help optimize treatment decisions and improve patients' overall well-being and satisfaction in their care.

“Racialized persons have a completely different experience”: the experiences of older adults with the Toronto Police Service

PurposeThis paper aims to provide an in-depth examination of culturally and linguistically diverse older adults’ perceptions of and experiences with the Toronto Police Service to inform the development of a training curriculum for police officers working with older persons.Design/methodology/approachA qualitative descriptive study using virtual focus groups with 26 older adults from Toronto was conducted.FindingsThree main themes emerged: understanding intersectionality; the impact of police officer attitudes and biases; and the need for age-friendly policing. Although many older adults rely on police services to keep them safe, there is dissatisfaction with some aspects of how police interact with older adults, particularly from minority groups.Originality/valueParticipants were older adults from culturally, ethnically and linguistically diverse backgrounds who are not usually included in studies on improving police services.

Mindfulness-based group intervention for adolescents with type 1 diabetes: initial findings from a pilot and feasibility randomized controlled trial.

To evaluate feasibility/acceptability of a virtual, group mindfulness-based intervention (MBI) adapted for pediatric type 1 diabetes (T1D). This two-way controlled trial randomized adolescents 1:1 to MBI (n = 20) or health education (HE; n = 22) groups lasting 6-7 weeks. Eligibility included 12-17 years, T1D ≥ 1 year, and elevated scores on PROMIS depression or anxiety measures. Recruitment, retention, and session attendance were tracked to measure feasibility. Acceptability was measured via youth-reported post-session surveys. Adolescents completed depression, anxiety, and diabetes-specific surveys at baseline, immediately post-program, and 3 months post-program completion. HbA1c values approximating these timeframes were obtained from chart review. 55% of screened participants were eligible to participate, and 100% of eligible youth enrolled. There was 93% study retention and 96% session attendance rates. Survey data were 100% complete at baseline, and 93% complete at post-program and 3-month follow-ups; 83% and 78% of MBI participants rated sessions as at least somewhat enjoyable and helpful, respectively, and 91% and 82% of HE participants rated sessions as at least somewhat enjoyable and helpful, respectively. Mean scores showed declines in depression, anxiety, disordered eating, diabetes distress, and HbA1c in both groups across time, with trends toward potential greater reductions in depression and HbA1c in MBI. This pilot provides preliminary evidence that virtual MBI and HE groups adapted for adolescents with T1D are feasible to deliver and acceptable, with potential improvement in psychosocial, behavioral, and diabetes-specific outcomes. Whether MBI is more effective for targeting negative affect and glycemic control in the context of adolescent T1D requires testing in a full-scale efficacy trial.

Fostering Trust in Public Health Messaging: Tailoring Communication for Rural Parents.

As pandemic-related mistrust of public health recommendations in rural communities may compound gaps in pediatric immunizations, our team explored parents' perceptions of trustworthiness in messaging. Qualitative study using 4 virtual focus groups. Rural Wisconsin. Participants (n = 25) were parents or guardians of children recruited through our contacts with community-based organizations serving rural communities. Researchers used task-oriented elicitation techniques to initiate discussion on the trustworthiness of messengers and messages providing health recommendations. Participants were asked to (1) review existing public health messaging on a range of topics and from a range of sponsors; and (2) rank a list of potential messengers in terms of trustworthiness (eg, local health department, Centers for Disease Control). Discussions were recorded, and audio files transcribed, to facilitate a team-based, thematic analysis. Competency in medical knowledge and parenting experience contributed to estimations of trustworthiness. Participants also responded well to messages and messengers that were able to project recognition of their children's uniqueness and their experience as parents. Participants distrusted messengers who were seen as biased or "one-sided" in their perspectives. For successful health promotion for rural-living parents, messengers must be recognized as "competent" to provide pediatric health advice and to avoid blanket recommendations that may undermine parents' experience and feelings of being "understood" and affect perceptions of trustworthiness.

