The Effectiveness of Combining AR/VR Technology in Virtual Clinical Auditory Hallucinations on the Comprehensive Auditory Hallucination Nursing Competency of Psychiatric Nurses

May 5, 2025 updated by: National Yang Ming Chiao Tung University

This study aims to develop and evaluate a Virtual Reality (VR) Auditory Hallucination Program to enhance psychiatric nurses' comprehensive care competence in managing auditory hallucinations among patients with schizophrenia. Given that 60-80% of patients on the schizophrenia spectrum experience auditory hallucinations, and many continue to do so despite medication, improving nurses' professional skills in this area is critical.

The research is conducted in two phases across four psychiatric institutions. Phase one involves the development and validation of the VR program and an OSCE (Objective Structured Clinical Examination), piloted with five participants and evaluated by psychiatric nursing experts. Phase two is a formal interventional study with 200 psychiatric nurses, using block randomization and three data collection time points.

Assessment tools include five instruments measuring nurses' confidence, knowledge, attitude, empathy, immersion, and care performance related to auditory hallucinations. The study expects to strengthen nurses' ability to assess and manage auditory hallucinations effectively, and proposes the VR program as a potential tool for nursing in-service education.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Background: The lifetime prevalence of auditory hallucinations among patients on the schizophrenia spectrum is 60-80%. More than half of these patients continue to experience auditory hallucinations even with regular medication adherence. The professional competence of nurses in managing auditory hallucinations affects the stability of patients' symptoms and their recovery process, highlighting the importance of nurses' capabilities in caring for patients with auditory hallucinations.

Purpose: To develop and test the effectiveness of a virtual reality auditory hallucination program on the comprehensive care competence of psychiatric nurses in managing auditory hallucinations.

Methods: This is a two-phase study conducted in four psychiatric medical institutions. The study includes a development phase, a testing phase, and a formal research phase. In the pilot phase, five participants are expected to be recruited. The first phase involves the development and testing of the virtual reality auditory hallucination program and the Objective Structured Clinical Examination (OSCE), which includes components such as auditory hallucination assessment, communication with individuals experiencing auditory hallucinations, and management of auditory hallucinations. Upon completion, content validation will be conducted by psychiatric experts. Five psychiatric nursing master's students will be invited as simulated candidates to examine the applicability of the "VR-based Auditory Hallucination Nursing OSCE" for psychiatric nurses. The second phase is the formal interventional study, which will recruit 200 psychiatric nurses through convenience sampling. Participants will be grouped by institution using block randomization software. Data will be collected at three time points using the HTC virtual human system in conjunction with Google online questionnaires. The research instruments include:

  • Self-rated Confidence Questionnaire on Auditory Hallucination Assessment and Management,② Auditory Hallucination Knowledge, Attitude, and Empathy Self-awareness Scale,③ Auditory Hallucination Immersion and Empathy Scale, ④ Comprehensive Auditory Hallucination Nursing OSCE Evaluation Form, and ⑤ Nurse Auditory Hallucination Literacy Scale. Expected Results: This study is expected to enhance psychiatric nurses' capabilities in assessing and managing auditory hallucinations. The program may be routinely used in in-service education for nursing staff and may serve as a reference to assist nurses in helping patients improve their insight into auditory hallucinations.

Keywords: Auditory hallucination care competence, interventional study, virtual reality, schizophrenia, Objective Structured Clinical Examination (OSCE)

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Taiwan
      • Hualien, Taiwan, 981
        • Yuli Hospital, Ministry of Health and Welfare
        • Contact:
      • Nantou County, Taiwan, 542
        • Tsaotun Psychiatric Center, Ministry of Health and Welfare
        • Contact:
      • New Taipei City, Taiwan, 249
        • Bali Psychiatric Center, Ministry of Health and Welfare
        • Contact:
      • Taipei, Taiwan, 112

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • A psychiatric nurse who has been engaged in nursing work in a psychiatric unit for at least three months;
  • Those who were willing to participate in the study and filled out the consent form;
  • Willing to use smartphones to watch VR360 videos;
  • Willing to cooperate with the study and use 3D glasses.

