How can immersive virtual reality be used to facilitate recovery and rehabilitation of patients following a stay in intensive care?

People admitted to intensive care (ICU) often experience ongoing health problems once they leave and have returned home. This is described as Post Intensive Care Syndrome (PICS) and can include problems with memory and thinking, physical impairments and reduced psychological wellbeing. This can result in a reduced quality of life, which also affects family members and friends. Although improvements have been made in caring for people within ICU, there is no standard approach to care after leaving ICU to support patients' recovery. A lack of staff and resources have also been a barrier to standard post -ICU care. With the recent increase in admissions to ICU, there is an urgent need to find ways of supporting the recovery of people with PICS that is readily available to patients. A recent review of how to combat PICS suggested that home-based and virtual care plans would be one way of making sure that as many people as possible could take advantage of rehabilitation support.

Immersive virtual reality (VR) can be accessed simply at home with an easy -to-use headset. VR has already been shown to be useful in helping relaxation and in combatting pain and anxiety. We think that VR might help support people recovering from PICS at home and this study is aimed at developing a VR program (intervention) that can be used at home.

In order to do this, we are proposing a three stage program of research. First, we need to understand what the recovery journey looks like. We will conduct a series of focus groups with ICU survivors, their family members and healthcare professionals involved in the care and rehabilitation of ICU patients. In these sessions, we will explore what the patient recovery journey looks like what the critical parts of recovery are. We will also work with these groups to determine, in terms of recovery, what is important to measure (known as outcomes) to find out whether or not a homebased care intervention works or not.

The second stage will use data from the focus groups which will then be used to alter an existing VR set-up (DR.VR) to specifically support the recovery of ICU patients, working with previous ICU patients and their family members to inform the design. We will also ask this group what features need to be included when testing the intervention at home and use this input to design the next stage of the project.

In the third part of the study, we will test the adapted VR intervention in a small group of patients admitted to ICU. The aim of this study will be to see if using a home-based VR intervention is possible and if people are happy and willing to use it. We will also explore how acceptable participants find the outcomes selected from the earlier focus groups. We will do this by interviewing participants about their experience. We will also interview the healthcare professionals involved in the care and rehabilitation of these participants to gather their views on the VR intervention. The interview data will be analysed qualitatively to provide an in-depth understanding of the intervention and outcomes. This data can then be used to inform the design of larger studies in the future to test how effective the VR intervention is at supporting the recovery of ICU patients.

At the end of the study, we will share the results with all of the study participants and more widely through appropriate web pages, social media and organisations concerned with the care of ICU patients.