Virtual Reality: Coming to a clinical care session near you
A robotic dog and virtual swims with dolphins are helping older Australians manage pain.
In what may be Australia’s first use of virtual reality (VR) in the community setting, aged and community care provider Bolton Clarke recently introduced VR in our At Home Support services as a method to reduce anxiety, pain and movement during wound dressing, and patients have reported a marked improvement in their experience.
Bolton Clarke’s aged and community care staff members are testing the usefulness of VRheadsets for senior clients, and it’s improving the experience of wound management procedures in the community.
Originally developed by the gaming industry, VR intervention has emerged in clinical care primarily as a non-pharmacological method to distract patients from uncomfortable experiences. VR has also recently been used in hospital settings during invasive procedures such as lumbar punctures, biopsies, dental extractions and as an adjunct to pharmacological pain relief.
The new technology uses a head-mounted display and head tracking system to immerse patients in a calming and simulated environment. Recently, Melbourne client Peter chose an underwater experience that allowed him to feel like he was swimming with dolphins during his 45-minute procedure.
“When I had dressings done at the hospital they said to visualise something nice, but now I can actually see something nice,” he said. “I can still feel it, but I can’t see the nurses doing the dressing, and that helps.”
Bolton Clarke nurses have reported that VR interventions led to less patient movement during wound dressing, making the process both quicker and easier.
Matiu Bush from the Bolton Clarke’s Design Integration Team has worked with VR clinically since 2015 and explained that to
maximise the effect for the client, the VR headset was used just before the most uncomfortable parts of the procedure.
“VR works by challenging the client’s attentional resources, reducing their ability to process pain at the usual intensity during wound dressings and other anxiety provoking procedures,” he said.
When an additional stimulus is introduced, such as VR, it acts as a cognitive distraction from the pain stimulus, interfering with nociceptors inputs and resulting in lower reported pain levels. The introduction of VR as a positive experience may contribute to positive psychology, which is related to decreased sensitivity to pain and negative emotions for clients with chronic health issues.
Clients are immersed in a simulated environment via an app on a mobile phone which is inserted into the headset that allows them to engage and feel immersed in the simulated reality. The image is 360 degrees, allowing clients to move their head and see more imagery. To date, the most popular content has been underwater interactions with computer-generated whales and dolphins.
Research shows levels of reported pain are associated with the level of attention given to the pain stimulus, so the introduction of a competing stimulus such as swimming underwater interferes with pain receptors and results in lower reported pain levels. The immersive nature of VR can contribute to a decrease in negative emotions and affect sense of balance and spatial orientation.
Several studies explored the effect of VR on time perception during invasive clinical procedures. Researchers found that participants had an altered perception of their chemotherapy duration, with most individuals estimating that their therapy had lasted 47 minutes, when the average treatment was 58 minutes. Clients using VR for dental procedures and serology also report procedures seemed to take a shorter time to complete, even if they take the same amount of time.
Bolton Clarke has had a strong focus on improving the client experience and the use of innovative technology is considered an important part of achieving this. For example, behavioural support specialist Elisabeth Elder has used robotic animals to improve the wellbeing of residents in Bolton Clarke’s aged care facilitates.
A robotic dog has brought new joy for resident Gertie, who grew up in Germany during World War II and was agitated and distressed for much of the time. Elisabeth worked with staff and Gertie’s daughter to find a solution that would improve her wellbeing.
“Gertie’s daughter said she just wanted to see her Mum smile,” Elisabeth said. “Staff noted Gertie responded well to pet therapy, so they introduced her to a FurReal Friends dog, that she then named Tiny. Now Tiny has become Gertie’s constant companion, and she is smiling much more.”
Technology has a role to play, supporting the wellbeing goals of clients and residents, and Matiu says staff are happy to embrace new technologies when they see the clear benefits to those they care for, from VR to robotic animals.
For more information go to boltonclarke.com.au or phone 1300 22 11 22.