Exclusion Criteria:

  • Nurses who are about to leave or be transferred out of the psychiatric ward within six months
  • Part-time nurses
  • Part-time supervisors
  • Specialist nurses.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: 50-minute Auditory Hallucination Care instructional video

Control Group

  • Pre-test: No intervention
  • Intervention 1: Auditory Hallucination Care Video only
  • Post-test: Conduct measurement (no new intervention)
  • Intervention 2: 50-minute Auditory Hallucination Care instructional video only
  • Follow-up: Conduct measurements (no new intervention)
Other: Auditory Hallucination Care Video
The videos include professional knowledge and skills related to auditory hallucinations.
Experimental: Virtual clinical auditory hallucination solution and Auditory Hallucination Care instructional vide

Experimental Group

  • Pre-test: No intervention
  • Intervention 1: Accept intervention A+B
  • A: Virtual clinical auditory hallucination solution combining AR/VR technology and virtual human interactive platform
  • B: 50-minute Auditory Hallucination Care instructional video
  • Post-test: Conduct measurement (no new intervention)
  • Intervention 2: Re-intervention of A+B
  • Follow-up: Conduct measurements (no new intervention)
Other: Auditory Hallucination Care Video
The videos include professional knowledge and skills related to auditory hallucinations.
Other: Virtual clinical auditory hallucination solution combining AR/VR technology
This study, titled "Effectiveness of AR/VR-integrated OSCE on Psychiatric Nurses' Comprehensive Auditory Hallucination Care Ability: A Randomized Controlled Trial," involves both experimental and control groups watching videos. The control group views standard educational videos, while the experimental group uses AR/VR technology, virtual patient interaction platforms, and educational videos in a simulated clinical environment. Four scripts were developed: two for training and two for pre/post-testing. All scripts and OSCE checklists are researcher-developed, reviewed by experts, and pilot tested.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Auditory Hallucination Immersion and Empathy Scale
Time Frame: At baseline (pre-intervention), 6 weeks after the first intervention, and 6 weeks after the second intervention.
To assess the impact of the intervention on empathy, this study uses the Situational Scale of Empathetic Responses (Schutte & Stilinović, 2017), consisting of 15 items-7 on empathic perspective taking and 8 on empathic concern. Participants imagine interacting with a person hearing voices and rate items on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); higher scores indicate greater empathy in auditory hallucination scenarios. The scale was translated and validated for content. Additionally, we will adopt the Jefferson Scale of Empathy (JSE-HP version), translated and adapted by Cheng et al. (2011), with a KMO of 0.93 and Cronbach's α = .73-.89.
At baseline (pre-intervention), 6 weeks after the first intervention, and 6 weeks after the second intervention.
Auditory Hallucination Knowledge, Attitude, and Empathic Self-Awareness Scale; Auditory Hallucination Literacy Scale.
Time Frame: At baseline (pre-intervention), 6 weeks after the first intervention, and 6 weeks after the second intervention.
This tool, developed by Mawson (2014), includes 11 items assessing knowledge, attitudes, and empathy toward auditory hallucinations. Participants respond using a 5-point Likert scale ranging from "strongly agree" (5) to "strongly disagree" (1). As it has not been used in Taiwan, we have completed forward and backward translation and content validity testing. Reliability and validity testing of the Chinese version will be completed before the intervention study.
At baseline (pre-intervention), 6 weeks after the first intervention, and 6 weeks after the second intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Demographic variables
Time Frame: Before intervention
Includes age, educational level, gender, marital status, total years of nursing experience, years of psychiatric nursing experience, advanced certifications (nurse practitioner, psychiatric mental health nurse, community psychiatric mental health nurse), level of competency advancement, workplace setting, and type of employment.
Before intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Yang Ming Chiao Tung University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 1, 2025

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

May 1, 2027

Study Registration Dates

First Submitted

April 14, 2025

First Submitted That Met QC Criteria

April 14, 2025

First Posted (Actual)

April 22, 2025

Study Record Updates

Last Update Posted (Actual)

May 8, 2025

Last Update Submitted That Met QC Criteria

May 5, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NYCU113052AE

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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