TY - JOUR
T1 - Do Extended Reality Interventions Benefit Patients Undergoing Elective Cardiac Surgical and Interventional Procedures? A Systematic Review and Meta-analysis
AU - Harris, Emma
AU - Fenton, Steven
AU - Stephenson, John
AU - Ewart, Fiona
AU - Goharinezhad, Salime
AU - Lee, Hyunkook
AU - Astin, Felicity
N1 - Funding Information:
Funding: The authors received no specific funding for this work. The authors would like to thank the information specialist at the University of Huddersfield for advising on the search strategy. There is a statistician on the author team (John Stephenson).
Publisher Copyright:
© 2024 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd.
PY - 2025/4/1
Y1 - 2025/4/1
N2 - Background: Extended reality (XR) interventions have the potential to benefit patients undergoing elective cardiac surgical and interventional procedures. However, there are no systematic reviews with meta-analyses to guide clinical care. Aim: To critically evaluate the evidence on the effectiveness of XR interventions on patient anxiety and pain and other associated outcomes. Design: Systematic review and meta-analysis following the PRISMA 2020 statement. Data Sources: A systematic search of five databases (CENTRAL, CINAHL, MEDLINE, PsycInfo, Scopus) from inception to July 2023. Methods: Screening and data extraction was conducted independently by multiple reviewers. Stata (Version 17) was used to conduct meta-analyses for patient anxiety and pain. Secondary patient outcomes were summarised in a synthesis. The Cochrane Risk of Bias (Version 2) tool was applied to trials and the NHLBI Study Quality Assessment tools to all other study designs. Results: Of the 3372 records identified, 22 were included, 10 of which were eligible for inclusion in the meta-analyses. Fifty-seven percent of randomised trials were rated as high risk of bias. Virtual reality (VR) was the only XR technology evaluated. VR significantly reduced pre-procedural anxiety (standardised mean difference: −1.29; 95% confidence interval − 1.96, −0.62, p < 0.001), and peri-procedural anxiety (standardised mean difference: −0.50; 95% confidence interval − 0.83, −0.18, p < 0.003) but did not reduce pain levels, compared with usual care. VR increased pre-procedural knowledge and postsurgical physical and pulmonary function. VR interventions may also improve emotional wellbeing, care delivery and physiological outcomes, but evidence was inconsistent. Conclusions: XR potentially benefits cardiac patients undergoing elective invasive procedures and surgery by reducing pre- and peri-procedural anxiety and increasing procedural knowledge and physical function. Relevance to Clinical Practice: Cardiac nurses' role can be supported by VR interventions to improve the patient experience and several aspects of patient care. Patient or Public Contribution: Not applicable as this is a systematic review.
AB - Background: Extended reality (XR) interventions have the potential to benefit patients undergoing elective cardiac surgical and interventional procedures. However, there are no systematic reviews with meta-analyses to guide clinical care. Aim: To critically evaluate the evidence on the effectiveness of XR interventions on patient anxiety and pain and other associated outcomes. Design: Systematic review and meta-analysis following the PRISMA 2020 statement. Data Sources: A systematic search of five databases (CENTRAL, CINAHL, MEDLINE, PsycInfo, Scopus) from inception to July 2023. Methods: Screening and data extraction was conducted independently by multiple reviewers. Stata (Version 17) was used to conduct meta-analyses for patient anxiety and pain. Secondary patient outcomes were summarised in a synthesis. The Cochrane Risk of Bias (Version 2) tool was applied to trials and the NHLBI Study Quality Assessment tools to all other study designs. Results: Of the 3372 records identified, 22 were included, 10 of which were eligible for inclusion in the meta-analyses. Fifty-seven percent of randomised trials were rated as high risk of bias. Virtual reality (VR) was the only XR technology evaluated. VR significantly reduced pre-procedural anxiety (standardised mean difference: −1.29; 95% confidence interval − 1.96, −0.62, p < 0.001), and peri-procedural anxiety (standardised mean difference: −0.50; 95% confidence interval − 0.83, −0.18, p < 0.003) but did not reduce pain levels, compared with usual care. VR increased pre-procedural knowledge and postsurgical physical and pulmonary function. VR interventions may also improve emotional wellbeing, care delivery and physiological outcomes, but evidence was inconsistent. Conclusions: XR potentially benefits cardiac patients undergoing elective invasive procedures and surgery by reducing pre- and peri-procedural anxiety and increasing procedural knowledge and physical function. Relevance to Clinical Practice: Cardiac nurses' role can be supported by VR interventions to improve the patient experience and several aspects of patient care. Patient or Public Contribution: Not applicable as this is a systematic review.
KW - anxiety
KW - extended reality
KW - interventional cardiology
KW - pain
KW - patient experience
KW - patient outcomes
KW - systematic review
KW - virtual reality
UR - http://www.scopus.com/inward/record.url?scp=85211820192&partnerID=8YFLogxK
U2 - 10.1111/jocn.17578
DO - 10.1111/jocn.17578
M3 - Review article
C2 - 39668582
AN - SCOPUS:85211820192
VL - 34
SP - 1465
EP - 1492
JO - Journal of Clinical Nursing
JF - Journal of Clinical Nursing
SN - 0962-1067
IS - 4
ER -
