Virtual Reality Clinical Trial
Official title:
Evaluating Virtual Reality as an Adjunct in Procedural Preparation for Magnetic Resonance Imaging (MRI)
This pilot project aims to establish evidence to investigate whether a virtual reality intervention can be implemented to reduce anxiety and efficiently prepare children for non-sedated MRI assessments. The study consists of comparing the current modes of delivery though a mock behavioural assessment and inquiry into the acceptability and utility of the intervention components, including potential barriers to adherence or behavioural change that could have unintended consequences.
Approximately 50% of pediatric patients experience elevated anxiety and distress prior to new
medical procedures. This issue is critically important because it not only impacts patient
experience and is associated with psychological and physiological distress, but it can affect
the efficiency of medical procedures, length of hospital stay, and resource utilization - all
of which have economic impacts to both families and the health system. During medical
procedures specifically, anxiety can cause non-compliance or unintentional movements which
often leads to failure to complete the procedure or poor image quality, necessitating
multiple attempts or the use of sedation to achieve the desired quality of imaging for
diagnosis.
The impact of sedating a patient has several downstream effects, including the increased
potential for adverse events, as well as the need for specialized clinical staff (i.e.
Anesthesiologists, Post-Anesthetic Care Nurses, etc), medications, and lengthier
post-procedural monitoring. Studies have also indicated an increase in negative
post-procedural clinical outcomes, such as increase pain perception, increased pharmaceutical
consumption, reductions in sleep and eating, anxiety, and greater overall patient
dissatisfaction.
Child Life Specialists (CLS) are specialty trained individuals that work with patients and
families to improve patient experiences during stress provoking medical procedures, such as
medical imaging. Procedural preparation with a CLS for MRI involves exposure to an MRI
simulator. The MRI simulator appears and sounds identical to the real MRI, but lacks a magnet
and thus functionality to take real images. It's suggested that this type of non-sedated
preparation program can reduce anxiety and distress, ultimately reducing sedation rates.
While access to preparation programs with the CLS have improved, capacity limitations exist
and there are socioeconomic costs of only having this support available on-site at BC
Children's Hospital. Transportation barriers have been repeatedly identified in the
literature and by parents as a source of unmet health needs for children in both rural and
inner-city populations. This is significant because it a caregiver cannot get their child to
the MRI simulator, they miss the opportunity for a non-sedated MRI. Consequently, resources
and the risk for complications increase. As such, a virtual reality program has the capacity
to increase access to patients who live afar, who are not mobile, and who need extra practice
without the financial and physical limitations associated with the traditional hospital
simulation.
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