Psychological treatments tend to be created based on group averaged results of how variables relate to each other. This means that treatments may not be applicable to individual people where variables may relate to each other in other ways than seen in the group models. While the personalization of psychological treatments is on the rise, such attempts need to be accompanied by idiographic research methods in order to achieve a high degree of personalization. Ideally, treatments can be formed targeting individual specific psychological processes of change. If personalization is conducted on the basis of subgroups, such subgrouping needs to be done using idiographic methods rather than using categories defined in nomothetic research.

Psychoeducation positively influences the psychological components of chronic low back pain (CLBP) in conventional treatments. The digitalization of health care has led to the discussion of virtual reality (VR) interventions. However, CLBP treatments in VR have some limitations due to full immersion. In comparison, augmented reality (AR) supplements the real world with virtual elements involving one's own body sensory perception and can combine conventional and VR approaches.

The aim of this study was to review the state of research on the treatment of CLBP through psychoeducation, including immersive technologies, and to formulate suggestions for psychoeducation in AR for CLBP.

A scoping review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in August 2024 by using Livivo ZB MED, PubMed, Web of Science, American Psychological Association PsycINFO (PsycArticle), and PsyArXiv Preprints databases. A qualitative content analysis of the included studies was conducted based on 4 deductively extracted categories.

We included 12 studies published between 2019 and 2024 referring to conventional and VR-based psychoeducation for CLBP treatment, but no study referred to AR. In these studies, educational programs were combined with physiotherapy, encompassing content on pain biology, psychological education, coping strategies, and relaxation techniques. The key outcomes were pain intensity, kinesiophobia, pain catastrophizing, degree of disability, quality of life, well-being, self-efficacy, depression, attrition rate, and user experience. Passive, active, and gamified strategies were used to promote intrinsic motivation from a psychological point of view. Regarding user experience from a software development perspective, user friendliness, operational support, and application challenges were recommended.

For the development of a framework for an AR-based psychoeducational intervention for CLBP, the combination of theories of acceptance and use of technologies with insights from health psychological behavior change theories appears to be of great importance. An example of a theory-based design of a psychoeducation intervention in AR for CLBP is proposed and discussed.

To explore the chain-mediating role and impact of rumination and psychological resilience on symptom burden and kinesiophobia in patients with chronic heart failure.

We selected a total of 318 patients with chronic heart failure from a hospital in Wuxi between November 2023 and May 2024 using a convenience sampling method. Various scales and questionnaires assessed general information, symptom burden, resilience, rumination thinking, and kinesiophobia. Statistical analysis was conducted using SPSS and the bootstrap method to examine the chain mediation effect.

The scores for symptom burden, rumination, psychological resilience, and kinesiophobia in patients with chronic heart failure were 0.81± 0.47, 50.63± 9.02, 23.43± 6.26, and 38.91± 8.01, respectively. Mediation analysis showed that symptom burden had a direct positive predictive effect on rumination (β = 0.475, 95% CI: 0.365-0.584), rumination had a direct negative predictive effect on psychological resilience (β = -0.199, 95% CI: -0.306-0.092), and psychological resilience had a direct negative predictive effect on kinesiophobia (β = -0.273, 95% CI: -0.340-0.206). Rumination and psychological resilience played a chain mediation role between symptom burden and kinesiophobia, with a total effect of 0.606, a direct effect of 0.380, and an indirect effect of 0.226. The mediation effect accounted for 37.29% of the total effect.

Kinesiophobia is at a high level in patients with chronic heart failure. Symptom burden can affect patients' kinesiophobia through the independent or chain mediation effects of rumination and psychological resilience. Healthcare professionals should actively adopt strategies to address symptom burden and rumination while enhancing psychological resilience to reduce patients' kinesiophobia.

Integration of virtual reality (VR) technology into preoperative patient education has shown potential to improve nursing practice. The study by Kim et al examines the impact of VR on nurse satisfaction, usability, and burnout. A prospective study involving 20 nurses and 80 patients was conducted, comparing traditional paper-based education with VR-based education in the plastic surgery ward at Chungnam National University Hospital. Findings demonstrated that VR significantly enhanced satisfaction and usability among nurses, while also reducing emotional exhaustion, a critical factor in nurse burnout. Consistency in education quality was also improved, ensuring uniform patient care. These results underscore the importance of VR in reducing the stress of repetitive tasks, improving job satisfaction, and potentially enhancing nurse retention. Future research should explore the broader applications of VR in healthcare and address the logistical challenges of integrating this technology into routine clinical practice. The study by Kim et al highlights VR's transformative potential in preoperative education for both patients and healthcare providers.

Background/Objectives: Sleep disturbance is often observed in the context of chronic pain. We hypothesize that, by providing an immersive Virtual Reality (VR) experience with a serious game to chronic pain patients an hour before bedtime, attention can be diverted from the pain condition, consequently leading to improved sleep quality. The aim is to evaluate the efficacy of VR compared to usual care in reducing the number of awakenings during the night and increasing sleep efficiency in patients suffering from painful diabetic polyneuropathy (PDPN). Methods: Eight patients with PDPN were randomized to either two weeks of VR or two weeks of usual care, followed by a cross-over. The primary outcome measurements were sleep efficiency and number of awakenings during the night. As secondary outcomes, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression, pain intensity, side effects and impression of change were evaluated. Results: Data of seven patients were analysed. Actigraphy data, self-reported sleep quality, insomnia, pain catastrophizing, anxiety, depression and pain intensity scores did not differ between usual care and VR. As for impression of change, more patients improved after VR compared to usual care (V = 21, p = 0.03). Conclusions: A 2-week period of pain neuroscience education through VR did not result in increased sleep efficiency or fewer awakenings compared to usual care in patients with PDPN. These pilot results indicate that patients subjectively experience an improvement, yet this is not substantiated by either self-reported or objective measurements.

