Virtual Reality Program to Reduce Stress in Neonatal Nurses

NCT06192368 | Completed

• 1 other identifier: INSPIRE
• Study Type: interventional
• Target: 18
• Locations: 1 country
• Sites: 1

Brief Summary

Background: In the context of neonatal care, the increasing complexity of medical interventions poses challenges to nurses, contributing to elevated workplace stress. This stress can impact the well-being of nurses and the overall quality of patient care. Despite the documented significance of workplace stress, there is a scarcity of research on effective stress management interventions for neonatal care nurses. This pilot study aims to explore the feasibility, acceptability, and preliminary effects of a virtual reality (VR) intervention on stress reduction among nurses in the neonatal intensive care unit (NICU) at CHU Sainte-Justine. Methods: A randomized intra-subject clinical trial will be conducted, involving 30 NICU nurses and nurse assistants. Participants will act as their own controls, receiving both experimental (VR) and control (tablet gaming) interventions in a random sequence. The study will assess the feasibility of the interventions, clinical trial procedures, and participant satisfaction. Stress levels will be measured using the State-Trait Anxiety Inventory (Trait subscale), Nurse Stress Scale, Stress Numerical Rating Scale-11, and salivary alpha-amylase. Additionally, participants will provide sociodemographic information, and the study will evaluate the perceived clinical workload during intervention sessions. Interventions: The study will employ Paperplane Therapeutics' VR program, INSPIRE, designed to offer a multisensory relaxation experience. The control intervention involves tablet gaming during breaks. Both interventions will be 15 minutes in duration, implemented over five weeks. Results: The study aims to provide insights into the feasibility, acceptability, and preliminary effects of VR-based stress management interventions for NICU nurses. Data analysis will involve statistical comparisons of stress measures between VR and control interventions, contributing to the evidence base for implementing workplace stress reduction programs. Conclusion: This research addresses a critical gap in the literature by investigating the potential benefits of VR interventions for stress reduction among NICU nurses. If successful, this approach could enhance workplace well-being, job satisfaction, and overall nursing care quality, leading to broader implications for stress management strategies in healthcare settings.

Conditions

Virtual Reality; Stress; Stress, Work Place

Keywords

Virtual reality; Nurse; Stress; Anxiety

Outcome Measures

Primary Outcomes (4)

• State-Trait Anxiety Inventory (STAI)

  State-Trait Anxiety Inventory allow to measure general anxiety, likert scale (4 points)

  Measured at baseline T0

• Nurse Stress Scale (NSS)

  Nurse Stress Scale allow to measure hospital related stress, likert scale (4 points)

  Measured at Baseline (T0) and two weeks after (T7)

• Stress Numerical Rating Scale-11 (SNRS-11)

  0-10 scale to measure immediate stress

  Before and after all the interventions (T0, 20 minutes after intervention-T1, at Day-2 (T2), 20 minutes after intervention-T3, at Day 4 (T4), 20 minutes after intervention-T5, at Day 6 (T6), 20 after minutes intervention-T7)

• Salivary Alpha-amylase (SAA)

  Physiological measure for psychosocial stress.

  Before the first intervention (T0) and two weeks after (T7)

Study Arms (2)

Sequence of virtual reality followed by tablet game.

OTHER

Over a period of two weeks (weeks 1 and 2), participants randomized to this sequence will be asked to use virtual reality for 15 minutes during four break periods. These two weeks of virtual reality will be followed by a week with no exposure (week 3). In the following two weeks, participants will be asked to play a game on a tablet for 15 minutes during four break periods (weeks 4 and 5).

Device: INSPIRE; Device: Tablet

Sequence of tablet game followed by virtual reality:

OTHER

Over a two-week period (weeks 1 and 2), participants randomized to this sequence will be asked to play a game on a tablet for 15 minutes during four break periods. These two weeks of tablet gaming will be followed by a week with no exposure (week 3). In the following two weeks, participants will be asked to use virtual reality for 15 minutes during four break periods (weeks 4 and 5).

Device: INSPIRE; Device: Tablet

Interventions

INSPIRE DEVICE

Virtual reality application for relaxing.

Sequence of tablet game followed by virtual reality:; Sequence of virtual reality followed by tablet game.

Tablet DEVICE

Gaming tablet

Sequence of tablet game followed by virtual reality:; Sequence of virtual reality followed by tablet game.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \- Nurses and nursing assistants holding a position or assigned to the neonatology intensive care unit

You may not qualify if:

• Epilepsy history
• Recent eye surgery

Sponsors & Collaborators

• St. Justine's Hospital: lead

Study Sites (1)

St.Justine's Hospital

Montreal, Quebec, H1T 3C5, Canada

Location

Related Publications (41)

• Andersen S, Mintz-Binder R, Sweatt L, Song H. Building nurse resilience in the workplace. Appl Nurs Res. 2021 Jun;59:151433. doi: 10.1016/j.apnr.2021.151433. Epub 2021 Apr 14.