Virtual reality vs. Tablet video for venipuncture education in children: A randomized clinical trial.

Pediatric patients usually experience high levels of pain and distress due to venipuncture. This randomised study aimed to evaluate the effects of virtual reality-based preprocedural education in comparison with video-based education in terms of pain and distress experienced by children scheduled to undergo venipuncture. Ninety children aged 4-8 years who were scheduled to undergo venipuncture surgery were randomly assigned to either a video or virtual reality group. Children in the video group received preprocedural education on venipuncture via a video displayed on a tablet and those in the virtual reality group received the same education via a head-mounted virtual reality display unit. The educational content for the two groups was identical. An independent assessor blinded to the group assignment observed the children's behavior and determined their Children's Hospital of Eastern Ontario Pain Scale scores, parental satisfaction score, procedure-related outcomes, venipuncture time, number of repeated procedures and difficulty score for the procedure. The virtual reality group experienced less pain and distress, as indicated by their Children's Hospital of Eastern Ontario Pain Scale scores compared with the video group (5.0 [5.0-8.0] vs. 7.0 [5.0-9.0], P = 0.027). There were no significant intergroup differences in parental satisfaction scores or procedure-related outcomes. For pediatric patients scheduled to undergo venipuncture, preprocedural education via a head-mounted display for immersive virtual reality was more effective compared with video-based education via a tablet in terms of reducing pain and distress.

Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial.

Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach.

Connected from Afar: Culturally Grounded Remote Peer Support During the COVID-19 Pandemic

In this article, two PhD students from separate Canadian universities, both sharing an immigrant background, engage in autobiographical narrative inquiry, highlighting the importance of peer-support experiences during the pandemic. They explore their journeys as immigrants and PhD students, recounting their experiences in a virtual support group. This narrative illustrates the exchange of academic, mental health and personal support rooted in shared culture, language and ethnicity. The study provides insights into the benefits of peer support on virtual platforms and adds immigrant perspectives. It suggests that university administrators can find innovative ways to support marginalized students, fostering mutual support among them, particularly in the remote-learning context of COVID. This article highlights the potential for authentic and effective support systems that address the unique challenges faced by immigrant and marginalized students, enhancing their academic and personal development.

Global hepatitis B and D community advisory board: expectations, challenges, and lessons learned.

Community Advisory Boards (CABs) play an important role in developing and delivering patient-centered care. However, the impact of participation on CAB members has not been well studied, particularly on the global scale. In 2022, the Hepatitis B Foundation (HBF) convened the first global hepatitis B and hepatitis delta CAB with 23 members from 17 countries, representing six out of the seven World Health Organization (WHO) regions, and countries with the largest hepatitis B and hepatitis delta disease burden. To reflect on the process of assembling an effective and motivated CAB and assess the impact on CAB participants, three virtual focus group sessions were held with 16 participants in July and August 2023. Sessions were recorded and transcribed. Questions focused on motivations for joining the CAB, membership experiences, and lessons learned. Grounded theory analysis was used to generate hypotheses about reasons for CAB members' participation, as well as challenges and suggestions. Qualitative analysis using inductive reasoning identified key themes within responses. Transcripts were independently analyzed by a primary and secondary coder. Motivations for joining the CAB included participants' desire to advocate for people living with hepatitis B and hepatitis delta, and other altruistic factors. Participants reflected that through CAB membership, they gained networking and advocacy opportunities and enhanced their hepatitis B- and hepatitis delta-related knowledge. Challenges participants experienced were related to time, physical limitations, and stigma. Finally, participants discussed their limited direct engagement with drug developers and proposed ways the CAB can increase interactions with stakeholders going forward. Based on participants' assessments, establishing a global CAB for stigmatized infectious diseases is worth the effort. Regular internal review of community advisory boards' structure and performance is critical to ensure the CAB is fulfilling its mission.

