대장내시경 검사를 받는 성인 환자를 위한 360도 가상현실 기반 교육 중재의 개발 및 효과 평가

Abstract

Purpose: Understanding the examination process along with adequate bowel preparation is essential for a successful colonoscopy. The 360-degree virtual reality(VR) program provides an immersive experience through high realism, and has recently been applied in various clinical settings. In particular, it is expected to be used for bowel preparation education for adult patients undergoing the first colonoscopy.

Methods: For this study, a 360-degree VR-based colonoscopy education programme based on situated learning theory was developed. The intervention was developed using the ADDIE (analysis, design, development, implementation, evaluation) model and tested for effectiveness on anxiety, attitude, knowledge, guideline adherence, bowel cleanliness, and educational satisfaction. The 360-degree VR intervention consisted of two sessions. The first session was on "Pre-colonoscopy precautions" and the second session was on "Colonoscopy process". The program was validated by endoscopists and clinical experts. A nonequivalent control group, non-synchronized pretest-posttest design was used in this study. The experimental group (n=40) participated in the 360-degree VR intervention, while the control group (n=40) received document-based and verbally explained routine education. In both groups, data were collected pre- and post-intervention via structured questionnaires, and bowel cleanness was collected via medical record review. The collected data were analyzed using the SPSS 27.0 program.

Results: There were no significant differences in general characteristics between the two groups, ensuring homogeneity. The experimental group showed a significant improvement in the study variables compared to the control group. There were significant differences between the two groups in colonoscopy-related anxiety (t=6.10, p<.001), attitudes (t=3.08, p=.003), compliance to medication and dietary guidelines for bowel preparation (t=3.07, p=.003), bowel cleanliness (t=5.69, p<.001) and educational satisfaction (t=7.67, p<.001); however, there was no statistically significant difference in the level of knowledge of bowel preparation guidelines (t=1.83, p=.072).

Conclusion: This study provides evidence that colonoscopy education using 360-degree VR is effective. In the future, it is expected that 360-degree VR can be used as a complementary nursing education medium to provide immersive educational experiences for adult patients on various diagnostic tests that are difficult to experience in real life.