  PMID: 33947518 BACKGROUND

• Bekelepi N, Martin P. Support interventions for nurses working in acute psychiatric units: A systematic review. Health SA. 2022 Apr 29;27:1811. doi: 10.4102/hsag.v27i0.1811. eCollection 2022.

  PMID: 35548058 BACKGROUND

• Beverly E, Hommema L, Coates K, Duncan G, Gable B, Gutman T, Love M, Love C, Pershing M, Stevens N. A tranquil virtual reality experience to reduce subjective stress among COVID-19 frontline healthcare workers. PLoS One. 2022 Feb 9;17(2):e0262703. doi: 10.1371/journal.pone.0262703. eCollection 2022.

  PMID: 35139092 BACKGROUND

• Bodet-Contentin L, Letourneur M, Ehrmann S. Virtual reality during work breaks to reduce fatigue of intensive unit caregivers: A crossover, pilot, randomised trial. Aust Crit Care. 2023 May;36(3):345-349. doi: 10.1016/j.aucc.2022.01.009. Epub 2022 Mar 1.

  PMID: 35246356 BACKGROUND

• Canada, S. (2022). Estimations des composantes de l'accroissement démographique, annuelles https://doi.org/https://doi.org/10.25318/1710000801-fra

  BACKGROUND

• Crompton, S. (2011). Qu'est-ce qui stresse les stressés? Principales sources de stress des travailleurs https://www150.statcan.gc.ca/n1/fr/pub/11-008-x/2011002/article/11562-fra.pdf?st=CL4LBGSE

  BACKGROUND

• Currie K, Gupta BV, Shivanand I, Desai A, Bhatt S, Tunuguntla HS, Verma S. Reductions in anxiety, depression and insomnia in health care workers using a non-pharmaceutical intervention. Front Psychiatry. 2022 Sep 6;13:983165. doi: 10.3389/fpsyt.2022.983165. eCollection 2022.

  PMID: 36147990 BACKGROUND

• Dyrbye LN, Shanafelt TD, Johnson PO, Johnson LA, Satele D, West CP. A cross-sectional study exploring the relationship between burnout, absenteeism, and job performance among American nurses. BMC Nurs. 2019 Nov 21;18:57. doi: 10.1186/s12912-019-0382-7. eCollection 2019.

  PMID: 31768129 BACKGROUND

• Favrod C, Jan du Chene L, Martin Soelch C, Garthus-Niegel S, Tolsa JF, Legault F, Briet V, Horsch A. Mental Health Symptoms and Work-Related Stressors in Hospital Midwives and NICU Nurses: A Mixed Methods Study. Front Psychiatry. 2018 Aug 20;9:364. doi: 10.3389/fpsyt.2018.00364. eCollection 2018.

  PMID: 30177890 BACKGROUND

• Fiske E. Nurse Stressors and Satisfiers in the NICU. Adv Neonatal Care. 2018 Aug;18(4):276-284. doi: 10.1097/ANC.0000000000000514.

  PMID: 29933342 BACKGROUND

• French SE, Lenton R, Walters V, Eyles J. An empirical evaluation of an expanded Nursing Stress Scale. J Nurs Meas. 2000 Fall-Winter;8(2):161-78.

  PMID: 11227582 BACKGROUND

• Gauthier, J., & Bouchard, S. (1993). Adaptation canadienne-française de la forme révisée du State-Trait Anxiety Inventory de Spielberger. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 25(4), 559.

  BACKGROUND

• Gray-Toft, P., & Anderson, J. G. (1981, 1981/03/01). The Nursing Stress Scale: Development of an instrument. Journal of behavioral assessment, 3(1), 11-23. https://doi.org/10.1007/BF01321348

  BACKGROUND

• Hannan KE, Bourque SL, Palmer C, Tong S, Hwang SS. Prevalence and Predictors of Medical Complexity in a National Sample of VLBW Infants. Hosp Pediatr. 2021 May;11(5):525-535. doi: 10.1542/hpeds.2020-004945.

  PMID: 33906959 BACKGROUND

• Haugland WA, Crenshaw JT, Gilder RE. Implementing a Resilience Bundle for Emergency Nurses: An Evidence-Based Practice Project. J Emerg Nurs. 2023 Jan;49(1):40-49. doi: 10.1016/j.jen.2022.08.009. Epub 2022 Sep 30.

  PMID: 36184334 BACKGROUND

• Hevezi JA. Evaluation of a Meditation Intervention to Reduce the Effects of Stressors Associated With Compassion Fatigue Among Nurses. J Holist Nurs. 2016 Dec;34(4):343-350. doi: 10.1177/0898010115615981. Epub 2015 Nov 23.

