Nevertheless, therapists show interest in using VR technology . A survey study among healthcare providers suggested the ability of VR to provide post-stroke treatment regardless patient’s physical or cognitive limits is a valuable tool for rehabilitation . However, the technology itself is currently limited. Thus, VR is not ready to completely supplant traditional treatment methods, and there is currently no threat in job security for therapists; this was a noted factor in subjects’ positive opinion of VR .
Paradoxically, their concern over VR’s inability to perfectly replicate reality as a therapeutic tool is providing job security . When therapists begin training for VR therapy, pre-existing learning resources have proven beneficial for optimized usage [13, 14]. Likewise, patients must become used to the technology as well. A study examining the use of educational tools for both post-stroke patients and medical practitioners demonstrated increased confidence in using VR platforms, as well as patients’ confidence in the therapeutic strategies provided .
The use of motor learning strategies (MLSs) must be replicable in real life to provide adequate rehabilitation; thus, their successful virtual replication is key . The interactive elements of VR, in regards to user feedback and input, provide scaffolding for patients to transfer therapy skills to real life . A more indirect means of VR integration into post-stroke rehabilitation is the virtual reconstruction of patients’ homes. By recreating their living arrangements into VR, therapists can identify and protect against any hazards currently within patients’ lives .
This is particularly beneficial when in-person visits to patients’ homes are expensive and time-consuming . However, in-person visits are still preferable due to their intimacy and accuracy; thus, VR recreations should not completely replace physical examinations of patients’ houses . Therapist-Patient Relationships in VR Treatment Research has also been conducted to better facilitate the use of VR therapy by healthcare professionals [12, 16]. A study examining the ability of VR as a tool for interpersonal communication between caretakers and patients demonstrated successful results .
Instead of asking patients to imagine situations, therapists trained in VR usage could illustrate the proper treatments environments most beneficial for users . Aside from VR’s ability to place users in digital environments, it would allow therapists to control and manipulate these virtual worlds specifically for their patients . This allows them to correct false perceptions held by individuals regarding social situations . The flexibility provided by VR tools could accommodate for a variety of situations. However, communicative barriers also exist for therapists’ use of VR. VR and Hospital Design
While virtual reality can be a teaching tool for health practitioners, virtual reality can also be used to assess the emotional well being of patients in health care. Due to the necessary functional furniture arrangements and sterile conditions of a hospital, patient rooms are often bare, creating an unpleasant emotional response . To some, this can be tolling on one’s emotional well being. Additionally, sterile environments and hospital equipment can be associated with “feeling unwell”” . Studies have examined the effects the interior design of a hospital room has on a person’s emotional response.
In several studies it is proven that interior design elements, such as artwork and natural elements, increase a patient’s positive emotional response, aiding the healing process by minimizing experienced stress and pain . A study was conducted investigating the type of emotional response an interior design element could evoke . In this study two major questions were examined: does the number of design elements affect the magnitude of an emotional response, and what type of emotional response results from each design element.
Design elements could be “plants, landscape views, artwork, [and/or] home furniture” . Using VR, subjects were immersed into 28 different virtual environments (VE), varying in the number and type of interior design elements. It was found that the both the number of design elements and the type of design element affected one’s emotional response . As predicted, a greater number of design elements placed in a resulted in a higher positive emotional response – Ves containing three design elements performed better in positive emotional responses than Ves containing two, or one design element .
Focusing more specifically on the type of design element, this study found the more natural a design element, the greater positive response it would elicit (see Fig. 3) . Though this study shed light on the components that elicit positive emotional responses in hospital rooms, this study contained design flaws and did not take advantage of the VR capabilities today. In order to see the VE from different perspectives while lying in the bed, the VR equipment used required the subject to move a mouse. If the subject’s head movement could control the VR system, it could potentially further immerse the subject into the VE.
