This randomized controlled trial aims to evaluate the effect of virtual reality guided imagery on selected health outcomes among adult patients receiving maintenance hemodialysis. Eligible participants will be randomly assigned to either a virtual reality-guided imagery intervention group or a routine-care control group. Participants in the intervention group will receive virtual reality guided imagery during hemodialysis sessions using a virtual reality headset and standardized guided imagery content, while the control group will receive routine care. The study will assess whether virtual reality-guided imagery can improve the selected outcomes among patients undergoing hemodialysis.
Patients aged ≥18 years.
Diagnosed with end-stage kidney disease (ESKD) and receiving maintenance hemodialysis.
Undergoing hemodialysis three times per week. Receiving maintenance hemodialysis for at least 3 months before enrollment.
Able to communicate verbally and understand Arabic.
Patients with cognitive impairment or altered mental status that may interfere with understanding the intervention or completing the assessment.
Patients with severe visual or auditory impairment that prevents effective use of the VR intervention.
Patients with a history of severe motion sickness, vestibular disorders, or significant intolerance to VR.
Patients who are hemodynamically unstable during the dialysis session.
Parallel
virtual reality-guided imagery (VRGI)
BehavioralVirtual reality-guided imagery (VRGI) is a non pharmacological behavioral intervention delivered during a hemodialysis session using a virtual reality headset. Participants will experience standardized immersive visual content accompanied by guided imagery audio designed to promote relaxation and provide distraction from the hemodialysis environment. The intervention will be delivered in a standardized manner in addition to routine hemodialysis care.
Pain intensity
Pain intensity will be assessed using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst possible pain. Higher scores indicate greater pain intensity.
Anxiety
Anxiety measured using the 6-item State-Trait Anxiety Inventory (STAI-6), with higher scores indicating greater state anxiety.
Fatigue
Fatigue severity will be assessed using a Numeric Rating Scale (NRS) ranging from 0 to 10, where 0 indicates no fatigue and 10 indicates the worst possible fatigue. Higher scores indicate greater fatigue severity.
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