  PMID: 26598000 BACKGROUND

• Jung SE, Ha DJ, Park JH, Lee B, Kim MS, Sim KL, Choi YH, Kwon CY. The Effectiveness and Safety of Mind-Body Modalities for Mental Health of Nurses in Hospital Setting: A Systematic Review. Int J Environ Res Public Health. 2021 Aug 23;18(16):8855. doi: 10.3390/ijerph18168855.

  PMID: 34444604 BACKGROUND

• Kwon CY, Lee B. Systematic Review of Mind-Body Modalities to Manage the Mental Health of Healthcare Workers during the COVID-19 Era. Healthcare (Basel). 2022 Jun 1;10(6):1027. doi: 10.3390/healthcare10061027.

  PMID: 35742076 BACKGROUND

• LiaBraaten BM, Linneman N, Czarnecki ML, Davies WH, Zhang L, Simpson PM, Jastrowski Mano KE, Weisman SJ, Hainsworth KR. Stress Numerical Rating Scale-11: Validation in Pediatric Inpatient and Outpatient Pain Settings. Pain Manag Nurs. 2023 Aug;24(4):e7-e12. doi: 10.1016/j.pmn.2023.03.008. Epub 2023 Apr 12.

  PMID: 37059666 BACKGROUND

• Linares-Chamorro M, Domenech-Oller N, Jerez-Roig J, Pique-Buisan J. Immersive Therapy for Improving Anxiety in Health Professionals of a Regional Hospital during the COVID-19 Pandemic: A Quasi-Experimental Pilot Study. Int J Environ Res Public Health. 2022 Aug 9;19(16):9793. doi: 10.3390/ijerph19169793.

  PMID: 36011433 BACKGROUND

• Lord-Gauthier J, de Montigny F, Bouchard S. Le stress au travail. Savoir y faire face. Perspect Infirm. 2016 Nov-Dec;13(5):21-25. No abstract available. French.

  PMID: 29381275 BACKGROUND

• Martin P, Lizarondo L, Kumar S, Snowdon D. Impact of clinical supervision on healthcare organisational outcomes: A mixed methods systematic review. PLoS One. 2021 Nov 19;16(11):e0260156. doi: 10.1371/journal.pone.0260156. eCollection 2021.

  PMID: 34797897 BACKGROUND

• Michael SH, Villarreal PM, Ferguson MF, Wiler JL, Zane RD, Flarity K. Virtual Reality-Based Resilience Programs: Feasibility and Implementation for Inpatient Oncology Nurses. Clin J Oncol Nurs. 2019 Dec 1;23(6):664-667. doi: 10.1188/19.CJON.664-667.

  PMID: 31730607 BACKGROUND

• Mintz-Binder R, Andersen S, Sweatt L, Song H. Exploring Strategies to Build Resiliency in Nurses During Work Hours. J Nurs Adm. 2021 Apr 1;51(4):185-191. doi: 10.1097/NNA.0000000000000996.

  PMID: 33734177 BACKGROUND

• Monroe C, Loresto F, Horton-Deutsch S, Kleiner C, Eron K, Varney R, Grimm S. The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments. Arch Psychiatr Nurs. 2021 Apr;35(2):189-194. doi: 10.1016/j.apnu.2020.10.003. Epub 2020 Oct 13.

  PMID: 33781399 BACKGROUND

• Muir KJ, Webb-Jones J, Farish N, Barker K, Miller-Davis C, Galloway S. "Room to Reflect": A Pilot Workplace Resiliency Intervention for Nurses. Int J Environ Res Public Health. 2022 Jun 14;19(12):7272. doi: 10.3390/ijerph19127272.

  PMID: 35742534 BACKGROUND

• Murthy K, Dykes FD, Padula MA, Pallotto EK, Reber KM, Durand DJ, Short BL, Asselin JM, Zaniletti I, Evans JR. The Children's Hospitals Neonatal Database: an overview of patient complexity, outcomes and variation in care. J Perinatol. 2014 Aug;34(8):582-6. doi: 10.1038/jp.2014.26. Epub 2014 Mar 6.

  PMID: 24603454 BACKGROUND

• Nijland JWHM, Veling W, Lestestuiver BP, Van Driel CMG. Virtual Reality Relaxation for Reducing Perceived Stress of Intensive Care Nurses During the COVID-19 Pandemic. Front Psychol. 2021 Sep 29;12:706527. doi: 10.3389/fpsyg.2021.706527. eCollection 2021.

  PMID: 34659021 BACKGROUND

• Nowrouzi B, Giddens E, Gohar B, Schoenenberger S, Bautista MC, Casole J. The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review. Int J Occup Environ Health. 2016 Oct;22(4):341-358. doi: 10.1080/10773525.2016.1241920. Epub 2016 Oct 13.

