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Trial registered on ANZCTR
Registration number
ACTRN12624000435583
Ethics application status
Approved
Date submitted
16/01/2024
Date registered
9/04/2024
Date last updated
9/04/2024
Date data sharing statement initially provided
9/04/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
Virtual Reality and Savoring to Promote Well-being of Patients With Chronic Respiratory Diseases: a Randomized Controlled Trial
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Scientific title
Virtual Reality and Savoring to Promote Well-being of Patients With Chronic Respiratory Diseases: a Randomized Controlled Trial
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Secondary ID [1]
311332
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None
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Universal Trial Number (UTN)
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Trial acronym
oVeRcomING CRDs
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic respiratory diseases
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emotional well-being
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psychological well-being
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Condition category
Condition code
Respiratory
329283
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0
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Other respiratory disorders / diseases
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Mental Health
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329284
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0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Together with the 3-week traditional pulmonary rehabilitation in the hospital, the experimental group took part in the VR-based enhanced with savoring intervention. It lasted two weeks and included four 25-minute sessions, with two sessions per week. In each session, the experimental group experienced a 10-minute relaxing virtual scenario using the Oculus Quest 2 headset integrated with a narrative voice. The content of the narrative voiceover was not created specifically for this intervention. Moreover, participants completed a savoring exercise proposed through pre-recorded 5-minute audio after each virtual scenario to consolidate and amplify the positive emotions generated by the VR experience. Sessions usually took place on Mondays and Thursdays, starting in the second week of traditional pulmonary rehabilitation. They were administered by the researchers and occurred one-on-one. Direct observation was used to assess adherence to the intervention. The baseline assessment was done in a separate session earlier to avoid overloading the patients and occurred in the same week as starting the traditional pulmonary rehabilitation.
In each session, participants were asked to sit down in a chair and experience the VR scenario and the following savoring exercise. In the first session, patients explored "the secret garden," guided by a relaxing narrative through a peaceful Japanese garden, including crossing a peaceful pond and passing cherry blossom trees. Following this, participants engaged in a savoring exercise, recalling positive emotions from the VR experience and savoring a positive memory where they felt similar emotions.
The second session involved watching "the waterfall in the prairie," where patients enjoyed the sights and sounds of nature, including colorful flowers, quiet lakes, and distant village voices. After this, they were invited to recall the positive emotions felt in the VR experience and to savor a positive past event shared with a loved one.
In the third session, participants were guided by the narrative voice along "the beach at sunset," observing the beauty of the sand, sea, and sunset hues, accompanied by the soothing sounds of waves and gentle wind. They were then prompted to recall positive emotions felt during the VR experience and imagine and savor a personal place connected to these emotions.
Lastly, in the fourth session, patients chose and experienced their favorite scenario from previous sessions. Following that, they were guided through the exercises completed in the previous sessions to consolidate them.
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Intervention code [1]
327777
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Treatment: Other
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Intervention code [2]
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Rehabilitation
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Intervention code [3]
328135
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Treatment: Devices
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Comparator / control treatment
Together with the 3-week traditional pulmonary rehabilitation in the hospital, the active control group listened to relaxing music (with a low pitch and a tempo of 60 to 72 beats per minute) in four 25-minute sessions, with two sessions per week. The music was selected from previous studies that have already used it with patients with chronic respiratory diseases, and it varied for each session. Sessions usually took place on Mondays and Thursdays, starting in the second week of traditional pulmonary rehabilitation. They were administered by the researchers and occurred one-on-one. Direct observation was used to assess adherence to the intervention. The baseline assessment was done in a separate session earlier to avoid overloading the patients and occurred in the same week as starting the traditional pulmonary rehabilitation.
