Authors (including presenting author) :
Lai SK(1), Ng TL(1), Lo KC(1), Jim HYC(1), Au HL(1), Lai YY(1), Tsang MY(1)
Affiliation :
(1) Occupational Therapy Department, Castle Peak Hospital
Introduction :
Stress is studied to be significantly associated with psychotic relapses, especially among patients with severe mental illnesses (SMI). Traditional stress management programme demonstrated promising effectiveness in alleviating stress level and emotional symptoms, thus reducing relapse and readmission. However, stress management could be challenging in inpatient settings due to environment constraints; and virtual reality (VR) emerged as a unique avenue to provide sensory experience that can effectively promote relaxation. By immersing users in visually engaging environment, it is hypothesis that the effectiveness and motivation to participate in stress management programme could be enhanced.
Objectives :
The objective is to investigate the feasibility and effectiveness of a brief stress management programme using partial-immersive VR on reducing stress level and mood symptoms for patients with SMI.
Methodology :
This pilot study adopted a single group pre-post design. Inpatients diagnosed with SMI referred to Occupational Therapy Department were eligible for recruitment. Patients with diagnosis of epilepsy, intellectual disability or dementia, presence of active psychotic symptoms, and any physical impairment that would impair participation were excluded.
The programme was delivered by two experienced occupational therapists and consisted of two components: psychoeducation and relaxation practice. There were two 1-hour psychoeducation sessions on sources of stress, stress reaction and coping strategies. In-class relaxation practices were guided by partial-immersive VR of different nature scenery created by multiple projectors. Three 15-minute post-intervention relaxation practices were arranged.
Baseline and post-intervention assessments were conducted using Depression, Anxiety and Stress Scale–21 items (DASS-21), visual analogue scale of motivation and interest to receive training, with a post-intervention questionnaire. All outcome measures were analysed using Wilcoxon signed-rank test.
Result & Outcome :
Fourteen subjects with mean age of 41.6 years (SD=14.3) were recruited. Majority of the participants (64.3%) were female, with diagnosis of schizophrenia spectrum disorders (78.6%) and depression (21.4%). Thirteen participants (92.8%) completed the programme, one subject dropped out as she was discharged from hospital before completion.
Significant improvements were observed in total score of DASS-21 (z=-2.19, p<.05), stress (z=-2.11, p<.05) and depression subscale (z=-1.96, p=.05). Significant increases in interest and motivation to receive training were also reported (z=-2.03 to 2.54, p<.05). Around three-quarters of the participants agreed the use of VR could facilitate relaxation practice. No adverse events were reported.
The results provided preliminary evidence on the feasibility and efficacy of using partial-immersive VR to assist stress management programme for patients with SMI. A more robust study design with control group is necessary to further confirm the treatment effectiveness.
