Tag: Healthcare provider

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Effects of Virtual Reality on Postoperative Pain Management Following Minimally Invasive Gynecologic Surgery: Randomized Controlled Trial

<strong>Background:</strong> Postoperative pain and anxiety remain common concerns after minimally invasive gynecologic surgery despite advances in surgical techniques and analgesic strategies. Virtual reality (VR) has been investigated as a potential nonpharmacological intervention for pain management; however, evidence in gynecologic postoperative settings is limited. <strong>Objective:</strong> This study aims to evaluate the efficacy and safety of VR technology compared with standard postoperative analgesia for pain and anxiety management in patients undergoing minimally invasive gynecologic surgery. <strong>Methods:</strong> This randomized controlled trial was conducted at Sun Yat-sen Memorial Hospital of Sun Yat-sen University in China. A total of 131 patients undergoing laparoscopy or combined hysteroscopy for benign gynecologic diseases were randomly assigned in a 1:1 ratio to either a VR group (n=68) or a control group (n=63). All patients received a standardized general anesthesia protocol intraoperatively. The control group received conventional analgesic therapy after surgery, and the VR group received a 20-minute VR intervention 6 hours postoperatively. The pain and anxiety levels were evaluated using a visual analog scale at 6 and 7 hours postoperatively. The primary outcome was the change in pain scores between 6 and 7 hours. Secondary outcomes included maximum pain score, anxiety score changes, length of hospital stay, hospitalization costs, and occurrence of adverse events. Analyses were performed according to the intention-to-treat principle. <strong>Results:</strong> There was no statistically significant difference in the primary outcome between the VR and control groups (mean difference 0.169, 95% CI −0.271 to 0.608; <i>P</i>=.45). Similarly, no significant differences were observed in the maximum pain score (mean difference 0.839, 95% CI −0.101 to 1.779; <i>P</i>=.08), and no improvement was observed in the anxiety score (mean difference 0.042, 95% CI −0.365 to 0.449; <i>P</i>=.84). No significant differences were found in length of hospital stay, hospitalization costs, or incidence of adverse events, including dizziness, nausea, and vomiting (all <i>P</i>&gt;.05). <strong>Conclusions:</strong> A single 20-minute VR intervention did not provide additional analgesic or anxiolytic benefit compared with standard postoperative care after minimally invasive gynecologic surgery. VR was well tolerated, and its role in postoperative recovery requires further investigation. <strong>Trial Registration:</strong> Chinese Clinical Trial Registry ChiCTR2400091244; https://tinyurl.com/4b92a9td
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Developing forensic patient-oriented research guidelines: a rapid review using an integrated knowledge translation approach

This paper reports findings from a rapid literature review that informed new guidelines for conducting patient-oriented research in forensic mental health settings. The project adopted an integrated knowledge translation approach at a mental health hospital in Ontario, Canada, engaging a project team that included current forensic patients, hospital staff, and members of an international community of practice. Sources were identified through nine academic databases and targeted grey literature searches, screened independently by two reviewers and extracted using a structured template guided by an a priori framework developed with patients and staff at a knowledge exchange event. Findings were iteratively refined through a patient advisory group, an implementation study, ethnographic observations, and related integrated knowledge translation activities conducted alongside the review. Together, 31 academic and grey literature sources informed a framework organized around five core dimensions: 1) Resourcing, orientation, and training; 2) Confidentiality, consent, and compensation; 3) Relationships, shared understanding, and support; 4) Levels of engagement; and 5) Evaluation and sustainability. Guided by cross-cutting principles common among participatory mental health research, such as dignity, trust, respect, and a commitment to redressing power and attending to forms of epistemic injustice, the guidelines respond to distinctive constraints of forensic environments while highlighting opportunities to promote authentic co-production and sustain patient involvement in research. Recommendations include dedicated resources and capacity-building for patients; relational, ongoing consent practices co-developed with patients; flexible patient researcher roles with fair, paid compensation; and sustained institutional support for participatory practices. We call on forensic hospitals and secure settings to adapt and evaluate these guidelines and to invest in expanding patient leadership to advance the field.
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Smoking as a correlate of suicidal behavior and self-harm in adolescents with depressive disorders

