Authors (including presenting author) :
Wu MC(1),Cheng,HW(1), Lo KY(1), Chan CM(2), WONG CM(1), Ho KH(1)
Affiliation :
(1)Department of Neurosurgery, Kwong Wah Hospital, Hong Kong
(2)Department of Anaesthesiology and Operating Theatre Services, Kwong Wah Hospital, Hong Kong
Introduction :
During awake craniotomy, surgeons and patients need to work together for cortical mapping, which is a specific procedure for finding out the eloquent area in the brain. By using this technique, surgeons can preserve patients’ neurological function while removing the maximum amounts of tumor.
However, patient’s anxiety reduces the quality of cortical mapping. Thus, several interventions were designed for coping with patients’ preoperative anxiety in our department.
Unfortunately, one of the interventions was cancelled recently due to the outbreak of COVID-19. It is 'Pre-operative operative theater (OT) visit', which helps patients to familiar the environment of OT. Without this, some patients complained of feeling severe preoperative anxiety. As a result, it directly impacted the quality of cortical mapping.
To solve this problem, a pilot program was proposed, that is “Virtual Reality (VR) orientation for awake craniotomy cases”.
Objectives :
To design and implement a preoperative VR orientation program for awake craniotomy cases, and to evaluate its effectiveness.
Methodology :
The technology of VR can provide stimulated experience that can be nearly to the real condition. Therefore, we apply this new technology for pre-operative patient education.
Patients are invited to watch a VR movie on the day before OT. And this VR movie includes 3 parts. The first part is an introduction of awake craniotomy, the 2nd part is a simulated OT travel on operation day, and the 3rd part is some VR photos of OT.
Through this VR movie, patients can have a ‘virtual rehearsal’ for the operation, thus they can have a better understanding about the realistic description of the operation theatre, expected discomforts, and the level of co-operation expected, and stages of procedure.
To evaluate the program, an assessment tool called ‘The Depression Anxiety Stress Scale-21’ (DASS-21), which can measure the patient’s anxiety level, is used. And the target number of cases is 30 in this study. Each audience are invited to do DASS-21 twice, before and after watching the movie. In comparison with those two results, the change of patient’s anxiety level could be found out. By using this method, we can know any improvement in patients’ anxiety level after watching the VR movie.
Result & Outcome :
This study started from 1st of October 2020. Till now (12th of January 2021), the no of case is 4, and all the figures look very encouraging. For example, one of the candidates showed a great improvement in her anxiety level (from Extremely severe level to Moderate level). As a result, a positive result is expected.