Based on the provided visuals, the VEs looked like digital renderings of furniture and design components . If the VE appeared to be more realistic, it is possible subjects would have different emotional responses (see Fig. 4). Additionally, this study did not take other body stimuli – such as auditory, tactile, and olfactory – into account, limiting the emotional experience a subject could have in the VE . Furthermore, the subjects were only given 10 seconds to view each of the 28 VEs. It was unclear from the study whether the emotional response survey was completed after each room, or after the whole study had finished .
Depending on when the survey was given, and the allocated time to experience a room, survey results could have been unintentionally biased. It is known that humans remember the first and last subjects/ topics/things best, and tend to forget those in the middle when given a large list. Though the order of the rooms was randomly generated for each subject, this sense of bias would still be present. Finally, the subjects of this student were ordinary citizens, unable to fully empathize with real hospital patients . While this experiment is leading interior designers in the right direction, this study does not provide sufficient data.
To gain more insight on how hospital rooms should be designed, simply more background research needs to be done. Researchers are equipped with the knowledge of what types of design elements are more successful in producing positive emotional results. It is the specifics of those elements that would lead to more valuable test results. For instance, researchers should investigate the effects of colors. They should test different wall and ceiling colors to see if that has an effect on emotional responses. Additionally, researchers should investigate if the sizes of plants matter, and/or if the type of plant matters.
Another area of research could be in trying to minimize the negatives. Knowing that design elements such as chairs elicit the least positive emotional response, researchers should investigate what it is about the chairs that cause those emotional responses. In addition, researchers should examine alternative furniture design elements, noting if any produce a greater emotional response than the standard chair. It is possible that hospital furniture, yet functional and potentially ergonomic, needs to be redesign with aesthetics and emotional response in mind.
VR as a Window to the Outside World for Immobile Patients VR can be a powerful tool for transporting patients out of the medical room and into exciting new spaces, allowing immobile patients to have new experiences even if their bodies don’t allow them to. In cancer patients for example, stress and anxiety leading up to chemotherapy has been correlated to a weakening of the patient’s immune system, leading to treatments that are not as safe and less effective . Existing research shows that psychological therapy for cancer patients can positively affect patient improvement rates .
Specifically, the “distraction technique” – bringing the patient’s attention away from her illness and upcoming procedures – has been shown to be a particularly effective psychotherapy method for alleviating pain and stress . VR “imaging therapy”, a more immersive variant of distraction therapy, can engage many senses and shows promise as one of the most effective methods to help patients cope with chemotherapy . Side Effects of VR-based Therapy Techniques Even if new VR-based therapies are proven to be effective, widespread clinical use requires that these new methods do not result in many unacceptable side effects for patients.
Fortunately, preliminary empirical research has found that unintended side effects caused by VR immersion therapies are limited. One study examined the self-reported magnitude of motion sickness in subjects with anxiety disorders before and immediately after exposure to a 60 minute long VR therapy session . While patients with certain disorders like claustrophobia reported significantly higher levels of discomfort after VR immersion, as a whole subjects rated their discomfort as less than “slight” on all items that were measured .
In a separate study by the same researchers, subjects reported slightly raised levels of discomfort in anticipation of VR immersion, the highest levels of discomfort immediately after immersion, and the lowest levels of discomfort 24 hours after immersion . The researchers found that within a full day after therapy sessions, subjects did not display any unexpected health or safety concerns, suggesting that subjects were able to recover from the immediate effects of VR immersion without additional intervention .
Using VR for the purposes of therapy does not appear to have additional side effects compared to using VR in any other context. Researchers have also looked into whether patients suffering from certain types of mental disorders respond uniquely to virtual and simulated stimuli. One study compared subjects with persecutory delusions to the general population during and after interacting with a virtual environment for a few minutes . Subjects were placed in a virtual rendering of a crowded subway train, surrounded by twenty computer-generated characters known as “avatars” (see Fig. ) .
The subjects could move around the virtual space and observe the actions of the avatars, but were asked to disembark from the train after a few stops . The researchers found that exposure to the virtual environment affected subjects with and without persecutory delusions in a very similar way, and that it did not trigger intrusive thoughts or flashbacks up to a week following the experiment . They concluded that short VR experiences seem to be safe for people with psychosis .