Platform Presentation The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

What physical environment factors influence stroke survivor experience and preference? A controlled experiment using virtual reality (#87)

Michelle M Shannon 1 2 , Marcus White 3 , Leonid Churilov 4 , Ruby Lipson-Smith 2 5 , Tianyi Yang 3 , Marie Elf 6 , John Olver 7 , Julie Bernhardt 2
  1. Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, VICTORIA, Australia
  2. Stroke Theme, Florey Institute of Neuroscience and Mental Health, Heidelberg, VICTORIA, Australia
  3. School of Design and Architecture, Swinburne University of Technology, Hawthorn, VICTORIA, Australia
  4. Department of Medicine (RMH), Faculty of Medicine, Dentristy, and Health Sciences, University of Melbourne, Melbourne, VICTORIA, Australia
  5. The MARCS Institute for Brain, Behaviour, and Development, Western Sydney University, Westmead, NSW, Australia
  6. School of Health and Welfare, Dalarna University, Falun, Sweden
  7. Epworth Monash Rehabilitation Medicine Unit, Monash University, Melbourne, VICTORIA, Australia

Background The hospital physical environment can influence care experience and outcomes.  Understanding the modifiable physical design variables potentially important for stroke survivors could help future design.

Aims We aimed to examine the affective and choice-preference responses of stroke participants to selected physical design variables related to hospital patient rooms. The secondary objectives were to examine the feasibility and safety of use of virtual reality (VR) in stroke.

Methods A factorial experimental approach employed a novel VR simulation of hospital patient rooms (single, multi-patient) experienced by stroke participants under controlled conditions (16 x 2 (day, night, respectively)), followed by a semi-structured interview. In each VR simulation, randomised single and multi-patient room designs were shown for <3 minutes, in the context of additional physical design variables (present/absent) i.e., social connectivity, night-time noise, spaciousness, and outdoor greenery outlook. Primary measures: Pick-A-Mood Scale (PAMS) and choice-preference on a visual analogue scale completed in each VR simulation. Feasibility and safety were measured throughout. Analysis used regression analyses. Experience of the physical design variables was illuminated by interview and thematic analysis.

Results Forty-four stroke participants, median (IQR) age=67years (57.25- 73.75years, 61.4% male, completed the study (43/44 all VR conditions: 701 daytime responses, 686 night-time)). PAMS: Being ‘relaxed’ or ‘calm’ were the most frequent affective states in day and night conditions. Regression analyses estimated differences in affective and choice-preference responses attributed to certain combinations of physical design variables and showed that affective responses changed in response to different variables (e.g., greenery, noise). There were no adverse events. Three qualitative themes described how the physical design variables aligned with quantitative outcomes.

Conclusion Findings indicate certainty of magnitude and direction (high, low affect) and choice-preference responses. Combining physical design variables, beyond single patient room type only, should now be targeted in real-world prototype, controlled trials.