Exploration of the Cultivation of Innovative Talents in Intelligent Construction in Application-oriented Universities

Relying on the first-class construction discipline platform, the field research was conducted on the application-oriented colleges and universities that have opened the intelligent construction major, and the necessity of the establishment of the intelligent building major, talent training, professional construction, practice base construction, and teacher construction were discussed. The new generation of information technology, such as BIM technology, 3D printing, assembly, unmanned aerial vehicles, smart construction site sand tables etc., optimizes and adjusts the training program and curriculum system of civil engineering professionals, and integrates them into the corresponding courses. Combine smart construction site and virtual simulation technology with practical courses to explore the cultivation of innovative talents in application-oriented universities. The exploration of the cultivation of innovative talents in intelligent construction in application-oriented colleges and universities pays more attention to application-oriented training, explores new modes of practical teaching, and constructs a smart construction site simulation practice teaching system and virtual simulation practice teaching project group from practice, so as to provide reference for colleges in the later stage of intelligent construction professional declaration and construction, and application-oriented talent training.

A Randomized Trial Evaluating Acceptance and Commitment Therapy and Smart Phone Care Management Application to Augment Buprenorphine Therapy for Opioid Use and Chronic Pain.

There is high comorbidity of opioid use disorder (OUD) and chronic pain (CP), which is often addressed by prescribing buprenorphine (BUP). While BUP is effective in preventing overdose, it does not address the psychological aspects of OUD and CP comorbidity and treatment retention rates are as low as 50%. The Virtual Opioid use disorder Integrated Chronic Pain Treatment (VOICE) study (NCT05039554) is a novel effectiveness-implementation trial to test a 12-week virtual group Acceptance and Commitment Therapy (ACT) protocol and a care management smartphone application (app; Valera Health) on pain and opioid use in patients with OUD and CP receiving BUP. Using a 2 × 2 factorial design, participants (expected N = 280) are randomized into: ACT, Valera app, ACT + Valera, or Treatment as Usual arm. This study is taking place in the Bronx, NY, a racially/ethnically diverse community that faces numerous socioeconomic stressors and is one of the nation's epicenters of the opioid epidemic. We created a culturally responsive ACT group protocol, and Valera psychoeducational material. Outcome measures include NIH HEAL Common Data Elements and ACT and Valera-specific measures. We are conducting a novel 2 × 2 trial investigating augmenting BUP treatment with ACT and Valera, with the goal that improved mental health and access to care will result in decreased and opioid use and pain interference.

The Effect of Breathing Exercises Using a Breathing Exercise Device and Virtual Reality Applications During Pregnancy and Labor on Labor.

The study aimed to determine the effects of breathing exercises using a breathing exercise device and virtual reality applications during pregnancy and labor on labor pain, duration, and birth satisfaction. This study was planned as a single-blind randomized controlled experimental study. The study was conducted with a total of 114 pregnant women who were randomized between September 2022 and May 2023 at a maternity hospital in Southeastern Anatolia, Turkey. The participants were divided into three groups: the breathing exercise group (39), the virtual reality group (37), and the control group (38). The data were collected by using the descriptive information form, labor observation form, visual analog scale, and Birth Satisfaction Scale. The incidence of average pain scores and labor duration were lower in the intervention groups when compared with the control group (P < .05). The average birth satisfaction scores of pregnant women in both experimental groups were determined to be higher than those in the control group (P < .05). The research results show that breathing exercises using a breathing exercise device during pregnancy and labor and virtual reality applications shorten the duration of labor, reduce labor pain, and increase birth satisfaction.

