出院前虚拟现实视频心理干预对面部深度烧伤患者出院后情绪影响的前瞻性随机对照研究

Effect of virtual reality video-based pre-discharge psychological intervention on the post-discharge emotions of patients with deep facial burns:a prospective randomized controlled study

目的探讨出院前虚拟现实视频心理干预对面部深度烧伤患者出院后情绪的影响。方法2017年10月—2019年9月,吉林大学第一医院收治84例面部深度烧伤患者符合入选标准,纳入本前瞻性随机对照研究。按随机数字表法将患者分为2组,随访脱落后,虚拟现实视频组纳入40例(男21例、女19例)、普通视频组纳入41例(男22例、女19例),年龄分别为18~53、19~55岁。选择7例于2014年1月—2016年12月经吉林大学第一医院治愈且回归正常工作生活的面部深度烧伤后康复患者,将每例患者受伤前后与治疗各阶段照片及相应解说、出院后面临的问题及解决方法、生活状态影像等编辑录制成视频。从出院前7 d开始,虚拟现实视频组患者通过虚拟现实眼镜观看视频,普通视频组患者通过平板电脑观看视频,共7 d。出院前7 d(观看视频前)及出院后1个月,采用焦虑自评量表、抑郁自评量表、社交回避与苦恼量表评估2组患者焦虑、抑郁、社交回避与苦恼情绪。对数据行配对样本或独立样本t检验、χ2检验或Fisher确切概率法检验。结果出院前7 d,普通视频组患者焦虑、抑郁、社交回避与苦恼评分分别为(34±7)、(34±6)、(11.5±3.9)分,与虚拟现实视频组的(35±7)、(35±5)、(10.5±3.9)分相近(t=-0.803、-1.050、1.122,P>0.05),且均高于国内常模。出院后1个月,虚拟现实视频组患者焦虑、抑郁、社交回避与苦恼评分分别为(31±5)、(31±5)、(7.2±2.5)分,明显低于出院前7 d(t=6.609、7.492、7.622,P<0.01);普通视频组患者焦虑、抑郁和社交回避与苦恼评分分别为(37±7)、(38±8)、(13.9±7.4)分,明显高于出院前7 d(t=2.802、3.599、2.739,P<0.01)。出院后1个月,虚拟现实视频组患者焦虑、抑郁和社交回避与苦恼评分明显低于普通视频组(t=4.722、5.043、5.490,P<0.01)。结论应用虚拟现实视频对面部深度烧伤患者进行出院前心理干预可减轻患者出院后焦虑、抑郁及社交回避与苦恼等不良情绪。

Objective To investigate the effect of virtual reality(VR)video-based pre-discharge psychological intervention on the post-discharge emotions of patients with deep facial burn.Methods From October 2017 to September 2019,84 patients with deep facial burn who were hospitalized in the First Hospital of Jilin University and met the inclusion criteria were enrolled in the prospective randomized controlled study were.According to the random number table,the patients were divided into two groups,with 40 cases(21 males and 19 females)left in VR video group,aged 18-53 years and 41 cases(22 males and 19 females)in general video group,aged 19-55 years after several patients dropped out in follow-up.Seven patients who had been treated in the First Hospital of Jilin University from January 2014 to December 2016 and returned to work and life after recovering from the deep facial burn were selected,and then the pictures and corresponding commentaries before and after burn injuries,the problems and solutions after discharge,and the image data of living status of each patient were edited and recorded into a video.From seven days before discharge,the patients in VR video group began to watch videos by wearing VR glasses,while the patients in general video group began to watch videos on a tablet computer,for 7 days.On the 7th day before discharge(before watching the videos)and one month after discharge,the Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),and Social Avoidance and Distress(SAD)Scale were used to evaluate the level of anxiety,depression,and social avoidance and distress of patients in both groups.Data were statistically analyzed with paired or independent sample t test,chi-square test,or Fisher′s exact probability test.Results On the 7th day before discharge,the scores of anxiety,depression,and social avoidance and distress of patients in general video group were(34±7),(34±6),and(11.5±3.9)points,respectively,close to(35±7),(35±5),and(10.5±3.9)points in VR video group(t=-0.803,-1.050,1.122,P>0.05),and the scores of both groups were higher than the national norms.One month after discharge,the scores of anxiety,depression,and social avoidance and distress of patients in VR video group were(31±5),(31±5),and(7.2±2.5)points,respectively,significantly lower than the scores on the 7th day before discharge(t=6.609,7.492,7.622,P<0.01);the scores of anxiety,depression,and social avoidance and distress of patients in general video group were(37±7),(38±8),and(13.9±7.4)points,respectively,significantly higher than the scores on the 7th day before discharge(t=2.802,3.599,2.739,P<0.01).One month after discharge,the scores of anxiety,depression,and social avoidance and distress of patients in VR video group were significantly lower than those in general video group(t=4.722,5.043,5.490,P<0.01).Conclusions Pre-discharge psychological intervention of patients with deep facial burn using VR videos can alleviate their bad emotions after discharge,such as anxiety,depression,and social avoidance and distress.