Traditional paper-based preoperative patient education is a struggle for new nurses and requires extensive training. In this situation, virtual reality technology can help the new nurses. Despite its potential benefits, there are studies on patient satisfaction but there is limited information on the usability of virtual reality (VR) technology for new nurses in giving preoperative education to patients.

To investigate the impact on satisfaction, usability, and burnout of a system using VR technology in preoperative patient education.

The study involved 20 nurses from the plastic surgery ward and 80 patients admitted between April and May 2019. Each nurse taught four patients: Two using traditional verbal education and two using virtual reality. The System Usability Scale, After-Scenario Questionnaire, and Maslach Burnout Inventory (MBI) were employed to evaluate the impact of these education methods.

The VR education groups showed a statistically higher satisfaction than the traditional verbal education groups. Among the three subscales of the MBI, emotional exhaustion and personal accomplishment improved statistically significantly. VR was also better in terms of usability.

This study suggests VR enhances usability and reduces burnout in nurses, but further research is needed to assess its impact on depersonalization and objective measures like stress and heart rate.

Individuals with low health literacy struggle to manage long-term conditions. Addressing pain-related health competencies is important in the management of chronic pain. Virtual reality may be a useful tool for empowering sustainable health-related stratgies due to its unique ability to engage users in artificial environments.

The aim of this scoping review was to explore existing research on the use of virtual reality as a tool to promote health literacy in people with chronic pain.

Scoping Review guided by framework proposed by Arksey & O'Malley.

Articles related to "pain", "virtual reality" and "health literacy" were searched in four electronic databases: CINAHL, PubMed, Embase and PsycINFO using a formal search strategy. Studies were categorised based on intervention content using the Health Literacy Pathway Model which encompasses health knowledge, self-management skills, health communication and information seeking.

Thirteen studies met the inclusion criteria. Several elements of pain related health literacy were not addressed in the research. Interventions addressed health knowledge, self-management skills, decision making and featured content aiming to address emotional barriers to pain-related health literacy. Other components including active information seeking and use, actively communicating with health professionals and seeking and negotiating treatment options, were not explicitly addressed.

There is heterogeneity in existing research exploring the use of VR to support people with chronic pain. Existing VR tools to address pain-related health literacy do not cover several key components of health literacy. More research is required before a robust assessment of efficacy can be undertaken.

Shoulder pain is common and associated with substantial morbidity. Different treatment strategies are being prescribed with equivocal results. Virtual reality (VR) is a novel technology and emerging research suggests that VR may be a promising alternative to current treatments. Prior to effectiveness research or any large-scale introduction, VR-applications require appropriate scrutiny including feasibility- and acceptability of clinicians and patients. Therefore, the aim of this study was to collect experiences of physiotherapists after using immersive VR.

A qualitative interpretive design was used to explore physiotherapists' experiences related to the use of VR for people with shoulder symptoms. 17 physiotherapists were asked to use VR at home for five days prior to a focus group interview. Data from the focus group interviews were analyzed using a six-phase process of thematic analysis.

Three main themes were identified, each divided into subthemes. The main themes were: 1. VR as an extension of contemporary physiotherapy care: physiotherapists were positive about the potential of VR and its applicability in daily care. 2. Physiotherapist uncertainties of future care using VR: participants expressed concerns about their professional identity, particularly as patients engage in independent home exercises. 3. Physiotherapist's requirements for implementation of VR: participants shared their needs for evidence regarding the effectiveness and parameters such as frequency, dosage and intensity of the VR intervention.

Physiotherapists were positive about VR as an intervention tool. However, they felt more knowledge is needed about parameters of VR. The findings of this study inform researchers and technology developers about optimal design of interventions and applications using VR.

Digital therapeutics (DTx, software as a medical device) provide personalized treatments for chronic diseases and expand precision medicine beyond pharmacogenomics-based pharmacotherapies. In this perspective article, we describe how DTx for chronic low back pain (CLBP) can be integrated with pharmaceutical drugs (e.g., NSAIDs, opioids), physical therapy (PT), cognitive behavioral therapy (CBT), and patient empowerment. An example of an FDA-authorized DTx for CLBP is RelieVRx, a prescription virtual reality (VR) app that reduces pain severity as an adjunct treatment for moderate to severe low back pain. RelieVRx is an immersive VR system that delivers at-home pain management modalities, including relaxation, self-awareness, pain distraction, guided breathing, and patient education. The mechanism of action of DTx is aligned with recommendations from the American College of Physicians to use non-pharmacological modalities as the first-line therapy for CLBP. Herein, we discuss how DTx can provide multimodal therapy options integrating conventional treatments with exposome-responsive, just-in-time adaptive interventions (JITAI). Given the flexibility of software-based therapies to accommodate diverse digital content, we also suggest that music-induced analgesia can increase the clinical effectiveness of digital interventions for chronic pain. DTx offers opportunities to simultaneously address the chronic pain crisis and opioid epidemic while supporting patients and healthcare providers to improve therapy outcomes.