The goal of this clinical trials is to primary learn if deep relaxation using Virtual Reality (VR) compared to a low stimulus environment can lower perceived and measured stress in healthcare professionals working in the operating room.
We aim to determine:
* whether the use of a low-stimulus environment significantly lowers the stress response in OR health care workers just before entering the OR; * whether the use of a responsive VR system environment significantly lowers the stress response in OR health care workers just before entering the OR; * Whether the use of a responsive VR environment is both an effective and cost-effective solution compared to the low-stimulus environment, in terms of significantly mitigating stress in OR team members as measured by their biometrics, just before they enter the OR to do their job.
Hypothesis
* The use of a 10-minute real-time adaptive VR intervention or a low-stimulus environment intervention administered at least 15 minutes before entering the operating room (OR), significantly reduces stress in OR staff, as measured by a within-person reduction in heart rate of at least 10 beats per minute (BPM) over the 10-minute intervention period * The reduction in heart rate over a 10-minute intervention period is significantly greater for the real-time adaptive VR intervention compared to the low-stimulus environment intervention, with an expected mean difference (delta) of 5 BPM, indicating superior stress-reducing effects of the VR intervention. * The use of a real-time adaptive VR intervention and the use of a low stimulus environment intervention of 10 minutes at least 15 minutes before entering the OR significantly reduces perceived stress for OR staff, as measured by Numeric Rating Scale (NRS) stress scores within person.
Volunteering and consented healthcare professionals ( ≥ 18 years) working in the operating room
Circulatory-, scrub-, and anesthesia nurses, anesthesiologists, surgical specialists, residents, medical students, or persons in training for the above mentioned.
history of epilepsy.
claustrophobia or nyctophobia.
experienced VR scenery via a headset including headphones a trigger for headache, migraine, dizziness, drowsiness, nausea or other physical or mental discomfort.
vestibular nystagmus, otosclerosis, ear infections,
Crossover
Virtual Reality intervention
DeviceParticipants will receive a VR headset, in which the participant can choose from a number of VR images and sceneries of the HealthyMind® (HM) VR simulation to relax. The software is able to adapt to user's HR and HRV, and developed by Partner HealthyMind (HM). HRV is chosen as prime parameter for biofeedback steering of scenery, as it is highly indicative and considered reliable in measuring a person's stress level. (27-30) Before starting the experience, participants select a VR scenery based on their personal preference. Allowing participants to choose their own VR scenery minimizes the risk of exposing them to an environment that could be stress-inducing rather than stress-reducing.(31, 32) HR and HRV will be measured in real time during the intervention using the POLAR OH1 armband built and registered for the purpose. We chose the POLAR OH1 band because of its accurate HRV measurements, its ability to connect with the VR device, and its user-friendliness. In respo
Low Stimulus Environment
Other interventionParticipants will be brought into an induced low-sensory, low-stimulus environment. This entails wearing the VR headset with a dark-only display, and no sound on headphones. This, to facilitate a calm environment without distractions. Before the start of the intervention, the VR headset will display a short visual and audio message confirming that the participant is in a low-stimulus environment and that the system is functioning properly.
Perceived Stress level
NRS score ranging from 0 (not stessed) to 10 (very stressed)
Non invasive biomarkers
Non invasive biomarkers eg heart rate and heart rate variability measured with a polarOH1 armband
User satisfaction
NRS score ranging from 0 (not satisfied) to 10 (very satisfied)
Cost-effectiveness analysis (CEA) of the intervention. up to 50 weeks after the last participant has completed all interventions
Cost-effectiveness will be assessed using a health economic evaluation framework. Direct and indirect costs of the intervention (e.g. staff time, training costs, materials, healthcare utilization) will be collected and compared against measured outcomes (e.g., reduction in stress/burnout and measured biomarkers)
Burnout
The Burnout Assessment Tool (BAT-12) is a brief 12-item self-report instrument that measures participant's four core burnout symptoms. Items are rated on a five-point Likert scale ranging from 1 (Never) to 5 (Always). Higher scores indicate the participant's frequency of these symptoms.
Burnout
Maslach Burnout inventory (MBI) is a validated self-report questionnaire that measures burnout across three dimensions. Items are rated on a seven-point Likert scale ranging from 0 (Never) to 6 (Every day). Higher scores on Emotional Exhaustion and Depersonalization, and lower scores on Personal Accomplishment, indicate higher levels of burnout.
Resilience
The 8-item Resilience Survey for Healthcare Professionals is a brief self-report instrument designed to assess resilience among healthcare workers. Items are rated on a five-point Likert scale ranging from 1 (Strongly disagree) to 5 (Strongly agree). Higher scores indicate greater resilience.
Resilience
The Connor-Davidson Resilience Scale (CD-RISC) is a validated self-report questionnaire. The scale contains 25 items rated on a five-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree). Higher total scores indicate greater resilience.
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Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Lead sponsor
Universitätsklinikum Hamburg-Eppendorf
Collaborator
Rigshospitalet, Denmark
Collaborator
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