An international, multicenter post hoc analysis comparing in-person and virtual medication management strategies in post-ICU recovery clinics.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To compare the incidence of ICU pharmacist interventions in intensive care unit recovery center (ICU-RC) in-person and virtual clinic visits. This was a post hoc analysis of interventions implemented by ICU pharmacists among adult patients who were referred to 12 ICU-RCs across the United States and the United Kingdom between September 2019 and July 2021, as reported in a previously published study "An International, Multicenter Evaluation of Comprehensive Medication Management by Pharmacists in ICU Recovery Centers." That study included patients who received a comprehensive medication review by an ICU pharmacist. Medication-related interventions performed by an ICU pharmacist during ICU-RC in-person clinic visits were compared to those performed during virtual clinic visits. There were 507 patients referred to an ICU-RC, of whom 474 patients attended a clinic visit. Of those, 472 received a comprehensive medication review, with 313 patients attending in-person visits and 159 patients attending virtual visits. The incidence of medication-related interventions implemented was higher in the ICU-RC in-person clinic group compared to the virtual clinic group (86.5% vs 79.2%, P = 0.04). There was no difference in the median number of ICU pharmacist interventions per patient between the in-person and virtual clinic groups (2 vs 2, P = 0.13). An ICU admission diagnosis was an independent predictor of medication-related interventions among all patients. The incidence of ICU pharmacist interventions was higher at ICU-RC in-person clinic visits compared to virtual clinic visits. Pharmacists aid in meeting the complex pharmacologic challenges of post-intensive care syndrome in both settings.

The Effect of Virtual Patient Visits in the Intensive Care Unit on Postpartum Depression.

Maternal postpartum depression negatively affects the baby's emotional, behavioral, and cognitive development and attachment pattern. We aimed to examine the effect of virtual patient visits in neonatal intensive care unit on postpartum depression in mothers. Research data were obtained from mothers whose preterm infants were hospitalized in the neonatal intensive care unit between April and December 2022. A total of 100 mothers of preterm infants (50 in the virtual patient visit and 50 in the control group) treated in the neonatal intensive care unit of a hospital constituted the sample of the study. Using the Zoom application, virtual patient visits were made for 5 minutes, seven days a week, between mother and the preterm infants, with no nursing intervention implemented for at least 30 minutes. Mothers in the control group saw their babies face to face two days a week. In standard hospital procedure, mothers saw their babies twice a week. Edinburgh postpartum depression scale (EPDS) was administered online to the all mothers before and after the study. The research resulted with statistically significant decreased EPDS scores of the mothers in virtual patient visit group with the pre-study scores. A statistically significant decrease was found compared to the control group (P<0.001). Virtual patient visits between preterm infants in neonatal intensive care unit and their mothers could be effective in preventing or reducing postpartum depression of the mother.

Beyond words: investigating non-verbal indicators of collaborative engagement in a virtual synchronous CSCL environment.

In the future of higher education, student learning will become more virtual and group-oriented, and this new reality of academic learning comes with challenges. Positive social interactions in virtual synchronous student learning groups are not self-evident but need extra support. To successfully support positive social interactions, the underlying group processes, such as collaborative group engagement, need to be understood in detail, and the important question arises: How can collaborative group engagement be assessed in virtual group learning settings? A promising methodological approach is the observation of students' non-verbal behavior, for example, in videoconferences. In an exploratory field study, we observed the non-verbal behavior of psychology students in small virtual synchronous learning groups solving a complex problem via videoconferencing. The groups were videorecorded to analyze possible relations between their non-verbal behaviors and to rate the quality of collaborative group engagement (QCGE). A rating scheme consisting of four QCGE dimensions (Behavioral, Social, Cognitive, and Conceptual-to-consequential QCGE) was applied, and non-verbal behaviors during the task were coded based on related research literature. We quantitatively and qualitatively analyzed non-verbal behaviors as indicators of QCGE. The results show that groups use a wide range of non-verbal behaviors. Furthermore, certain non-verbal behaviors are significantly related to specific dimensions of QCGE. These results help to identify relevant indicators of QCGE in virtual synchronous learning settings and thus promote the development of advanced methods for assessing QCGE. Furthermore, the indicators can be discussed as possible anchors for supporting collaborative learning in virtual synchronous groups.

Navigating the challenges: exploring the association between COVID-19 lockdowns and eating behavior in university students: a systematic review and investigation of factors impacting ed levels.

