Abstract

Purpose: This study aimed to determine the efficacy of an Immersive Virtual Reality (IVR) relaxation intervention for postoperative surgical patients, focusing on evaluating postoperative pain and anxiety by group, examining differences in postoperative outcomes, and assessing the perceived usefulness of IVR relaxation.

Background: Surgery often results in significant acute postoperative pain and anxiety, which can impair recovery. These issues can lead to increased use of analgesics, hemodynamic instability, poor quality of life, longer hospital stays, and compromised functioning. Complementary and alternative medicine (CAM) therapies can help optimize postoperative pain management and reduce anxiety.

Methods: A two-arm randomized control study compared usual postoperative care to the use of an IVR relaxation session. Participants in the usual care group were instructed on standard relaxation care available at the institution. Those in the intervention group had access to the usual care resources plus an IVR headset with a relaxation application. Participants were educated on using IVR and asked to complete two 20-minute sessions daily. The headsets featured a meditation application. The study was conducted at two Midwestern US hospitals. Inclusion criteria included: post cardiothoracic or total joint (hip or knee) surgery, extubated, aged >19 years, no severe visual or auditory impairments, English-speaking, and clinically stable. Exclusion criteria included: known psychotic disorders with delusions, airborne or special contact isolation, or cognitive impairment. Demographics and comorbidities were collected at baseline, while perceived pain and anxiety scores were gathered from patient diaries, and pain scores, pain medication use, and John Hopkins scores were collected from patient charts. Post-study surveys were distributed after discharge.

Results: There were no statistically significant differences in John Hopkins Scores and Morphine equivalents (MME) between groups. However, the intervention group showed a larger mean score change in anxiety and pain compared to the usual care group. Subjects reported that the IVR was easy to use, and the intervention group was more satisfied with their pain control than the control group. Notably, 100% of the intervention subjects would recommend the IVR to other patients, and 95% would want to use it again during future admissions.

Notes

References:

Bailey, A. L., Kirsh, S., Rawlins, C. R., Persky, S., & Clancy, C. (2024). Early Scaling of Immersive Technology Within the Veterans Health Administration. NEJM Catalyst, 5(4), CAT.23.0356. https://doi.org/10.1056/CAT.23.0356

Diller, M. L., & Master, V. (2023). Integrative Surgery: Embedding Complementary and Nonpharmacologic Therapies into Surgical Pain Management Strategies. The American Surgeon, 89(2), 192–196. https://doi.org/10.1177/00031348221110244

Kashif, M., Hamid, M., & Raza, A. (2022). Influence of Preoperative Anxiety Level on Postoperative Pain After Cardiac Surgery. Cureus, 14(2), e22170. https://doi.org/10.7759/cureus.22170

Patterson, D. R., Drever, S., Soltani, M., Sharar, S. R., Wiechman, S., Meyer, W. J., & Hoffman, H. G. (2023). A comparison of interactive immersive virtual reality and still nature pictures as distraction-based analgesia in burn wound care. Burns, 49(1), 182–192. https://doi.org/10.1016/j.burns.2022.02.002

Theingi, S., Leopold, I., Ola, T., Cohen, G. S., & Maresky, H. S. (2022). Virtual Reality as a Non-Pharmacological Adjunct to Reduce the Use of Analgesics in Hospitals. Journal of Cognitive Enhancement: Towards the Integration of Theory and Practice, 6(1), 108–113. https://doi.org/10.1007/s41465-021-00212-9

Description

The study demonstrates that patients can be easily taught to use IVR. The IVR relaxation intervention decreased pain and anxiety more effectively than usual care in postoperative patients. In post-study surveys, 95% of subjects reported they would use IVR again during another hospital admission, and 100% would recommend it to others. IVR presents an effective option for potentially reducing pain and anxiety in postoperative patients.

Author Details

Sue Schuelke, PhD, RN, CNE, CHSE, CCRN; Krystal Davis, EdD, RN; Susan Barnason, PhD, RN, APRN-CNS, CCRN, CEN, FAHA, FAEN, FAAN; Megan Dubas, MSN, RN

Sigma Membership

Gamma Pi at-Large, Nu Rho at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Randomized Controlled Trial

Research Approach

Quantitative Research

Keywords:

Acute Care, Stress Coping, Pain Management, Postoperative Pain, Anxiety Reduction, Immersive Virtual Reality, IVR

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

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Innovative Pain Care: Using IVR to Improve Postoperative Pain and Anxiety

Seattle, Washington, USA

Purpose: This study aimed to determine the efficacy of an Immersive Virtual Reality (IVR) relaxation intervention for postoperative surgical patients, focusing on evaluating postoperative pain and anxiety by group, examining differences in postoperative outcomes, and assessing the perceived usefulness of IVR relaxation.

Background: Surgery often results in significant acute postoperative pain and anxiety, which can impair recovery. These issues can lead to increased use of analgesics, hemodynamic instability, poor quality of life, longer hospital stays, and compromised functioning. Complementary and alternative medicine (CAM) therapies can help optimize postoperative pain management and reduce anxiety.

Methods: A two-arm randomized control study compared usual postoperative care to the use of an IVR relaxation session. Participants in the usual care group were instructed on standard relaxation care available at the institution. Those in the intervention group had access to the usual care resources plus an IVR headset with a relaxation application. Participants were educated on using IVR and asked to complete two 20-minute sessions daily. The headsets featured a meditation application. The study was conducted at two Midwestern US hospitals. Inclusion criteria included: post cardiothoracic or total joint (hip or knee) surgery, extubated, aged >19 years, no severe visual or auditory impairments, English-speaking, and clinically stable. Exclusion criteria included: known psychotic disorders with delusions, airborne or special contact isolation, or cognitive impairment. Demographics and comorbidities were collected at baseline, while perceived pain and anxiety scores were gathered from patient diaries, and pain scores, pain medication use, and John Hopkins scores were collected from patient charts. Post-study surveys were distributed after discharge.

Results: There were no statistically significant differences in John Hopkins Scores and Morphine equivalents (MME) between groups. However, the intervention group showed a larger mean score change in anxiety and pain compared to the usual care group. Subjects reported that the IVR was easy to use, and the intervention group was more satisfied with their pain control than the control group. Notably, 100% of the intervention subjects would recommend the IVR to other patients, and 95% would want to use it again during future admissions.