Effect of VR/MR based Education Program for Managing Behavioral and Psychological Symptoms of Dementia

Abstract

Purpose Since dementia behavioral psychological symptoms (BPSD) appear in 80-90% of dementia patients and are unpredictable and difficult to respond (Huang et al., 2012), it is reported that it puts a great burden on the family and affects family depression (Omstein & Gaugler, 2012). Therefore, education is needed to strengthen the ability to cope with BPSD for families with dementia. Recently, cases of using VR/MR technology in education for families of dementia patients in the UK and the Netherlands have been reported (Alzheimer’s Research UK, 2016; Wijma et al., 2018), but all aimed at understanding dementia patients through their experiences, and BPSD-focused content has not yet been developed. The purpose of this study was to develop and verify VR/MR based education program for managing BPSD (VR-EduBPSD) to enhance the ability of families with dementia to cope with BPSD. Method This study was conducted in three stages. In the first stage, contents of the VR-EduBPSD were developed based on literature review, in-depth interviews with dementia families, and need surveys. In the second stage, VR/MR program was designed and produced using the developed contents. In the final stage, the VR-EduBPSD (a total of 9 contents) was applied to dementia families (n=63, 33 in experimental groups, 30 controls) using a randomized controlled design and its effectiveness was evaluated.  Results and Discussion Repeated measurement variance analysis was performed on five outcome variables: BPSD coping ability, interrelationship, self-efficacy, dementia attitude, and behavioral management technology by covariate treatment of care time, which had a significant difference between the experimental and the control group. In the experimental group, the ability to cope with BPSD significantly increased when compared with the previous one month and the post-mortem one month later (p=0.049). The correlation increased significantly in the experimental group when compared with the previous one month (p =0.001) and in the control group when compared with the post one month later (p =0.043). Based on VR/MR technology, the result of this study is composed of immersive content that includes a training course that enables interaction between dementia patients and their families while enhancing a vivid experience by reflecting live-action characters and multimodality (using the five senses) format. The VR-EduBPSD is expected to maximize its effect if it is used alone and/or with other programs for education of families of dementia patients.

References

Alzheimer’s Research UK. (2016). Virtual Reality app offers unique glimpse into life with dementia. May 29, 2019, Retrieved from http://www.alzheimersresearchuk.org/a-walk-through-dementia-news/

Huang, S. S., Lee, M. C., Liao, Y. C., Wang, W. F., & Lai, T. J. (2012). Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderly. Archives of Gerontology and Geriatrics, 55, 55-59.

Ornstein, K., & Gaugler, J. E. (2012). The problem with “problem behaviors”: a systematic review of the association between individual patient behavioral and  psychological symptoms and caregiver depression and burden within the dementia patient–caregiver dyad. International psychogeriatrics, 24(10), 1536-1552.

Wijma, E. M., Veerbeek, M. A., Prins, M., Pot, A. M., & Willemse, B. M. (2018). A virtual reality intervention to improve the understanding and empathy for people with dementia in informal caregivers: results of a pilot study. Aging Ment Health, 22(9), 1121-1129.

Keywords: Dementia family, Virtual reality, BPSD, Coping competence, Education program

Address: College of Nursing, BK21 FOUR R&E Center for Learning Health Systems, Korea University, Republic of Korea

Email: jasong@korea.ac.kr

Acknowledgement: This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2019R1A2C1086649).