Immersive Virtual Reality for Procedural Pain and Anxiety During Postoperative Wound Dressing in Cardiac Surgery ICU Patients: A Quasi-Experimental Study.

چکیده اصلی

BACKGROUND: Postoperative wound dressing procedures are a common source of pain and anxiety among intensive care unit (ICU) patients following cardiac surgery. Virtual Reality Distraction Therapy (VRDT) has emerged as a promising non-pharmacological intervention for symptom management; however, evidence regarding its use during postoperative wound care in critically ill cardiac surgery patients remains limited. AIM: To evaluate the effect of Virtual Reality Distraction Therapy on physiological parameters, pain intensity, anxiety levels and patient satisfaction during wound dressing procedures among ICU patients following cardiac surgery. STUDY DESIGN: A one-group pretest-posttest quasi-experimental study was conducted among 50 adult patients admitted to the Cardiothoracic Intensive Care Unit at Tanta University Hospital. Participants received routine postoperative care in addition to VRDT during three consecutive wound dressing sessions. Physiological parameters, pain intensity and anxiety levels were assessed before the intervention, immediately after dressing and 15 min post-dressing. Patient satisfaction with the VR experience was evaluated on the final dressing day. Data were analysed using repeated-measures analysis of variance, paired-samples t-tests, Friedman tests and Pearson correlation coefficients, with a significance level of p < 0.05. RESULTS: Among the 50 enrolled participants who completed the study, VRDT significantly reduced pain intensity (mean difference = -2.44, 95% CI -2.72 to -2.16) and anxiety scores (mean difference = -17.76, 95% CI -18.84 to -16.68) during dressing procedures. Improvements were also observed in selected physiological parameters, particularly respiratory rate and oxygen saturation, while cardiovascular parameters remained stable throughout the intervention period. Most participants reported high levels of satisfaction with the VR experience and expressed willingness to reuse and recommend the intervention. Significant positive correlations were identified between pain intensity and anxiety levels across assessment periods. CONCLUSION: The findings suggest that VRDT may be a feasible and acceptable non-pharmacological adjunct for reducing pain and anxiety during postoperative wound dressing procedures among ICU patients following cardiac surgery. The intervention demonstrated potential benefits in enhancing patient comfort and procedural experiences. Further randomized controlled trials with larger multicentre samples are recommended to confirm these findings and establish the effectiveness of VRDT in critical care practice. RELEVANCE TO CLINICAL PRACTICE: Virtual Reality Distraction Therapy (VRDT) may provide a feasible and acceptable non-pharmacological adjunct to routine postoperative wound care for cardiac surgery patients in intensive care units. Integrating VRDT into nursing practice has the potential to reduce procedural pain and anxiety, improve patient comfort and satisfaction and support more patient-centred care during painful dressing procedures.

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