ABSTRACT
OBJECTIVE: Burn care providers continue to search for non-pharmacologic adjuncts for pain control. Virtual reality (VR) has been shown to be a useful adjunct by reducing pain during burn care and therapy. The feasibility of implementation for clinical use (non-research related) has not been studied in a burn center. The purpose of this study was to determine staff resources needed to implement VR in a regional burn center. METHODS: Ten patients with burns participated in VR during occupational or physical therapy sessions. A portable computer and VR head mounted device (Proview VO35, Kaiser Electro-Optics, Inc.) and the "SnowWorld" software (Patterson and Hoffman, University of Washington) were used. Two staff members trained in the use of VR participated in each session in order to adhere to infection control policies. VR set-up time, patient instruction time, VR therapy time, and equipment cleaning time were recorded and rounded to the nearest minute. RESULTS: A mean of 59 staff time minutes (S.D. 18; range 29-85) were required for set-up, instruction, VR therapy, and cleaning. Set-up required the most time, averaging 23min. Instruction, participation, and clean-up means were 6, 13, and 16min respectively. Time for set-up decreased over time, however technical difficulties with the VR equipment accounted for most of the variability in the time required. CONCLUSIONS: These results suggest VR requires a significant time commitment from staff for implementation. One clear disadvantage was the lack of on-site technical support for equipment troubleshooting. In the current healthcare environment where therapists and nurses are accounting for each minute, it would be difficult for smaller burn centers to allocate staff and resources to implement a VR program. Further research is needed to determine if VR benefits are worth the implementation costs.
Subject(s)
Burns/rehabilitation , Pain/prevention & control , User-Computer Interface , Adult , Burn Units/organization & administration , Burns/complications , Computer Graphics , Feasibility Studies , Female , Humans , Male , Occupational Therapy , Pain/etiology , Physical Therapy ModalitiesABSTRACT
Ninety-three men and women with histories of polio were administered the Symptom Check List-90 Revised (SCL-90R), Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), and a questionnaire about their polio histories. The SCL-90R and PAIS-SR are measures of emotional and psychosocial functioning. Two samples were used: a clinic sample (n = 71) and a postpolio support group sample (n = 22). Initial results for both on the SCL-90R and PAIS-SR indicated elevated scores on a number of subscales. SCL-90R subscale elevated scores for men included those for somatization, depression, anxiety, hostility, and phobia, whereas for women there were elevations on measures of somatization, depression, anxiety, and psychoticism. Elevations were found in the following subscales on the PAIS-SR (pooling men and women): health care orientation, social environment, and extended family relationships. Men scored slightly, but not significantly, higher than women in the SCL-90R except for the hostility subscale, in which the difference was significant (p less than 0.05). Symptom profiles indicated psychologic distress. Comparisons with variables associated with polio and its late effects (such as severity of initial polio, use of an iron lung during initial illness, number of involved limbs, etc) were not statistically significant.
