Publications by authors named "Thomas J Caruso"
Background: Virtual reality (VR) technologies have demonstrated therapeutic usefulness across a variety of health care settings. However, graduate medical education (GME) trainee perspectives on VR acceptability and usability are limited. The behavioral intentions of GME trainees with regard to VR as an anxiolytic tool have not been characterized through a theoretical framework of technology adoption.
View Article and Find Full Text PDFBackground: Anxiety is common in pediatric patients, especially during vascular access procedures. Most well-studied affect and anxiety scales, including the Observation Scale of Behavioral Distress-Revised (OSBD-r), the modified Yale Preoperative Anxiety Scale (mYPAS), and the modified Induction Compliance Checklist (mICC), are too cumbersome for clinical use outside of research settings. HRAD± (Happy, Relaxed, Anxious, Distressed with yes/no to cooperation) is a clinically-efficient observational scale that evaluates pediatric procedural affect and cooperation.
View Article and Find Full Text PDFResponse to the Letter to the Editor Regarding 'Let Kids Play: Using Virtual Reality as a Substitute for General Anesthesia for Minor Procedures in Pediatric Population'.
J Pediatr Surg
November 2024
Article Synopsis
- - The study aimed to evaluate anesthesiologists' acceptance of virtual reality (VR) for reducing patient anxiety before surgery using a technology acceptance model (TAM).
- - Researchers surveyed 109 anesthesiologists about their attitudes and beliefs towards a VR application, determining factors like perceived usefulness, ease of use, and enjoyment as key predictors of their willingness to adopt this technology.
- - Results showed that younger anesthesiologists found VR easier to use, and overall, perceptions of usefulness and enjoyment greatly influenced their intention to use and purchase the VR tool, while factors like past experience and price did not.
Article Synopsis
- Hospitalized children and their caregivers often face anxiety, and using virtual reality (VR) can help reduce this stress, but the effectiveness of different software design elements remains unclear.
- A study involving 202 participants evaluated how aspects like fictional environments and graphics quality influence feelings of awe and overall engagement with a custom VR application.
- Results showed that fictional settings increased awe in pediatric patients, while high-quality graphics were more effective for adult caregivers, and all measures of awe positively correlated with engagement. Future research will look into additional VR design elements.
Article Synopsis
- The study aimed to explore how virtual reality (VR) combined with exercise affects sympathetic activity and pain perception, as a safer alternative to traditional pain medications.
- Healthy volunteers underwent a cold pressor test while using a VR application, measuring how sympathetic activation and pain responses changed between VR-only and VR-facilitated exercise conditions.
- Results showed higher sympathetic activity during VR-facilitated exercise, with pain perception decreasing significantly after the intervention, suggesting that this combination could be beneficial for pain management in settings like physical therapy.
Article Synopsis
- - Pediatric patients often experience anxiety during mask induction for general anesthesia, and augmented reality (AR) headsets are being explored as a potential way to help reduce this anxiety.
- - In a study involving 50 children using AR for mask induction compared to 150 controls receiving standard care, those using AR showed significantly lower mask rejection rates (4% vs. 19.3%) and high levels of cooperation (98% vs. 91.3%).
- - The study concluded that AR improves mask acceptance without affecting cooperation or the incidence of emergent delirium, suggesting it could be a helpful non-pharmacological option in clinical settings.
Article Synopsis
- HRAD± is a tool designed to quickly see how kids feel and act before surgery, using simple feelings like happy or anxious and a yes/no for cooperation.
- The study checked how useful HRAD± was for kids getting anesthesia with a mask and looked into how reliable the scores were when different people used it.
- Researchers worked with 197 kids at a children's hospital and found HRAD± scores matched well with other anxiety and behavior scales, helping predict how kids would feel after waking up from surgery.
Background: In the pediatric population, virtual reality (VR) has been used as an adjunct to augment analgesia and reduce the need for opioids. In this study, we review our experience using VR in lieu of anesthesia or sedation to enable minor procedures in children.
Methods: A retrospective chart review study was performed on patients who presented to our institution from 2019 to 2022 for hormone implant placement, exchange, or removal with VR distraction.
Article Synopsis
- Pediatric patients and their caregivers often face anxiety during surgery, and reducing caregiver anxiety can enhance patient cooperation and overall experience.
- A study tested the effectiveness of virtual reality (VR) mindfulness meditation to lower caregiver anxiety compared to standard care, measuring anxiety levels with Visual Analogue Scale for Anxiety (VAS-A) and other tools.
