Virtually home: Exploring the potential of virtual reality to support patient discharge after stroke

Abstract

Introduction: The level of assessment and intervention received by patients prior to discharge varies widely across stroke services\ud in the United Kingdom. This study aimed to explore the potential value of virtual reality in preparing patients for discharge\ud following stroke.\ud Method: Semi-structured interviews were carried out with 13 occupational therapists, eight patients with a stroke and four\ud community stroke survivors. Views were sought of the perceived acceptability, potential utility and limitations of a ‘virtual\ud home’ environment for use in pre-discharge education and assessment. Data were analysed thematically.\ud Findings: Interviewees found the virtual home to be an acceptable and visual means of facilitating discussions about discharge. It\ud was perceived as valuable in assessing patient insight into safety risks and exploring the implications of installing assistive\ud equipment at home. Limitations were identified relating to specific software issues and the use of virtual reality with patients with\ud cognitive or perceptual impairments.\ud Conclusion: The results demonstrate the potential utility of the virtual home within stroke rehabilitation. Patients and therapists\ud engaged with the virtual home and, moreover, made practical suggestions for future development. Feasibility and pilot testing in a\ud clinical setting is required to compare the use of the virtual home with traditional approaches of pre-discharge assessment

Effects, Barriers and Facilitators in Predischarge Home Assessments to Improve the Transition of Care from the Inpatient Care to Home in Adult Patients: An Integrative Review

“…(1) an individual or cluster-randomized controlled or controlled trial design was used, (2) study participants were aged ≥ 18 years, admitted to hospitals or rehabilitation facilities for any diagnosis except for mental / cognitive disorders only and subsequently discharged home, (3) PDHA was reported as a primary intervention, though it could vary in purpose (e.g., discharge planning or functional assessment), delivery mode (e.g., with / without patient), intensity, length and frequency, (4) PDHA was compared to another intervention or to usual care, (5) outcomes were associated with a successful return to community living (e.g., functioning in the home environment, readmissions), quality of life, patient satisfaction, caregiver burden and / or the immediate output of the predischarge home assessment (e.g., home modi cations), (6) the study was published in the English or German language.…”

“…Predischarge home assessments (PDHA) are conducted in hospitals and inpatient rehabilitation facilities to gain information for therapy and discharge management [1] and to provide individual technical aids and modi cation of the home environment. Practice widely varies [2][3][4], ranging from ward-based assessments of abilities and environment [6] to home assessment visits [2][3][4]. The latter are described as costly and time consuming [3,5,6].…”

“…Practice widely varies [2][3][4], ranging from ward-based assessments of abilities and environment [6] to home assessment visits [2][3][4]. The latter are described as costly and time consuming [3,5,6]. Sometimes, "access visits" at the patient's home are performed by occupational therapists (OTs) on their own to assess any environmental demands for assistive equipment and access issues [4,7].…”

“…In recent years, studies on new technologies for PDHA have been published, which were not included in the review by Lockwood et al [8]. These studies focus on 3D visualization that offers computer-generated environments, scenarios and objects [3,4,9] that are used to avoid travelling to a patient's home and to improve the patient's involvement in home modi cation planning. Thus, an update of the evidence synthesis on PDHA is warranted.…”

Special Issue: Assistive technology (I)

“…Jamwal et al (2017) consider the user satisfaction and psychosocial impact of electronic assistive devices for people with severe acquired brain injury in shared supported accommodation, and how technology can positively influence everyday function, being in some cases less intrusive than support from paid carers. Threapleton et al (2017) focus on discharge home after stroke, interviewing both occupational therapists and people with stroke regarding the potential utility of a 'virtual home' within pre-discharge rehabilitation. Participants found the virtual home acceptable and useful, making suggestions on how to develop it.…”