The Use of Extended Reality in Rehabilitation for Patients with Acquired Brain Injury: A Scoping Review.

BACKGROUND: Extended reality (XR) seems promising for rehabilitation for people with acquired brain injury in terms of reducing professional supervision, faster recovery, shorter hospital stays, and reduced expenses. Since there is no overview this scoping review describes how XR can be utilized in rehabilitation, particularly for people with acquired brain injury (ABI). METHODS: The Arksey and O'Malley framework and PRISMA-ScR reporting guideline were followed. Studies between 2010 and May 2022 screened from healthcare as well as technical databases were imported in RAYYAN. Three researchers selected relevant articles in three rounds based on title, abstract and full text. RESULTS: 75 articles were included in this scoping review. Most studies used VR as technology with therapy objectives in three main categories: cognitive, physical and diagnostic. The outcomes of the studies show potential and promising results of the use of XR, and enthusiasm with as well patients as professionals. A selection of four domains of the NASSS framework: condition, technology, value proposition and adopters were reported. Important lessons learned by the included studies are development of XR software, improvement of the hardware, improving feeling of safety and giving support to the patient, and support healthcare professionals for acceptance of XR. DISCUSSION: the use of XR for people with ABI has potential and is promising but not common practice yet. Future research should focus on implementation factors with a diverse and inclusive patient group using service modelling.

From clinical reasoning to ehealth interventions; a study on how nurses asses care and ehealth in home care.

The assessment of care in homecare today is complex. Nurses have to decide on care for clients with multiple health problems. Technological innovations promise solutions for support of self-management of older people. We do not know, however, how and when nurses assess eHealth. A qualitative study design was used, in which 43 homecare nurses participated in focus groups and think aloud interviews. The study shows that nurses believe a trusting relationship necessary in order to suggest eHealth interventions. Nurses say they need home visits for the assessment of eHealth. Nurses also have some strong opinions on eHealth, like the notion that eHealth isn't a fitting option for frail older people. It becomes clear that nurses need to see eHealth interventions fit for clients in a person-centred way and in close connection to health problems they've prioritised in order to assess it. Implications for practice and further research are to focus on how nurses can be convinced to assess and use eHealth in a person-centred way and how to discuss this with their clients. Next to that training and a tool that provides up to date information linked to frequently seen health problems are recommended.