3.8 Article

Automated Virtual Reality Cognitive Therapy (gameChange) in Inpatient Psychiatric Wards: Qualitative Study of Staff and Patient Views Using an Implementation Framework

Journal

JMIR FORMATIVE RESEARCH
Volume 6, Issue 4, Pages -

Publisher

JMIR PUBLICATIONS, INC
DOI: 10.2196/34225

Keywords

virtual reality; automated; therapy; inpatient psychiatric care; implementation

Funding

  1. National Health Service National Institute for Health Research (NIHR) invention for innovation program [II-C7-0117-20001]
  2. NIHR Oxford Health Biomedical Research Centre
  3. Mental Health Research UK
  4. Wellcome Trust Clinical Doctoral Fellowship [102176/B/13/Z]
  5. National Institutes of Health Research (NIHR) [II-C7-0117-20001] Funding Source: National Institutes of Health Research (NIHR)

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This study explores the views of patients and staff on the use of automated virtual reality (VR) therapy in psychiatric wards. The findings indicate that patients and staff are enthusiastic about using VR therapy in psychiatric wards, as it helps build confidence, reduce anxiety, and bridge the gap between hospitalization and discharge. However, the main barrier to implementation is the lack of sufficient private space for therapy.
Background: Automated virtual reality (VR) therapy could allow a greater number of patients to receive evidence-based psychological therapy. The aim of the gameChange VR therapy is to help patients overcome anxious avoidance of everyday social situations. gameChange has been evaluated with outpatients, but it may also help inpatients prepare for discharge from psychiatric hospital. Objective: The aim of this study is to explore the views of patients and staff on the provision of VR therapy on psychiatric wards. Methods: Focus groups or individual interviews were conducted with patients (n=19) and National Health Service staff (n=22) in acute psychiatric wards. Questions were derived from the nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability framework. Expectations of VR therapy were discussed, and participants were then given the opportunity to try out the gameChange VR therapy before they were asked questions that focused on opinions about the therapy and feasibility of adoption. Results: There was great enthusiasm for the use of gameChange VR therapy on psychiatric wards. It was considered that gameChange could help build confidence, reduce anxiety, and bridge that gap between the differences of being in hospital and being discharged to the community. However, it was reflected that the VR therapy may not suit everyone, especially if they are acutely unwell. VR on hospital wards for entertainment and relaxation was also viewed positively. Participants were particularly impressed by the immersive quality of gameChange and the virtual coach. It was considered that a range of staff groups could support VR therapy delivery. The staff thought that implementation would be facilitated by having a lead staff member, having ongoing training accessible, and involving the multidisciplinary team in decision-making for VR therapy use. The most significant barrier to implementation identified by patients and staff was a practical one: access to sufficient, private space to provide the therapy. Conclusions: Patients and staff were keen for VR to be used on psychiatric wards. In general, patients and staff viewed automated VR therapy as possible to implement within current care provision, with few significant barriers other than constraints of space. Patients and staff thought of many further uses of VR on psychiatric wards. The value of VR therapy on psychiatric wards now requires systematic evaluation.

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