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Published on: July 28, 2022
Early Individualized Psychological Intervention Using Virtual Reality-assisted Decision System Reduces Decisional
Yuhang Hu1, Qiong Wu1, Xidong Jin1
1Department of Thoracic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Objective:
To investigate the impact of early individualized psychological intervention utilizing a virtual reality-assisted decision system (VR-ADS) on preoperative decisional conflict and postoperative recovery quality in patients with pulmonary nodules.
Methods:
A prospective, single-center, randomized controlled trial enrolled 304 surgical patients with pulmonary nodules (June 2022-June 2024). Patients were randomized into an early intervention group (n = 155) and a conventional intervention group (n = 149). The early intervention group received individualized psychological intervention within 24-48 hours after diagnosis, incorporating decision-making style assessment, VR-ADS, and a decision partner mechanism. The primary endpoint was the Decisional Conflict Scale (DCS) score. Secondary endpoints included Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), EORTC QLQ-C30, postoperative pain, chest tube duration, hospital stay, pulmonary function, and complication rates over a 6-month follow-up.
Results:
Baseline characteristics were comparable between groups (p > 0.05). The early intervention group showed significantly lower DCS total scores (32.4 ± 12.8 vs. 45.7 ± 15.3, p < 0.001). Intervention timing was the strongest independent predictor of decisional conflict (β = -0.412, p < 0.001). Preoperative HAMA and HAMD scores were significantly lower in the early intervention group (both p < 0.001), with sustained improvement through follow-up. The early intervention group also demonstrated lower postoperative pain scores, shorter chest tube duration (2.8 ± 1.2 vs. 3.6 ± 1.5 days, p = 0.008), fewer hospital days (5.2 ± 1.8 vs. 6.7 ± 2.3 days, p < 0.001), lower complication rates (12.9% vs. 22.6%, p = 0.032), higher decision satisfaction (85.7 ± 12.3 vs. 78.2 ± 15.6, p < 0.001), and lower decision regret rates (8.6% vs. 18.3%, p = 0.014).
Conclusion:
Early individualized psychological intervention combined with VR-ADS reduces preoperative decisional conflict, improves psychological status, promotes postoperative recovery, and enhances quality of life in patients with pulmonary nodules.
