Patient Experience and Virtual Reality: The Use of an MRI Exam Simulator

Magnetic resonance (MR) imaging is a safe diagnostic method of high accuracy detection and characterization of various pathological conditions. However, due to the very closed aspect of the apparatus, the high sound amplitude emitted and the need to remain motionless for a significant time, some patients experience discomfort and high levels of anxiety, compromising time and image quality management that can impair the clinical outcome of the patient or even give up the performance of this procedure. Therefore, this study aimed to validate, with patients, the use of Virtual Reality (VR) as a humanized practice of exposure to magnetic resonance imaging, to reduce the discomfort often present in the procedure. For this purpose, we used a cross-sectional method of quantitative-qualitative approach, incorporating purposeful sampling and semi-structured interviews of evaluative nature with 303 patients from two health institutions located in the state of Alagoas, Brazil, in which patients immersed in VR before the examination. As a result, exposure to VR led 98.9% of patients to feel more prepared and confident to perform the examination. There was no significant correlation between age, previous contact with technology and gender with the effectiveness of the intervention. However, there was a significant correlation between the form of approach, the quality of information and the level of feeling of relaxation of the patient. Thus, these results highlight the positive impact of VR on the patient\u27s experience in performing the MRI examination and the variety of audiences that can enjoy the benefits that this technology provides

Acute and chronic effects of aerobic exercise on blood pressure in resistant hypertension: study protocol for a randomized controlled trial

Abstract Background Resistant hypertension is a specific condition that affects approximately 10% of subjects with hypertension, and is characterized by persistently high blood pressure levels even using therapy of three or more antihypertensive agents or with blood pressure control using therapy with four or more antihypertensive agents. Changes in lifestyle, such as physical exercise, are indicated for controlling blood pressure. However, investigating studies about this therapy in individuals with resistant hypertension are few. Methods/design This is a randomized controlled clinical trial. Forty-eight patients with resistant hypertension will be submitted to perform four short-term interventions: aerobic exercise sessions (mild-, moderate- and high-intensity) and control session, in random order and on separate days. After the short-term sessions, the patients will be randomly allocated into four groups for 8 weeks of follow-up: mild-, moderate- and high-intensity aerobic exercise, and a control group. The primary outcome is the occurrence of blood pressure reduction (office and ambulatory analysis, and acute and chronic effects). Secondary outcomes are autonomic and hemodynamic mechanisms: cardiac and vasomotor autonomic modulation, spontaneous baroreflex sensitivity, forearm blood flow and vascular resistance. Discussion The importance of exercise for hypertension has been known for decades, but little is known about the effects on patients with resistant hypertension. This study will help to understand whether different aerobic exercise intensities can induce different responses, as well as by what mechanisms adjustments in blood pressure levels may occur. Trial registration ClinicalTrials.gov, ID: NCT02670681 . Registered on 28 January 2016 (first version); Brazilian Registry Platform Clinical Trials: protocol RBR-5q24zh . Registered on 24 June 2015

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