风险导向虚拟现实干预模式在重症医学科神经外科患者谵妄预防中的应用效果OA

Objective To establish a risk-oriented intervention system for delirium combined with virtual reality(VR)relaxation training,and explore its efficacy in delirium prevention among neurosurgical critically ill patients in the critical care medicine.Methods A total of 116 neurosurgical patients admitted to the department of critical care medicine of Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Southern Medical University,from March 2025 to February 2026 were selected as the study subjects.The 58 neurosurgical critically ill patients admitted from March to August 2025 served as the control group and received the routine intensive care delirium prevention protocol.The 58 neurosurgical critically ill patients admitted from September 2025 to February 2026 served as the intervention group and received a combined intervention of risk-stratified tiered management plus VR relaxation training on the basis of the routine delirium prevention protocol.The incidence,duration,and severity of delirium assessed[memorial delirium assessment scale(MDAS)],as well as sleep quality assessed[Pittsburgh sleep quality index(PSQI)],pain evaluated[numerical rating scale(NRS)],anxiety[state-trait anxiety inventory-state subscale(STAI-S)],patient nursing satisfaction score[5-point Likert scale(Likert 5)],and the occurrence of adverse events were observed in both groups.Results Among the 116 patients included in the final analysis,the incidence of delirium in the intervention group was significantly lower than that in the control group[13.79%(8/58)vs.31.03%(18/58),P<0.05].The duration of delirium was significantly shorter in the intervention group than in the control group(hours:31.62±9.18 vs.48.31±11.46,P<0.05).The MDAS score(10.31±3.42 vs.15.55±4.11),PSQI score(6.05±2.00 vs.8.63±2.38),NRS score(2.28±1.03 vs.3.78±1.18),and STAI-S score(12.28±3.10 vs.16.78±3.48)were significantly lower in the intervention group than those in the control group(all P<0.05).The patient's nursing satisfaction score was significantly higher in the intervention group than that in the control group(4.40±0.51 vs.3.55±0.62,P<0.05).There was no statistically significant difference in the incidence of adverse events between intervention group and control group[10.34%(6/58)vs.13.79%(8/58),P>0.05].Conclusion Risk-oriented VR intervention can effectively prevent delirium,improve the physical and mental status of neurosurgical critically ill patients,with favorable safety profile;therefore,it is worthy of clinical promotion.