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Abstract
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Virtual Reality (VR) has shown promise as
a non-pharmaceutical intervention for both anxiety and pain management.
Consequently, specially designed VR experiences may be a useful tool to
counteract anxiety during procedures that require a blood draw. In the current
study we examined negative and positive mood states before and after a brief VR
intervention at a Red Cross blood drive. Results demonstrated a significant
increase in positive mood states (Happiness, Calmness) and a reduction of
negative mood states (Tension, Fatigue). These results support the accumulating
evidence that VR has the potential to act as a powerful and effective tool for
anxiety and stress management in anxiety provoking situations.
Keywords: VR; Virtual reality; Healium; Blood
donation; Anxiety; Stress; Needle Fear; Needle phobia
Introduction
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Needle injections are an integral part of
many medical procedures, yet “needle fear” and “needle phobia” frequently
result in the avoidance of necessary treatments and an unwillingness to donate
blood [1]. Studies examining fear of needles have reported prevalence estimates
as high as 91% [2]. Because this anxiety has real life consequences, a recent
review of research on needle fear recommended that “greater attention should be
given to evidence-based approaches to alleviate fear during injections” [1].
When considering interventions to assist in the reduction of needle fear,
virtual reality seems like an obvious choice. VR has already demonstrated its
utility in the treatment of anxiety disorders including phobias and PTSD [3,4].
However, most of these studies incorporated VR into an existing therapeutic
context, making it difficult to isolate the impact of the VR intervention from
other aspects of treatment. One recent study examined the ability of a
stand-alone VR experience to reduce state anxiety in an anxious population [5].
The results indicated that both the VR and a rest control condition
significantly reduced reports of anxiety. However, only the VR experience
shifted brainwave activity in a manner consistent with reduced nervous system
arousal [5]. To our knowledge, only one study has specifically examined the use
of VR during a blood draw. This study was conducted with a pediatric population
and demonstrated that specific VR experiences significantly reduced pain and
anxiety when compared to “treatment as usual” [6]. In the current study, we
sought to explore the potential of using a calming VR experience to increase
positive mood states and decrease negative mood states just prior to a needle
stick at a community blood drive.
Materials and Methods
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Participants
33 donors at a community Red Cross blood
drive volunteered to participate. The study consisted of 19 females and 14
males aged 15 to 70 (M= 25.85, SD= 16.35). All participants provided informed
consent through the Red Cross.
Materials
Virtual reality
The VR experience used an Oculus Go
headset with Healium software. A 4.5-minute guided experience encouraged the
user to use their internal feeling state (positivity) to transform a VR
landscape. The experience begins in a rather bleak setting with a large tree
covered in graffiti. The area around the tree is barren with trash strewn
about. As the experience progresses, the user is coached through engaging in
feelings of positivity and gratitude which gradually transforms the tree and
surrounding environment into a clean, lush landscape (see Figure 1).
Figure 1: Screen shot of “The Big Tree” experience from Healium
software.
Brunel Mood Scale
The Brunel Mood Scale [7] consists of 32
mood descriptors that are categorized into 8 unipolar dimensions: anger,
tension, depression, vigor, fatigue, confusion, happiness, calmness. Using a
response frame of “how do you feel right now?” subjects indicated the extent of
their experience of the mood descriptors on a 5-point scale (0= not at all, 1=
a little, 2= moderately, 3= quite a bit, 4= extremely).
Procedure
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Participants at a community blood drive
were invited to experience “The Big Tree” virtual reality (VR) experience in
the Healium software platform just prior to the needle stick. Participants
completed the Brunel Mood Scale before and after the VR experience. A Matched
Pair Analysis was used to examine pre - post significant differences for the 8
aggregated Brunel Mood Scores. The data were grouped by Mood to create an
Across Group analysis.
Results
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Table 1: Mean of Pre and Post Scores for the 8
aggregated Brunel Moods.
A matched pairs analysis with time of
testing (pre-post) as independent variables, and scores on the Brunel Mood
Scale as dependent variables, showed a significant effect (F(2,256)= 52.79,
p<.0001). The pre-post means for each scale are displayed in (Table 1). When
presented as a Tukey mean-difference plot (see Figure 2), it is clear that 4 of
the aggregate mood scores were significant (p <.05). Specifically, Calmness
and Happy increased from prepost while Tension and Fatigue decreased
significantly from prepost.
.
Discussion
This study demonstrated that an
inexpensive and brief VR intervention can have a significant positive impact on
mood just prior to a needle stick, reducing tension and fatigue and increasing
feelings of calmness and happiness in an adult population. This is consistent
with other research showing that VR reduces pain and anxiety better than
“treatment as usual” in a pediatric population during a routine blood draw [6].
The apparent success of VR in reducing anxiety may be, in part, due to the
strong feeling of “presence” achieved in these environments [8,9]. “Presence,”
is defined as the subjective feeling of being in another place. As there are
multiple visual and auditory cues in a traditional hospital or blood donation
setting that could trigger or exacerbate an anxiety response, removal of these
cues may be helpful in reducing anxiety. In addition, rather than simply
removing a potentially stressful environment, VR can replace these stressful
cues with an environment designed to be soothing, comforting, and mood
enhancing. VR research for pain management has shown that this strategy works
quite well. For example, VR experiences designed to assist burn victims often
utilize visual scenes that include cold weather and snow, taking advantage of
the brain’s tendency to respond physiologically to environmental cues. A recent
review of research examining VR for pain management in burn victims concluded
that the addition of VR to dressing change or physical therapy sessions
significantly reduced pain intensity, time spent thinking about pain, and
unpleasantness [10]. The current study adds to the accumulating evidence that
VR has the potential to make basic medical procedures, such as a blood draw,
much more tolerable, potentially improving patient compliance and willingness
to donate blood [11]. Obviously, this study lacked a control group and is
therefore limited in the degree to which the results can be generalized. Future
studies would benefit from using a randomized control procedure, allowing
subjects to use the VR experience during the blood draw (rather than prior to
the needle stick), and examining a variety of additional outcome measures as
well as personality characteristics.
https://lupinepublishers.com/psychology-behavioral-science-journal/pdf/SJPBS.MS.ID.000150.pdf
For more Lupine Publishers Open Access Journals Please visit our website: https://lupinepublishersgroup.com/
For more Psychology And Behavioral Sciences Please Click
Here:https://lupinepublishers.com/psychology-behavioral-science-journal/
To Know more Open Access Publishers Click on Lupine Publishers
Follow on Linkedin : https://www.linkedin.com/company/lupinepublishers
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