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BACKGROUND: Depression significantly impacts quality of life, affecting approximately 280 million people worldwide. However, only 16.5% of those affected receive treatment, indicating a substantial treatment gap. Immersive technologies (IMTs) such as virtual reality (VR) and augmented reality offer new avenues for treating depression by creating immersive environments for therapeutic interventions. Despite their potential, significant gaps exist in the current evidence regarding the design, implementation, and use of IMTs for depression care. OBJECTIVE: We aim to map the available evidence on IMT interventions targeting depression treatment. METHODS: This scoping review followed a methodological framework, and we systematically searched databases for studies on IMTs and depression. The focus was on randomized clinical trials involving adults and using IMTs. The selection and charting process involved multiple reviewers to minimize bias. RESULTS: The search identified 16 peer-reviewed articles, predominantly from Europe (n=10, 63%), with a notable emphasis on Poland (n=9, 56%), which contributed to more than half of the articles. Most of the studies (9/16, 56%) were conducted between 2020 and 2021. Regarding participant demographics, of the 16 articles, 5 (31%) exclusively involved female participants, and 7 (44%) featured participants whose mean or median age was >60 years. Regarding technical aspects, all studies focused on VR, with most using stand-alone VR headsets (14/16, 88%), and interventions typically ranging from 2 to 8 weeks, predominantly in hospital settings (11/16, 69%). Only 2 (13%) of the 16 studies mentioned using a specific VR design framework in planning their interventions. The most frequently used therapeutic approach was Ericksonian psychotherapy, used in 56% (9/16) of the studies. Notably, none of the articles reported using an implementation framework or identified barriers and enablers to implementation. CONCLUSIONS: This scoping review highlights the growing interest in using IMTs, particularly VR, for depression treatment but emphasizes the need for more inclusive and comprehensive research. Future studies should explore varied therapeutic approaches and cost-effectiveness as well as the inclusion of augmented reality to fully realize the potential of IMTs in mental health care.
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Depression , Humans , Depression/therapy , Virtual Reality Exposure Therapy/methodsABSTRACT
RESUMEN Introducción. Las aplicaciones móviles representan una alternativa prometedora para brindar soporte en la gestión de pacientes con dengue. Sin embargo, se desconoce la usabilidad de estas herramientas en el Perú. Objetivo. Evaluar la usabilidad y las recomendaciones de uso de la aplicación Dengue ONQOY en la gestión de pacientes con dengue en zonas rurales de Perú. Métodos. Se realizó un estudio cualitativo que incluyó entrevistas semiestructuradas a 8 expertos en el tratamiento del dengue, los datos fueron codificados mediante el programa Atlas. Ti. Fueron evaluadas tres categorías: (1) usabilidad informativa, (2) usabilidad de diseño y (3) recomendaciones para su mejoramiento. Resultados. Se destacaron tres aspectos clave: (1) la aplicación es percibida como valiosa para los médicos de primer nivel en áreas periféricas con poca experiencia en dengue debido a su enfoque personalizado y valor académico; (2) se destacó su facilidad de uso y practicidad, aunque se señaló la limitación de la conectividad en algunas áreas; y, (3) se recomendó la inclusión de diagnósticos diferenciales, factores de riesgo adicionales, referencias actualizadas, guías de hidratación y dosis de medicamentos para mejorar la aplicación. Conclusión. Dengue ONQOY fue considerado altamente utilizable por médicos que atienden casos de dengue en el primer nivel de atención en Perú. A pesar de las limitaciones relacionadas con la conectividad y las posibles mejoras en su diseño, su desarrollo e implementación ofrecen una alternativa prometedora para el manejo de pacientes con Dengue en el país.
ABSTRACT Introduction. Mobile applications represent a promising alternative for providing support in the management of Dengue patients. However, the usability of these tools in Peru is unknown. Objectives. To evaluate the usability and usage recommendations of the Dengue ONQOY application in managing Dengue patients in rural areas of Peru. Methods. A qualitative study was conducted, which included semi-structured interviews with 8 experts in Dengue management. Data were coded using Atlas. Ti software. Three categories were assessed: (1) informative usability (2) design usability, and (3) recommendations for improvement. Results. Three key aspects were highlighted. (1) The application is perceived as valuable for first- level doctors in peripheral areas with limited Dengue experience due to its personalized approach and academic value. (2) Its ease of use and practicality were emphasized, although connectivity limitations in some areas were noted. (3) Recommendations for improvement included the inclusion of differential diagnoses, additional risk factors, updated references, hydration guidelines, and medication dosages. Conclusions. Dengue ONQOY is considered highly usable by doctors treating Dengue cases at the primary care level in Peru. Despite connectivity limitations and potential design improvements, its development and implementation offer a promising alternative for managing Dengue patients in the country in this field.
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Resumen Introducción. En el Perú el sistema de tele-triaje (STT) conducido por estudiantes voluntarios permitió la identificación remota de casos sospechosos de COVID-19. Sin embargo, aun no se conocen las barreras y facilitadores de su implementación. Objetivos. Describir las barreras y facilitadores sobre la implementación de un sistema de tele-triaje para la identificación de casos sospechosos de COVID-19 en el Perú. Métodos. Se desarrolló un estudio de métodos mixtos que describió las características de los usuarios que participaron en el STT (cuantitativo). También se exploró las percepciones de usuarios y voluntarios respecto a las barreras y facilitadores sobre la implementación de este servicio (cualitativo). Resultados. Entre los 4317 usuarios evaluados por el STT, la edad media fue 36,2 años (desviación estándar: 13,2), 58,6% fueron mujeres y solo el 41,4% fueron clasificados como casos sospechosos de COVID-19. Los voluntarios destacaron que su participación fue facilitada por su disponibilidad de tiempo y deseos de ayudar, aunque señalaron problemas de organización y falta de equipos disponibles para las llamadas. Los usuarios valoraron el apoyo emocional y la claridad de la información brindada, pero expresaron desconfianza sobre la evaluación de COVID-19 de forma remota, y un conocimiento limitado sobre el rol de los voluntarios. Conclusiones. El STT conducido por estudiantes voluntarios pemitió la identificación de casos sospechosos de COVID-19 en el Perú, además sirvió como medio para compartir información. Sin embargo, aspectos de desorganización y desconocimiento por parte de los usuarios fueron percibidos como barreras para su implementación.
ABSTRACT Introduction. In Peru, the tele-triage system (TTS) led by volunteer students allowed for the remote identification of suspected COVID-19 cases. However, the barriers and facilitators of its implementation are still unknown. Objectives. To describe the barriers and facilitators regarding the implementation of a tele-triage system for the identification of suspected COVID-19 cases in Peru. Methods. A mixed methods study was developed that described the characteristics of the users who participated in the TTS (quantitative). It also explored the perceptions of users and volunteers regarding the barriers and facilitators of implementing this service (qualitative). Results. Among the 4,317 users evaluated by the TTS, the average age was 36.2 years (standard deviation: 13.2), 58.6% were women, and only 41.4% were classified as suspected cases of COVID-19. Volunteers highlighted that their participation was facilitated by their availability of time and desire to help, although they noted problems with organization and a lack of equipment available for calls. Users valued the emotional support and clarity of the information provided but expressed mistrust about the remote COVID-19 assessment, and a limited understanding of the volunteers' role. Conclusions. The TTS led by volunteer students allowed for the identification of suspected COVID-19 cases in Peru, and also served as a means to share information. However, aspects of disorganization and a lack of knowledge on the part of users were perceived as barriers to its implementation.
