Effects of virtual reality on stress management of disasters

Aim: Technology-supported applications used in health services are effective in improving quality that providing fewer errors and allowing patients to recover in a shorter time. Virtual reality (VR) applications are one of the popular of these technologies. VR offers a new human-computer interaction paradigm where users are on a computer screen and active participants in a computer-generated threedimensional virtual world. In this study, it is aimed to evaluate the use of VR in medical triage and whether provide benefits in terms of stress management for emergency response team (ERT) personnel working at the scene of disasters. Method: Sakarya University Training and Research Hospital Emergency Department health workers and Sakarya University Faculty of Medicine senior students were included in the study. The participants took one hour theoretical and video-supported practical lessons about field management, triage, life-saving interventions, field hospitals and stress management in disasters by an emergency medicine and disaster management specialist. After this training, the participants stress levels were checked with the Short Version of the Burnout Scale (BMSV), the Perceived Stress Scale (PSS), and the Beck Anxiety Inventory (BAI). Later, in a VR environment, the participants watched a chemical explosion disaster scenario in which they had to make the right decision and perform appropriate triage classification. Stress levels of the participants were re-determined with BAI after VR. The obtained data were analyzed in the IBM STATISTICS SPSS program. Results: 165 healthcare professionals participated in the study. 56% (n=93) of the participants were female, the mean age was 23.77 years. In our study, 43% (n=71) of them worked on 24-hour shifts, 18.2% (n=30) of them worked on 12-hour shifts and 38.8% (n=64) of them worked only day shifts. After the theoretical and videoassisted training, 11 of the participants in our study received a full score (10) from START (Simple Triage and Rapid Treatment) triage that practices performed within three minutes in a chemical explosion scenario in VR environment. The mean score of all participants was determined as 5,6. There was no statistically significant difference between the number of correct practices performed by the participants in START triage and the change in BAI scores before and after VR (p=0.298; p<0.05). There was no statistically significant difference between the stress levels of the participants before and after VR (p=0.121; p<0.05). A statistically significant difference was found between the change in BAI between the stress levels of the participants before and after VR and the presence of previous psychiatric illness, the presence of chronic stress in working life, the idea of working in a suitable unit for the staff, and the satisfaction with the institution where they work. (p=0.007; p=0.020; p=0.035; p=0.047; p<0.05). Conclusion: It may include fear and avoidance factors, including hospital staff, in ERT. In order to eliminate this fear, pre-disaster simulations and exercises for xvi healthcare workers should be increased and the participation of emergency response teams in these trainings should be encouraged. Simulation-based and applied course curriculum including VR should be added to the education curriculum of ERTs. We believe that VR assisted trainings will also contribute to stress management in fast and difficult decision-making situations, especially in healthcare professionals who need psychological support at baseline. Keywords: Disaster, Stress, Triage, Virtual Reality