The COVID-19 pandemic has significantly impacted the mental and physical well-being of individuals globally, with university students being particularly susceptible to mental health issues. Factors such as the transition to adulthood, economic hardships, and academic responsibilities, compounded by pandemic-related disruptions like lockdowns and remote learning, have elevated stress levels and altered daily routines. The pandemic has given rise to post-traumatic stress symptoms in certain individuals, including university students which may contribute to the emergence of emotional eating or adopting unhealthy eating patterns as a coping mechanism, leading to excessive consumption or unhealthy dietary choices. This review aims to investigate the influence of COVID-19 restrictions on eating disorders among university students and identifying the contributing factors. Out of 59 identified articles, 10 met the inclusion criteria, involving 23,542 participants (70.2 % women, 29.35 % men, 0.42 % gender fluid/undisclosed). The lockdown led to increased prevalence and severity of eating disorders among university students, particularly in women. The review highlights a notable increase in eating disorders among university students during the COVID-19 pandemic. Mental health issues, reduced physical activity, and economic stress were significant contributors to this trend, with women being disproportionately affected. To mitigate the impact of future pandemics or similar disruptions, universities should implement early screening, provide mental health counseling, virtual support groups, nutritional guidance, and opportunities for physical activity. Encouraging students to seek professional help is crucial for managing mental health and eating habits in such scenarios.

Perspectives and Attitudes Toward Healthcare and Access Among Transgender and Nonbinary Patients in Ventura County, CA

Transgender and nonbinary (TNB) patients require clinically and culturally appropriate and responsive care in affirming spaces, but barriers exist that prevent TNB patients from accessing or dissuade them from pursuing such care. In this research brief, we summarize findings from a virtual focus group (N= 6) designed to assess perspectives and attitudes toward accessing and receiving care among TNB patients in Ventura County, CA. Qualitative analysis revealed themes related to (1) the importance of enhanced TNB knowledge and sensitivity among medical personnel (particularly among nonprovider staff in healthcare settings), (2) the importance of updating data collection and data management systems with TNB-appropriate terms and diagnoses (e.g., on intake forms), and (3) the importance of self-advocacy and self-education among TNB patients in navigating the healthcare system. Findings indicate that those looking to increase healthcare access and quality among TNB patients in the area should focus their efforts on increasing TNB knowledge and sensitivity among all healthcare employees (i.e., not just providers), enhancing TNB data collection, and making institutional changes such that TNB patients do not have to rely as heavily on themselves when navigating the healthcare system.

Barriers and facilitators to home blood pressure monitoring in women with pregnancies complicated by hypertensive disorders: a qualitative study.

Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality in the US. Improved diagnosis and treatment of HDP may be achieved through home blood pressure monitoring (HBPM). However, there are challenges to effective HBPM during pregnancy. This qualitative study was conducted to explore patients' perspectives and experiences with HBPM. Pregnant or recently postpartum women with HDP (≥18 years) were recruited from an academic medical center to virtual focus groups from March to September 2023. The discussions centered on experiences with HDP and barriers and facilitators to HBPM. Qualitative thematic analysis was performed. Among 20 participants, the mean age was 33.8 (SD 5.9) years, with 35% Hispanic and 35% Black/African-American. Facilitators to HBPM included understanding the parameters/purpose of HBPM, prior experience with healthcare/duration of hypertension, free access to HBPM equipment and decision support, creating a routine, external support/counseling (e.g., partner/healthcare/family), and technology support. Barriers to HBPM included uncertainty/lack of training about the HBPM process, accessing/using HBPM equipment, the belief that clinic monitoring was sufficient/achieving good control, and activation barriers to making HBPM a priority (e.g., fear of affirming the diagnosis, higher priorities/life stressors). Many of the barriers to HBPM in pregnancy can be overcome through patient education/counseling, technology support, clinician/family reinforcement, and better access to validated blood pressure monitors. Given the importance of HBPM in improving outcomes for HDP, it is important for healthcare providers and policy makers to work to reduce barriers and amplify facilitators to HBPM for better adoption.