- Results showed that caregivers using VR reported significantly lower anxiety levels and higher satisfaction than those in the standard care group, suggesting VR mindfulness is a safe and effective intervention in pediatric healthcare.
Article Synopsis
- Rapid response teams (RRTs) help reduce heart problems in hospitals, but their use during surgeries was low.
- A project aimed to get more staff to use a similar help system called "staff assists" (SAs) instead of waiting for emergencies (code blues).
- After training and simulations, the use of SAs increased significantly, showing that the project was successful in improving patient care.
Background: Simulations are a critical component of anesthesia education, and ways to broaden their delivery and accessibility should be studied. The primary aim was to characterize anesthesiology resident, fellow, and faculty experience with augmented reality (AR) simulations. The secondary aim was to explore the feasibility of quantifying performance using integrated eye-tracking technology.
View Article and Find Full Text PDFArticle Synopsis
- This study aims to explore how virtual reality (VR) combined with exercise can affect pain perception and anxiety.
- Conducted at Lucile Packard Children's Hospital, the trial involved healthy participants who underwent a cold pressor test with and without VR-facilitated exercise.
- Results showed that VR-facilitated exercise significantly reduced pain sensitivity, suggesting it could benefit patients with chronic pain or those needing physical therapy, although pain tolerance levels remained unchanged.
Article Synopsis
- The study aimed to evaluate a new technology acceptance model (TAM) for virtual reality (VR) in healthcare, focusing on pediatric health providers' intentions to use VR as a tool for reducing anxiety in hospitalized kids.
- Healthcare providers experienced VR as an anxiolytic during minor procedures and filled out surveys on their attitudes and behaviors toward adopting the technology.
- Results showed that factors like perceived usefulness and enjoyment of VR strongly predicted providers' intention to use VR, while age, past experiences, and cost did not significantly affect their usage intentions, indicating potential widespread adoption in pediatric care.
Article Synopsis
- Pediatric emergencies require specialized training for EMS clinicians, making augmented reality (AR) an innovative tool for crisis management training.
- A study was conducted with 22 EMS clinicians using Chariot AR software on the ML1 headset, which created realistic simulations of pediatric medical emergencies like seizures and cardiac arrest.
- Participants appreciated the training's realism and effectiveness in skill building but noted difficulties in merging AR elements with real-world scenarios and expressed a learning curve in using the technology.
Article Synopsis
- Chronic musculoskeletal pain significantly affects adolescents, causing disabilities and increased health care costs, while physiotherapy is a key treatment but often faces challenges due to pain-related fears.
- The trial aims to assess the effectiveness of integrating virtual reality (VR) into physiotherapy rehabilitation for adolescents with MSK pain, comparing it against standard physiotherapy.
- Initial pilot studies show promising results, indicating that VR engagement can lead to improvements in pain, fear, avoidance behaviors, and overall physical function among participants.
Background And Aim: Due to limited clinical exposure, non-acute care pediatric providers often rely on simulated experiences to maintain resuscitation skills. Few training options designed for the non-acute care setting exist, are often difficult to access, and lack incorporation of non-technical skills. The first five minutes (FFM) is a previously published curriculum designed to train non-acute care providers.
View Article and Find Full Text PDFBackground: Augmented reality (AR) and eye tracking are promising adjuncts for medical simulation, but they have remained distinct tools. The recently developed Chariot Augmented Reality Medical (CHARM) Simulator combines AR medical simulation with eye tracking. We present a novel approach to applying eye tracking within an AR simulation to assess anesthesiologists during an AR pediatric life support simulation.
View Article and Find Full Text PDFPerioperative anxiety and distress are common in pediatric patients undergoing general anesthesia and increase the risk for immediate and long-term postoperative complications. This concise review outlines key research and clinically-relevant scales that measure pediatric perioperative affect. Strengths and weaknesses of each scale are highlighted.
View Article and Find Full Text PDFVirtual reality (VR) technology has seen increasing use in physical rehabilitation and in the management of acute and chronic pain. Functional movement disorders (FMDs) are a source of disability with no known association to neurologic pathology, and patients are generally offered multidisciplinary treatment approaches to improve functional movement. However, patients who are not compliant with rehabilitation may have persistent FMD and long-term disability.
View Article and Find Full Text PDFBackground: Virtual Reality (VR) has been used as a distraction tool in various medical settings to reduce pain and anxiety associated with procedures. This study evaluates the effectiveness of VR as a distraction tool for decreasing fear, anxiety, and pain in pediatric patients undergoing common outpatient orthopaedic procedures.
Methods: A total of 210 patients were recruited from a single orthopaedic clinic between October 2017 and July 2019.