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Virtual hospital before visit helps those with intellectual disablities

December 1, 2011 | Hogan Keyser
virtual_hospital_tour.jpg
The Virtual Hospital

November 30, 2011 by Katy Cowan via ISPR.com
-- Computer-generated tours of virtual hospitals can help patients with intellectual disabilities overcome fears and to understand treatments they are about to undergo, according to a new study.

The research was led by Professor Val Hall, professor of midwifery at the Centre for Health Research, University of Brighton. She was one of four experts who studied the virtual hospital as a means of helping patients and providing medical staff with a toolkit to better assess a patient's capacity to give consent to treatment.

The findings, published in the latest edition of the open access publication, Journal of Medical Internet Research (JMIR), a leading journal in health informatics, showed the virtual hospital was effective and could be delivered to patients in institutions, community settings or in their own homes.

The team designed a multimodal experience based on a hospital scenario and situated on an island in Second Life, an online world in which people participate in the form of virtual representatives or avatars.

Each patient is directed to a waiting room before being taken by a nurse to a bed where they will lie down and have their blood pressure taken. They will then be taken to the anaesthetic room and from there to the operating theatre.

The programme contains a storyboard scenario, pre-programmed to represent the patient's experience and ready to be triggered by the patient or their helper.

Professor Hall said: "We wanted to know how people of different ages and with varying levels of cognitive function would participate in the customised virtual environment, what they understood from being there, and what they remembered a week later."

The study involved 20 people aged between 20 and 80 with mild to severe intellectual disabilities.

Results showed all participants were able to access the environment, voluntarily stayed there for between 23 and 57 minutes, and that they enjoyed the experience. With facilitator support, all participants moved the avatar themselves.

Professor Hall said: "Participants engaged with the scenario as if they were actually there, indicating cognitive presence. Some referred back to previous medical experiences, indicating the potential for experiential knowledge to become the foundation of new learning and retention of knowledge. When interviewed, all participants remembered some aspects of the environment."

The research was commissioned by the National Institute for Health Research (NIHR) under its Invention for Innovation (i4i) programme and there are hopes the virtual hospital could enhance decision making, and improve treatment compliance.

Professor Hall said she was encouraged by the results: "People with intellectual disabilities have poor access to health care, which may be further compromised by a lack of accessible health information. To be effective, health information must be easily understood and remembered.

"People with intellectual disabilities learn better from multimodal information sources, and virtual reality offers a 3D computer-generated environment that can be used for providing information and learning.

"Our study clearly demonstrates the potential for using virtual reality to provide health care-related information to people with intellectual disabilities.

"People with intellectual disabilities engaged with a health-related virtual environment experience as if they were actually there, which prompted them to talk about previous health care experiences. It also provided an opportunity for them to practice being patients, potentially providing more information about themselves and their worries, which could lead to an increase in confidence in treatment situations.

"Our study is the first step on a path to providing effective health information to people with intellectual disabilities, and we have learned a great deal by taking it.

"Our next step is to further develop the prototype with help from volunteers from our participant group. We will then test it out in a larger and more diverse population of people with intellectual disabilities and in a range of settings, drawing on the lessons learned in this exploratory study."





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