Authors (including presenting author) :
Lee MSC(1), Fong NKK(2), Mok MYM(3), Lam MK(4), Kung Y(4), Chan PWP(4), Ma KMM(4), Lui SL(3), Kwan PYL(3), Chu WL(3), Hui PC(3), Yau SFC(5), Kwan WLI(5), Chan YMK(1), Chan TM(4)
Affiliation :
(1) Department of Occupational Therapy, Queen Mary Hospital, (2) Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, (3) Department of Medicine, Tung Wah Hospital, (4) Department of Medicine, The University of Hong Kong, Queen Mary Hospital, (5) Department of Occupational Therapy, Tung Wah Hospital
Introduction :
Peritoneal dialysis (PD) involves complex procedures demanding knowledge, skills and dexterity. Patients with end-stage renal disease (ESRD) having cognitive impairment (CI) may miss or incorrectly carry out steps, leading to increased risk of peritonitis. We developed a novel non-immersive virtual reality (VR) training program using a Leap motion hand tracking device to facilitate patients’ understanding and learning of PD exchange procedures before real task training by renal nurse specialists.
Objectives :
To investigate the efficacy and impact of VR computer program on the training of PD exchange in ESRD patients with CI.
Methodology :
A single-blind randomized controlled trial was conducted concurrently at dialysis units of Queen Mary Hospital and Tung Wah Hospital respectively. Incident ESRD patients for PD training were randomly allocated to Experimental (receive VR training) or Control groups. Repeated measures analysis of covariance (RANCOVA) was used to analyze within-subject (time effects) and between-subject (group effects) outcome measurements. A 2-items questionnaire was used to assess patient satisfaction towards the VR training program.
Result & Outcome :
Twenty-three patients were recruited (12 in Experimental Group and 11 in Control Group, with similar baseline characteristics). Results showed a significant between-group effect favoring VR training on PD exchange knowledge and skills (F=4.59, p<0.05), especially the crucial steps such as connecting/disconnecting the catheter, opening/closing clips during drain-in and drain-out processes, and the overall procedural sequence, that are critical to minimizing peritonitis. Patients who received VR training demonstrated significantly more correct responses in procedures compared with Controls. In addition, VR training was associated with a high patient satisfaction rate of 89%, and all patients preferred it to be incorporated in PD exchange training.
To conclude, our VR-assisted PD exchange training program is effective and achieves high patient satisfaction. It also has the distinct merit of overcoming restrictions of time, space, and manpower associated with conventional training methods.
