Register      Login
Brain Impairment Brain Impairment Society
Journal of the Australasian Society for the Study of Brain Impairment
RESEARCH ARTICLE (Open Access)

The use of augmented reality for patient and significant other stroke education: a feasibility study

Emma Finch A B C * , Ellie Minchell A , Ashley Cameron B D , Katherine Jaques E , Jennifer Lethlean B , Darshan Shah E and Christian Moro https://orcid.org/0000-0003-2190-8301 F
+ Author Affiliations
- Author Affiliations

A School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia

B Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Australia

C Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia

D Clinical Support Services, Metro South Health, Brisbane, Australia

E Division of Medicine, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Australia

F Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia

* Correspondence to: e.finch@uq.edu.au

Brain Impairment 24(2) 245-259 https://doi.org/10.1017/BrImp.2022.16
Submitted: 23 March 2021  Accepted: 14 April 2022  Published: 10 June 2022

© The Author(s), 2022. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

Stroke education is a key factor in minimising secondary stroke risk, yet worldwide stroke education rates are low. Technology has the potential to increase stroke education accessibility. One technology that could be beneficial is augmented reality (AR). We developed and trialled a stroke education lesson using an AR application with stroke patients and significant others.

Methods:

A feasibility study design was used. Following development of the AR stroke education lesson, 19 people with stroke and three significant others trialled the lesson then completed a customised mixed method questionnaire. The lesson involved narrated audio while participants interacted with a model brain via a tablet. Information about participant recruitment and retention, usage, and perceptions were collected.

Results:

Fifty-eight percent (n = 22) of eligible individuals consented to participate. Once recruited, 100% of participants (n = 22) were retained. Ninety percent of participants used the lesson once. Most participants used the application independently (81.82%, n = 18), had positive views about the lesson (over 80% across items including enjoyment, usefulness and perception of the application as a good learning tool) and reported improved confidence in stroke knowledge (72.73%, n = 16). Confidence in stroke knowledge post-lesson was associated with comfort using the application (p = 0.046, Fisher’s exact test) and perception of the application as a good learning tool (p = 0.009, Fisher’s exact test).

Conclusions:

Technology-enhanced instruction in the form of AR is feasible for educating patients and significant others about stroke. Further research following refinement of the lesson is required.

Keywords: Augmented reality, stroke, stroke education, feasibility, prevention.

References

Albrecht, U. V., Folta-Schoofs, K., Behrends, M., Von Jan, U. (2013) Effects of mobile augmented reality learning compared to textbook learning on medical students: Randomised controlled pilot study. Journal of Medical Internet Research 15(8), e182.
| Google Scholar |

Birt, J. R., Stromberga, Z., Cowling, M. A., Moro, C. (2018) Mobile mixed reality for experiential learning and simulation in medical and health sciences education. Information (Switzerland) 9(2), 31.
| Google Scholar |

Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., Fernandez, M. (2009) How we design feasibility studies. American Journal of Preventive Medicine 36(5), 452-457.
| Google Scholar |

Cameron, J. I., O’Connell, C., Foley, N., Salter, K., Booth, R., Boyle, R., Dulude, A. (2016) Canadian stroke best practice recommendations: Managing transitions of care following stroke, guidelines update 2016. International Journal of Stroke 11(7), 807-822.
| Google Scholar |

Chan, Y. F. Y., Richardson, L. D., Nagurka, R., Hao, K., Zaets, S. B., Brimacombe, M. B., Levine, S. R. (2015) Stroke education in an emergency department waiting room: A comparison of methods. Health Promotion Perspectives 5(1), 34-41.
| Google Scholar |

Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., Petticrew, M. (2008) Developing and evaluating complex interventions: The new Medical Research Council guidance. BMJ 337, a1655.
| Google Scholar |

Creswell, J. W., & Plano Clark, V. L. (2011). Choosing a mixed methods design. In Designing and conducting mixed methods research (Vol. 2, pp. 53–106). Thousand Oaks, CA: SAGE.

Feigin, V. L., Norrving, B., Mensah, G. A. (2017) Global burden of stroke. Circulation Research 120(3), 439-448.
| Google Scholar |

Feng, Z., González, V. A., Amor, R., Lovreglio, R., Cabrera-Guerrero, G. (2018) Immersive virtual reality serious games for evacuation training and research: A systematic literature review. Computers & Education 127(4), 252-266.
| Google Scholar |

Forster, A., Brown, L., Smith, J., House, A., Knapp, P., Wright, J. J., Young, J. (2012) Information provision for stroke patients and their caregivers. Cochrane Database of Systematic Reviews 11, CD001919.
| Crossref | Google Scholar |

Fuller, T. E., Pong, D. D., Piniella, N., Pardo, M., Bessa, N., Yoon, C., Dalal, A. K. (2020) Interactive digital health tools to engage patients and caregivers in discharge preparation: Implementation study. Journal of Medical Internet Research 22(4), e15573.
| Google Scholar |