  PMID: 27734769 BACKGROUND

• Park JH, Jung SE, Ha DJ, Lee B, Kim MS, Sim KL, Choi YH, Kwon CY. The effectiveness of e-healthcare interventions for mental health of nurses: A PRISMA-compliant systematic review of randomized controlled trials. Medicine (Baltimore). 2022 Jun 24;101(25):e29125. doi: 10.1097/MD.0000000000029125.

  PMID: 35758346 BACKGROUND

• Penque S. Mindfulness to promote nurses' well-being. Nurs Manage. 2019 May;50(5):38-44. doi: 10.1097/01.NUMA.0000557621.42684.c4.

  PMID: 30985526 BACKGROUND

• Rochefort CM, Clarke SP. Nurses' work environments, care rationing, job outcomes, and quality of care on neonatal units. J Adv Nurs. 2010 Oct;66(10):2213-24. doi: 10.1111/j.1365-2648.2010.05376.x. Epub 2010 Jul 2.

  PMID: 20626479 BACKGROUND

• Rodwell J, Noblet A, Demir D, Steane P. Supervisors are central to work characteristics affecting nurse outcomes. J Nurs Scholarsh. 2009;41(3):310-9. doi: 10.1111/j.1547-5069.2009.01285.x.

  PMID: 19723280 BACKGROUND

• Rogers, E. E., Hintz, S. R., & Gould, J. B. (2019). Quality improvement in neonatal care: Does it work for the very preterm infant? . Seminars in Perinatology, 43(6)(151156). https://www.sciencedirect.com/science/article/abs/pii/S0146000519300319

  BACKGROUND

• Shepley, M. M., Harris, D. D., & White, R. (2008, 2008/03/01). Open-Bay and Single-Family Room Neonatal Intensive Care Units: Caregiver Satisfaction and Stress. Environment and Behavior, 40(2), 249-268. https://doi.org/10.1177/0013916507311551

  BACKGROUND

• Stemmer R, Bassi E, Ezra S, Harvey C, Jojo N, Meyer G, Ozsaban A, Paterson C, Shifaza F, Turner MB, Bail K. A systematic review: Unfinished nursing care and the impact on the nurse outcomes of job satisfaction, burnout, intention-to-leave and turnover. J Adv Nurs. 2022 Aug;78(8):2290-2303. doi: 10.1111/jan.15286. Epub 2022 May 9.

  PMID: 35533090 BACKGROUND

• Thacker K, Haas Stavarski D, Brancato V, Flay C, Greenawald D. CE: Original Research: An Investigation into the Health-Promoting Lifestyle Practices of RNs. Am J Nurs. 2016 Apr;116(4):24-30; quiz 31. doi: 10.1097/01.NAJ.0000482141.42919.b7.

  PMID: 26974744 BACKGROUND

• Thomas AO, Bakas T, Miller E, Johnson K, Tubbs-Cooley HL. Burnout and Turnover among NICU Nurses. MCN Am J Matern Child Nurs. 2022 Jan-Feb 01;47(1):33-39. doi: 10.1097/NMC.0000000000000780.

  PMID: 34860785 BACKGROUND

• Tucker SJ, Weymiller AJ, Cutshall SM, Rhudy LM, Lohse CM. Stress ratings and health promotion practices among RNs: a case for action. J Nurs Adm. 2012 May;42(5):282-92. doi: 10.1097/NNA.0b013e318253585f.

  PMID: 22525292 BACKGROUND

• Vahedian-Azimi A, Hajiesmaeili M, Kangasniemi M, Fornes-Vives J, Hunsucker RL, Rahimibashar F, Pourhoseingholi MA, Farrokhvar L, Miller AC. Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study. J Intensive Care Med. 2019 Apr;34(4):311-322. doi: 10.1177/0885066617696853. Epub 2017 Mar 10.

  PMID: 29277137 BACKGROUND

• Walden M, Janssen DW, Lovenstein A. What Keeps Neonatal Nurses Up at Night and What Gets Them Up in the Morning? Adv Neonatal Care. 2020 Dec;20(6):E102-E110. doi: 10.1097/ANC.0000000000000723.

  PMID: 32118649 BACKGROUND

MeSH Terms

Conditions

Occupational Stress; Anxiety Disorders

Interventions

Vaginal Creams, Foams, and Jellies

Condition Hierarchy (Ancestors)

Occupational Diseases; Stress, Psychological; Behavioral Symptoms; Behavior; Mental Disorders

Intervention Hierarchy (Ancestors)

Dosage Forms; Pharmaceutical Preparations; Feminine Hygiene Products; Equipment and Supplies

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: December 18, 2023
• First Posted: January 5, 2024
• Study Start: June 19, 2024
• Primary Completion: March 5, 2025
• Study Completion: March 5, 2025
• Last Updated: August 24, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)