Published online Oct 19, 2024. doi: 10.5498/wjp.v14.i10.1521
Revised: July 11, 2024
Accepted: August 20, 2024
Published online: October 19, 2024
Processing time: 225 Days and 16 Hours
Restrictive practices (RPs) are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency. Seclusion is an equal part of RPs intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity. Using interventions by way of virtual reality (VR) could assist with reducing the need for RPs as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments. This could also aid staff to and change current RPs.
To assess the feasibility and effectiveness of using a VR platform to provide reduction in RP training.
A randomised controlled feasibility study, accompanied by evaluations at 1 month and 6 months, was conducted within inpatient psychiatric wards at Southern Health National Health Service Foundation Trust, United Kingdom. Virti VR scenarios were used on VR headsets to provide training on reducing RPs in 3 inpatient psychiatric wards. Outcome measures included general self-efficacy scale, generalised anxiety disorder assessment 7 (GAD-7), Burnout Assessment Tool 12, the Everyday Discrimination Scale, and the Compassionate Engagement and Action Scale.
Findings revealed statistically significant differences between the VR and treatment as usual groups, in the Everyday Discrimination Scale items Q8 and Q9: P = 0.023 and P = 0.040 respectively, indicating higher levels of perceived discrimination in the VR group. There were no significant differences between groups in terms of general self-efficacy, generalised anxiety disorder assessment 9, and Burnout Assessment Tool 12 scores. A significant difference was observed within the VR group for compassionate engagement from others (P = 0.005) over time. Most respondents recorded System Usability Scale scores above 70, with an average score of 71.79. There was a significant reduction in rates of RPs in the VR group vs treatment as usual group with a fluctuating variability observed in the VR group likely due to external factors not captured in the study.
Ongoing advancement of VR technology enables the possibility of creating scenarios and simulations tailored to healthcare environments that empower staff by providing more comprehensive and effective training for handling situations.
Core Tip: This study explores the feasibility and effectiveness of a virtual reality (VR) platform for reducing restrictive practices in psychiatric care. Conducted at Southern Health National Health Service Foundation Trust, United Kingdom, the study used VR scenarios for training staff in three inpatient psychiatric wards. Various outcome measures like the general self-efficacy scale, generalised anxiety disorder assessment 7, and others were used. Results indicated high statistical significance for some variables, although some showed lower statistical power. The VR platform, evaluated using the System Usability Scale, was found to be highly usable. No significant differences in confidence levels were observed between the VR and treatment as usual groups, indicating the potential of VR as an effective tool for training in reducing restrictive practices.