Graneheim, U. H., Lundman, B. (2004) Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24(2), 105-112.
| Crossref | Google Scholar |

Hardie, K., Hankey, G. J., Jamrozik, K., Broadhurst, R. J., Anderson, C. (2004) Ten-year risk of first recurrent stroke and disability after first-ever stroke in the Perth Community Stroke Study. Stroke 35(3), 731-735.
| Crossref | Google Scholar |

Johnson, B., Handler, D., Urrutia, V., Alexandrov, A. W. (2018) Retention of stroke education provided during hospitalization: Does provision of required education increase stroke knowledge? Interventional Neurology 7(6), 471-478.
| Google Scholar |

Kang, Y. N., Shen, H. N., Lin, C. Y., Elwyn, G., Huang, S. C., Wu, T. F., Hou, W. H. (2019) Does a Mobile app improve patients’ knowledge of stroke risk factors and health-related quality of life in patients with stroke? A randomized controlled trial. BMC Medical Informatics and Decision Making 19(1), 1-9.
| Google Scholar |

Kim, J. I., Lee, S., Kim, J. H. (2013) Effects of a web-based stroke education program on recurrence prevention behaviors among stroke patients: A pilot study. Health Education Research 28(3), 488-501.
| Google Scholar |

Marto, J. P., Borbinha, C., Filipe, R., Calado, S., Viana-Baptista, M. (2017) Impact of stroke education on middle school students and their parents: A cluster randomized trial. International Journal of Stroke 12(4), 401-411.
| Google Scholar |

Meighan, M. M. (2018) Stroke education video does not affect patient satisfaction scores: A system analysis. Journal of Neuroscience Nursing 50(4), 233-237.
| Google Scholar |

Moro, C., Stromberga, Z., Raikos, A., Stirling, A. (2017) The effectiveness of virtual and augmented reality in health sciences and medical anatomy. Anatomical Sciences Education 10(6), 549-559.
| Crossref | Google Scholar |

Ownsworth, T., Theodoros, D., Cahill, L., Vaezipour, A., Quinn, R., Kendall, M., Lucas, K. (2020) Perceived usability and acceptability of videoconferencing for delivering community-based rehabilitation to individuals with acquired brain injury: A qualitative investigation. Journal of the International Neuropsychological Society 26(1), 47-57.
| Google Scholar |

Pallesen, H., Andersen, M. B., Hansen, G. M., Lundquist, C. B., Brunner, I. (2018) Patients’ and health professionals’ experiences of using virtual reality technology for upper limb training after stroke: A qualitative substudy. Rehabilitation Research and Practice 2018, 4318678.
| Crossref | Google Scholar |

Pedersen, P. M., Stig Jørgensen, H., Nakayama, H., Raaschou, H. O., Olsen, T. S. (1995) Aphasia in acute stroke: Incidence, determinants, and recovery. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society 38(4), 659-666.
| Google Scholar |

Pithara, C., Farr, M., Sullivan, S. A., Edwards, H. B., Hall, W., Gadd, C., Horwood, J. (2020) Implementing a digital tool to support shared care planning in community-based mental health services: Qualitative evaluation. Journal of Medical Internet Research 22(3), e14868.
| Google Scholar |

Stroke Foundation (2017). National stroke audit: Acute services report 2017. Executive summary. Stroke Foundation. Retrieved from https://strokefoundation.org.au

Stroke Foundation (2019). My stroke journey. Stroke Foundation. Retrieved from https://strokefoundation.org.au/What-we-do/For-survivors-and-carers/My-Stroke-Journey

Stroke Foundation (2020). Clinical guidelines for stroke management. Retrieved September 19, 2020, from https://informme.org.au/en/Guidelines/Clinical-Guidelines-for-Stroke-Management

Thompson-Butel, A. G., Shiner, C. T., McGhee, J., Bailey, B. J., Bou-Haidar, P., McCorriston, M., Faux, S. G. (2018) The role of personalized virtual reality in education for patients post stroke—a qualitative case series. Journal of Stroke and Cerebrovascular Diseases 28(2), 450-457.
| Google Scholar |

Venkatesh, V., Morris, M. G., Davis, G. B., Davis, F. D. (2003) User acceptance of information technology: Toward a unified view. MIS Quarterly 27(3), 425-478.
| Google Scholar |

Williams, O., Leighton-Herrmann Quinn, E., Colello, A., Perdomo, C., Chong, J., Thompsen, B., Labovitz, D. (2019) Community stroke education practices in New York State designated stroke centres. Health Education Journal 78(8), 1012-1019.
| Google Scholar |

Yonaty, S. A., Kitchie, S. (2012) The educational needs of newly diagnosed stroke patients. . Journal of Neuroscience Nursing 44(5), E1-E9.
| Google Scholar |