The comparison between intratympanic gentamicin prehabilitation and postoperative virtual reality exposure to standard vestibular training in patients with vestibular schwannoma.

Resection of the vestibular schwannoma causes acute peripheral vestibular loss. The process of central compensation starts immediately afterward. The rehabilitation goal is to support this process and restore the quality of life. In this prospective single-center study, 67 consecutive patients underwent vestibular schwannoma resection (40 females, mean age 52 ± 12 years). The patients were divided into three groups: the prehabilitation with intratympanic gentamicin group, the virtual reality group (optokinetic stimulation via virtual reality goggles in the first ten days after the surgery), and the control group. All patients were examined with objective methods and completed questionnaires before the prehabilitation, before the surgery, at the hospital discharge, and after three months. Intratympanic gentamicin prehabilitation leads ipsilaterally to a significant aVOR reduction in all semicircular canals (p < 0.050), the increase of the unilateral weakness in air calorics (p = 0.026), and loss of cVEMPs responses (p = 0.017). Prehabilitation and postoperative exposure to virtual reality scenes improved the patient's perception of vertigo problems according to Dizziness Handicap Inventory (p = 0.039 and p = 0.076, respectively). These findings conform with the optokinetic testing results, which showed higher slow phase velocities at higher speeds (40deg/s) in both targeted groups compared to the control group. Preoperative intratympanic gentamicin positively affects peripheral vestibular function, influencing balance perception after VS resection. In long-term follow-up, prehabilitation and postoperative exposure to virtual reality improve patients' quality of life in the field of vertigo problems.

Virtual Compared With In-Office Postoperative Visits After Urogynecologic Surgery: A Randomized Controlled Trial.

To compare patient satisfaction, health care resource utilization, and adverse events among patients receiving a virtual video compared with in-office postoperative visit after urogynecologic surgery. We hypothesized that virtual video visits would be noninferior to in-office visits. This was a randomized noninferiority clinical trial of patients undergoing surgery for pelvic organ prolapse and urinary incontinence at a single academic tertiary referral center. Participants were randomized to receive either a virtual video postoperative visit or a standard in-office postoperative visit. The primary outcome was patient satisfaction measured by the validated PSQ-18 (Patient Satisfaction Questionnaire-18) (noninferiority margin 5 points) at the 6-week postoperative visit. Secondary outcomes included PSQ-18 domain scores (noninferiority margin 0.5 points) and composite health care resource utilization and adverse events after the 6-week postoperative visit up to 12 weeks after surgery (noninferiority margin 10%). A sample size of 100 participants (50 per group) would allow 80% power to assess a 5-point noninferiority margin on the total PSQ-18 with an SD of 10 and α=0.05. From January 2023 to September 2023, 265 patients were screened for eligibility, and 104 were randomized. A total of 100 participants (50 per arm) completed the study and were included in the analysis. The mean±SD age of all participants was 57.0±13.2 years. The mean±SD PSQ-18 total score was 75.18±8.15 in the virtual group and 75.14±8.7 in the in-office group. The mean PSQ-18 total score was 0.04 points higher (ie, greater degree of satisfaction) in the virtual group, with a 95% CI of -2.75 to 2.83, which met the criterion for noninferiority. Between-group differences for all PSQ-18 domain scores likewise met criterion for noninferiority. Composite health care resource utilization was 14.0% lower in the virtual group than in the in-office group (20.0% vs 34.0%, 95% CI, -28.0% to 1.0%). For composite adverse events, the between-group difference was 2.0% (2.0% in virtual group vs 0.0% in in-office group, 95% CI,-3.0% to 8.0%). Virtual video postoperative visits were noninferior to in-office visits with regard to patient satisfaction, health care resource utilization, and adverse events and can be offered as an alternative to in-office visits for postoperative follow-up after urogynecologic surgery. ClinicalTrials.gov, NCT05641077.