The Effectiveness of Combining AR/VR Technology in Virtual Clinical Auditory Hallucinations on the Comprehensive Auditory Hallucination Nursing Competency of Psychiatric Nurses

National Yang Ming Chiao Tung University

Status: Not yet enrolling

Conditions: Schizophenia Disorder; Hallucinations, Auditory; Nurses

Treatments: Other: Virtual clinical auditory hallucination solution combining AR/VR technology; Other: Auditory Hallucination Care Video

Study type: Interventional

Funder types: Other

Identifiers

NCT06938997

NYCU113052AE

Details and patient eligibility

About

This study aims to develop and evaluate a Virtual Reality (VR) Auditory Hallucination Program to enhance psychiatric nurses' comprehensive care competence in managing auditory hallucinations among patients with schizophrenia. Given that 60-80% of patients on the schizophrenia spectrum experience auditory hallucinations, and many continue to do so despite medication, improving nurses' professional skills in this area is critical.

The research is conducted in two phases across four psychiatric institutions. Phase one involves the development and validation of the VR program and an OSCE (Objective Structured Clinical Examination), piloted with five participants and evaluated by psychiatric nursing experts. Phase two is a formal interventional study with 200 psychiatric nurses, using block randomization and three data collection time points.

Assessment tools include five instruments measuring nurses' confidence, knowledge, attitude, empathy, immersion, and care performance related to auditory hallucinations. The study expects to strengthen nurses' ability to assess and manage auditory hallucinations effectively, and proposes the VR program as a potential tool for nursing in-service education.

Full description

Background: The lifetime prevalence of auditory hallucinations among patients on the schizophrenia spectrum is 60-80%. More than half of these patients continue to experience auditory hallucinations even with regular medication adherence. The professional competence of nurses in managing auditory hallucinations affects the stability of patients' symptoms and their recovery process, highlighting the importance of nurses' capabilities in caring for patients with auditory hallucinations.

Purpose: To develop and test the effectiveness of a virtual reality auditory hallucination program on the comprehensive care competence of psychiatric nurses in managing auditory hallucinations.

Methods: This is a two-phase study conducted in four psychiatric medical institutions. The study includes a development phase, a testing phase, and a formal research phase. In the pilot phase, five participants are expected to be recruited. The first phase involves the development and testing of the virtual reality auditory hallucination program and the Objective Structured Clinical Examination (OSCE), which includes components such as auditory hallucination assessment, communication with individuals experiencing auditory hallucinations, and management of auditory hallucinations. Upon completion, content validation will be conducted by psychiatric experts. Five psychiatric nursing master's students will be invited as simulated candidates to examine the applicability of the "VR-based Auditory Hallucination Nursing OSCE" for psychiatric nurses. The second phase is the formal interventional study, which will recruit 200 psychiatric nurses through convenience sampling. Participants will be grouped by institution using block randomization software. Data will be collected at three time points using the HTC virtual human system in conjunction with Google online questionnaires. The research instruments include:

• Self-rated Confidence Questionnaire on Auditory Hallucination Assessment and Management,② Auditory Hallucination Knowledge, Attitude, and Empathy Self-awareness Scale,③ Auditory Hallucination Immersion and Empathy Scale, ④ Comprehensive Auditory Hallucination Nursing OSCE Evaluation Form, and ⑤ Nurse Auditory Hallucination Literacy Scale. Expected Results: This study is expected to enhance psychiatric nurses' capabilities in assessing and managing auditory hallucinations. The program may be routinely used in in-service education for nursing staff and may serve as a reference to assist nurses in helping patients improve their insight into auditory hallucinations.

Keywords: Auditory hallucination care competence, interventional study, virtual reality, schizophrenia, Objective Structured Clinical Examination (OSCE)

Enrollment: 200 estimated patients

Sex: All

Ages: 20 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• A psychiatric nurse who has been engaged in nursing work in a psychiatric unit for at least three months;
• Those who were willing to participate in the study and filled out the consent form;
• Willing to use smartphones to watch VR360 videos;
• Willing to cooperate with the study and use 3D glasses.

Exclusion criteria

• Nurses who are about to leave or be transferred out of the psychiatric ward within six months
• Part-time nurses
• Part-time supervisors
• Specialist nurses.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

---

200 participants in 2 patient groups, including a placebo group

50-minute Auditory Hallucination Care instructional video

Placebo Comparator group

Description:

Control Group * Pre-test: No intervention * Intervention 1: Auditory Hallucination Care Video only * Post-test: Conduct measurement (no new intervention) * Intervention 2: 50-minute Auditory Hallucination Care instructional video only * Follow-up: Conduct measurements (no new intervention)

Treatment:

Other: Auditory Hallucination Care Video

Virtual clinical auditory hallucination solution and Auditory Hallucination Care instructional vide

Experimental group

Description:

Experimental Group * Pre-test: No intervention * Intervention 1: Accept intervention A+B * A: Virtual clinical auditory hallucination solution combining AR/VR technology and virtual human interactive platform * B: 50-minute Auditory Hallucination Care instructional video * Post-test: Conduct measurement (no new intervention) * Intervention 2: Re-intervention of A+B * Follow-up: Conduct measurements (no new intervention)

Treatment:

Other: Auditory Hallucination Care Video

Other: Virtual clinical auditory hallucination solution combining AR/VR technology