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Control group
Active
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Outcomes
Primary outcome [1]
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Emotional well-being and psychological well-being
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Assessment method [1]
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Mental Health Continuum Short Form
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Timepoint [1]
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Baseline (T0), immediately after the completion of all four sessions (T1, primary timepoint), and in the one-month follow-up (T2) for both groups
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Primary outcome [2]
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Positive affect and negative affect
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Assessment method [2]
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Scale of Positive and Negative Experiences
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Timepoint [2]
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Baseline (T0), immediately after the completion of all four sessions (T1, primary timepoint), and in the one-month follow-up (T2) for both groups
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Primary outcome [3]
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Relaxation
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Assessment method [3]
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10-point Visual Analogue Scale
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Timepoint [3]
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Baseline (T0), immediately after the completion of all four sessions (T1, primary timepoint), and in the one-month follow-up (T2) for both groups
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Secondary outcome [1]
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Sense of presence in the virtual environment
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Assessment method [1]
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Slater Usoh Steed Presence Questionnaire
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Timepoint [1]
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Immediately after the completion of all four sessions (T1)
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Secondary outcome [2]
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VR acceptance
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Assessment method [2]
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Ad hoc questionnaire based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model designed specifically for this study
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Timepoint [2]
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Immediately after the completion of all four sessions (T1)
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Secondary outcome [3]
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Relaxation
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Assessment method [3]
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10-point Visual Analogue Scale
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Timepoint [3]
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Immediately before and after each of the four sessions
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Secondary outcome [4]
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Peripheral oxygen saturation (SpO2)
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Assessment method [4]
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NONIN Palm Saturimeter
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Timepoint [4]
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Immediately before and after each of the four sessions
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Eligibility
Key inclusion criteria
- Age 18 years and over
- A diagnosis of chronic respiratory disease according to European Respiratory Society (ERS)/American Thoracic Society (ATS) criteria
- Written informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Diagnosis of dementia or cognitive impairment reported within the medical records
- Mini Mental State Examination score of < 26
- Pre-existing medical conditions that preclude the use of the Oculus Quest 2 headset, such as (1) the presence of binocular vision abnormalities, (2) a positive history of seizures and epileptic conditions, (3) the presence of cardiac pacemakers, defibrillators, or implanted devices, and (4) the presence of hearing aids
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Block randomization. A label of A or B (A=intervention, B=control) was assigned to each group (block size=4). Free online software (Research Randomizer 4.0) was used to generate the randomization list.
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
23/01/2023
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Date of last participant enrolment
Anticipated
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Actual
31/07/2023
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Date of last data collection
Anticipated
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Actual
15/09/2023
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Sample size
Target
46
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Accrual to date
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Final
52
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Recruitment outside Australia
Country [1]
26081
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Italy
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State/province [1]
26081
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) INRCA (Italian National Research Centre on Aging) Casatenovo
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Address [1]
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Via Monteregio 13, Casatenovo, 23880, Lecco
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Country [1]
315589
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Italy
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Funding source category [2]
315591
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University
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Name [2]
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Università Cattolica del Sacro Cuore di Milano
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Address [2]
315591
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Largo Gemelli 1, 20123, Milano
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Country [2]
315591
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Italy
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Primary sponsor type
Hospital
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Name
IRCCS INRCA (Italian National Research Centre on Aging) Casatenovo
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Address
Via Monteregio 13, Casatenovo, 23880, Lecco
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Country
Italy
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Secondary sponsor category [1]
317682
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University
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Name [1]
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Università Cattolica del Sacro Cuore di Milano
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Address [1]
317682
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Largo Gemelli 1, 20123, Milano
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Country [1]
317682
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Italy
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314481
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Comitato Etico INRCA
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Ethics committee address [1]
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Via della Montagnola 81, 60127, Ancona
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Ethics committee country [1]
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Italy
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Date submitted for ethics approval [1]
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22/12/2022
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Approval date [1]
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19/01/2023
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Ethics approval number [1]
314481
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3739_2023
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Summary
Brief summary
This randomized controlled trial aimed to investigate the effectiveness of a Virtual Reality (VR)-based relaxation intervention with savoring, which is the ability to generate and amplify positive emotions, in increasing emotional and psychological well-being, positive emotions, relaxation, and decreasing negative emotions in chronic respiratory diseases (CRDs) patients. The maintenance of the changes in the one-month follow-up was also investigated . This RCT used a between-subjects design and involved 52 hospitalized CRDs patients. The experimental group took part in the four-session VR enhanced with savoring intervention for two weeks, while the active control group listened to relaxing music. Questionnaires were administered at baseline (T0), post-intervention (T1), and one-month follow-up (T2). Pre and post-session assessments of relaxation and oxygen saturation (SpO2) were conducted for both groups and the emotions felt during the sessions were qualitatively investigated. The experimental group's VR acceptance and sense of presence were also measured.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mrs Alessia Fumagalli
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Address
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IRCCS INRCA Casatenovo, Via Monteregio, 13, 23880 Casatenovo, Lecco
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Country
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Italy
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Phone
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+39 3468298601
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Elisa Pancini
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Address
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Università Cattolica del Sacro Cuore di Milano, Largo Gemelli 1, 20123, Milano
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Country
131739
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Italy
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Phone
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+39 0272342585
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Elisa Pancini
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Address
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Università Cattolica del Sacro Cuore di Milano, Largo Gemelli 1, 20123, Milano
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Country
131740
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Italy
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Phone
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+39 0272342585
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Fax
131740
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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