Suicidal behavior and self-harm are major public health concerns among adolescents, particularly those with depressive disorders. While smoking has been linked to suicidality in general populations, its independent role in both suicidal behavior and self-harm within well-characterized clinical samples of youth with depressive disorders remains understudied. This study consecutively enrolled 2,343 adolescents (aged 12–18 years) diagnosed with unipolar depression, bipolar disorder, or depressive episode according to DSM-5 criteria at Nanhai Public Health Hospital of Foshan City and The Third People’s Hospital of Foshan between January 2025 and December 2025. Suicidal behavior (≥1 suicide attempt) and self-harm (intentional self-injury or poisoning regardless of intent) were assessed via clinical interviews. Multivariable binary logistic regression models were constructed to identify factors independently associated with each outcome, adjusting for age, sex, education, income, parental education, psychiatric diagnosis, family history of mental illness, physical disease, and smoking status. Among 2,343 participants (mean age 14.99 ± 1.65 years; 77.8% female), the prevalence of self-harm was 76.0% and suicidal behavior was 44.2%. In fully adjusted models, smoking status was the only variable significantly associated with suicidal behavior after adjustment for measured covariates: current smokers (OR = 2.74, 95% CI: 1.81–4.22, P<0.001) and past quitters (OR = 2.32, 95% CI: 1.66–3.28, P<0.001) had higher odds compared to never smokers. For self-harm, current smoking was significantly associated with increased risk (OR = 2.31, 95% CI: 1.33–4.37, P = 0.006). Education level showed a borderline association with self-harm, with each additional year of schooling corresponding to a 10% lower odds (OR = 0.90, 95% CI: 0.81–1.00, P = 0.050); however, this finding should be interpreted cautiously given the exploratory nature of the analysis. No other demographic or clinical variables, including age, sex, or psychiatric diagnosis, were independently associated with either outcome. Smoking was strongly associated with both suicidal behavior and self−harm after adjustment for measured demographic and clinical covariates. These findings underscore the importance of assessing tobacco use as a potential clinical marker of vulnerability in youth mental health settings.
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Use of a Conversational Agent for Training Mental Health Professionals in Suicide Safety Planning: Pilot Feasibility and Acceptability Study

Background: Safety planning is recognized as one of the most effective interventions for reducing suicidal behaviors. The quality of safety plans strongly depends on professional training, and traditional methods, such as role-playing, are time-consuming and offer limited opportunities for repetition across diverse patient profiles. Generative artificial intelligence (GenAI) may provide innovative solutions by offering accessible, flexible, and realistic training environments. Objective: This pilot study aimed to evaluate the acceptability and feasibility of a GenAI-based simulator designed to train mental health professionals in safety planning. Methods: Twenty nurses and nursing assistants from psychiatric units in a French university hospital participated in a pre-post, single-session evaluation. After self-rating their ability, competence, and willingness to manage patients experiencing suicidal ideation, participants interacted individually with the text-based simulator for 20 minutes to perform a safety plan with a chatbot, then completed postsimulation acceptability items, and open-ended feedback. Composite scores were computed: acceptability (eg, helpfulness; 0‐40), realism (eg, looking like real interaction with patient; 0‐20), and challenge (eg, emotional challenge; 0‐30). Pre-post changes were tested (Wilcoxon signed-rank test), and age-group comparisons were performed. Results: Acceptability was high (mean 31.9/40, SD 5.3; median 32, IQR 7), realism moderate-to-high (mean 15.1/20, SD 4.1; median 15, IQR 5.25), and challenge manageable (mean 17.0/30, SD 8; median 18, IQR 12.5). Participants rated usefulness (mean 7.65/10, SD 1.57; median 8, IQR 1.57), perceived learning (mean 7.6/10, SD 1.79; median 8, IQR 2), recommendation to use the chatbot for training (mean 8.3/10, SD 1.59; median 9, IQR 2.25), and feedback quality (mean 8.35/10, SD 1.27; median 8.5, IQR 1.25) favorably. Willingness to actively manage patients experiencing suicidal ideation significantly increased postsimulation (.03). Younger participants reported higher acceptability (.04) and realism (.03). Participants reported minimal concerns regarding the simulator’s use. Conclusions: This pilot study demonstrates that a GenAI-based simulator for safety planning is feasible and highly acceptable among experienced mental health professionals. The findings are promising and warrant larger, controlled trials to assess impacts on training effectiveness and patient outcomes.
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