Virtual Reality for Hemophilia
| Status: | Completed |
|---|---|
| Conditions: | Anemia, Hematology |
| Therapuetic Areas: | Hematology |
| Healthy: | No |
| Age Range: | 6 - 19 |
| Updated: | 4/27/2018 |
| Start Date: | April 2016 |
| End Date: | December 28, 2016 |
A Feasibility and Usability Study of a Nursing Orchestrated, Customized 3 Dimensional Virtual Reality Environment in Children With Hemophilia Undergoing Routine Intravenous Procedures
Children with hemophilia are exposed to intravenous (IV) procedures that cause pain/anxiety
and distraction methods can be employed to improve the patient experience. Three-dimensional
virtual reality (VR) environments can reduce distress related to procedures. To be utilized
in a clinical setting, however, these devices must address infection control concerns and fit
pediatric patients. Additionally, for use in hemophilia care, environments should encourage a
subject to keep their hands/arms still to facilitate procedures. Nursing orchestration of the
VR environment via an iPad dashboard has the potential to increase feasibility and acceptance
by patients, families and providers of the VR experience without disrupting routine clinical
care.
and distraction methods can be employed to improve the patient experience. Three-dimensional
virtual reality (VR) environments can reduce distress related to procedures. To be utilized
in a clinical setting, however, these devices must address infection control concerns and fit
pediatric patients. Additionally, for use in hemophilia care, environments should encourage a
subject to keep their hands/arms still to facilitate procedures. Nursing orchestration of the
VR environment via an iPad dashboard has the potential to increase feasibility and acceptance
by patients, families and providers of the VR experience without disrupting routine clinical
care.
Patients with hemophilia A and B (HA/HB) are frequently treated with IV infusions of clotting
factor concentrates to treat and prevent bleeding. Additionally they typically have at least
yearly IV laboratory assessments. Pain and anxiety with needle related procedures
particularly in children with hemophilia can lead to development of needle phobia, treatment
avoidance and poor adherence to treatment regimens. Conventional virtual reality (VR)
environments have been shown to reduce pain/anxiety in pediatric populations however in a
clinical setting children with hemophilia have specific VR design needs that have not been
addressed. Certain issues related to VR environments are related to the pediatric age range.
These include the size and weight of VR headsets, the ease of donning and doffing headsets,
and degree of engagement with VR environments. Hemophilia specific issues include the need
for the VR experience to limit movement of the hands/arms to facilitate IV procedures,
customization to prevent boredom/disengagement from repeated use and ability of clinical
staff to trigger events via an orchestration dashboard that occur for the patients benefit at
key times during IV procedures. Lastly, there are issues related to integration into a
clinical setting. These include ability to integrate into clinical care without adversely
affecting clinic flow, and infection control issues related to headset design.
factor concentrates to treat and prevent bleeding. Additionally they typically have at least
yearly IV laboratory assessments. Pain and anxiety with needle related procedures
particularly in children with hemophilia can lead to development of needle phobia, treatment
avoidance and poor adherence to treatment regimens. Conventional virtual reality (VR)
environments have been shown to reduce pain/anxiety in pediatric populations however in a
clinical setting children with hemophilia have specific VR design needs that have not been
addressed. Certain issues related to VR environments are related to the pediatric age range.
These include the size and weight of VR headsets, the ease of donning and doffing headsets,
and degree of engagement with VR environments. Hemophilia specific issues include the need
for the VR experience to limit movement of the hands/arms to facilitate IV procedures,
customization to prevent boredom/disengagement from repeated use and ability of clinical
staff to trigger events via an orchestration dashboard that occur for the patients benefit at
key times during IV procedures. Lastly, there are issues related to integration into a
clinical setting. These include ability to integrate into clinical care without adversely
affecting clinic flow, and infection control issues related to headset design.
Inclusion Criteria:
1. Provide signed and dated informed consent form
2. Willing to comply with all study procedures and be available for the duration of the
study
3. Diagnosed with Hemophilia A or B
4. Male or female, aged >6 years to <19 years
5. Subject and caregiver able to understand and speak English
6. Being seen for routine comprehensive hemophilia care visits during which an IV
procedure is planned as standard of care.
Exclusion Criteria:
1. Inability to use the VR equipment (ie visual, cognitive or hearing impairment that
would preclude engagement with the VR environment)
2. History of motion sickness as reported by patient or caregiver
3. History of poorly controlled seizures as reported by patient or caregiver
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