<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Consortium PSYCHIATRICUM</journal-id><journal-title-group><journal-title xml:lang="en">Consortium PSYCHIATRICUM</journal-title><trans-title-group xml:lang="ru"><trans-title>Consortium PSYCHIATRICUM</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2712-7672</issn><issn publication-format="electronic">2713-2919</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">221</article-id><article-id pub-id-type="doi">10.17816/CP221</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>RESEARCH</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ИССЛЕДОВАНИЕ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Efficacy of a Relaxation Scenario in Virtual Reality for the Comorbid Symptoms of Anxiety and Asthenia in a General Hospital Setting: A Pilot Comparative Randomized Open-Label Study</article-title><trans-title-group xml:lang="ru"><trans-title>Эффективность применения релаксационного сценария в технологии виртуальной реальности в отношении коморбидных симптомов тревоги и астении в условиях соматического стационара: пилотное сравнительное рандомизированное открытое исследование</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2640-4658</contrib-id><contrib-id contrib-id-type="scopus">35773329800</contrib-id><contrib-id contrib-id-type="researcherid">J-1852-2017</contrib-id><contrib-id contrib-id-type="spin">7623-4288</contrib-id><name-alternatives><name xml:lang="en"><surname>Lepilkina</surname><given-names>Taisiya А.</given-names></name><name xml:lang="ru"><surname>Лепилкина</surname><given-names>Таисия Алексеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci (Psychol.), Scientist Researcher, Laboratory of Psychopharmacology</p></bio><bio xml:lang="ru"><p>кандидат психологических наук, научный сотрудник лаборатории психофармакологии</p></bio><email>lepilkina@hotmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5149-3760</contrib-id><contrib-id contrib-id-type="scopus">56337096600</contrib-id><contrib-id contrib-id-type="researcherid">J-4649-2017</contrib-id><contrib-id contrib-id-type="spin">2223-0991</contrib-id><name-alternatives><name xml:lang="en"><surname>Beniashvili</surname><given-names>Allan G.</given-names></name><name xml:lang="ru"><surname>Бениашвили</surname><given-names>Аллан Герович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci (Med.), Senior Research Officer, Laboratory of Psychopharmacology</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, старший научный сотрудник лаборатории психофармакологии</p></bio><email>beniashvilia@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6018-6327</contrib-id><contrib-id contrib-id-type="spin">6480-9096</contrib-id><name-alternatives><name xml:lang="en"><surname>Cheremin</surname><given-names>Roman A.</given-names></name><name xml:lang="ru"><surname>Черемин</surname><given-names>Роман Авенирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci (Med.), Director</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, главный врач</p></bio><email>drcher@yandex.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1142-0804</contrib-id><contrib-id contrib-id-type="spin">7578-9524</contrib-id><name-alternatives><name xml:lang="en"><surname>Malyukova</surname><given-names>Natalya G.</given-names></name><name xml:lang="ru"><surname>Малюкова</surname><given-names>Наталья Георгиевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci (Psychol.), Head of the Department of Medical Psychology</p></bio><bio xml:lang="ru"><p>кандидат психологических наук, заведующая отделом медицинской психологии</p></bio><email>maliukova@rambler.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7847-2716</contrib-id><contrib-id contrib-id-type="scopus">7006920838</contrib-id><contrib-id contrib-id-type="researcherid">D-9098-2015</contrib-id><contrib-id contrib-id-type="spin">6162-5816</contrib-id><name-alternatives><name xml:lang="en"><surname>Morozova</surname><given-names>Margarita A.</given-names></name><name xml:lang="ru"><surname>Морозова</surname><given-names>Маргарита Алексеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Sci (Med.), Professor, Head of the Laboratory of Psychopharmacology</p></bio><bio xml:lang="ru"><p>профессор, доктор медицинских наук, заведующая лабораторией психофармакологии </p></bio><email>margmorozova@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5033-7221</contrib-id><name-alternatives><name xml:lang="en"><surname>Bogdanov</surname><given-names>Mikhail A.</given-names></name><name xml:lang="ru"><surname>Богданов</surname><given-names>Михаил Александрович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Medical Psychologist</p></bio><bio xml:lang="ru"><p>медицинский психолог</p></bio><email>mb0gdanov@yandex.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7098-2570</contrib-id><contrib-id contrib-id-type="researcherid">S-1759-2016</contrib-id><contrib-id contrib-id-type="spin">4895-9352</contrib-id><name-alternatives><name xml:lang="en"><surname>Burminsky</surname><given-names>Denis S.</given-names></name><name xml:lang="ru"><surname>Бурминский</surname><given-names>Денис Сергеевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Sci (Med.), Senior Researcher, Laboratory of Psychopharmacology</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, научный сотрудник лаборатории психофармакологии</p></bio><email>desbur@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9180-1940</contrib-id><contrib-id contrib-id-type="scopus">56010445300</contrib-id><contrib-id contrib-id-type="researcherid">L-1455-2016</contrib-id><contrib-id contrib-id-type="spin">3817-9217</contrib-id><name-alternatives><name xml:lang="en"><surname>Potanin</surname><given-names>Sergei S.</given-names></name><name xml:lang="ru"><surname>Потанин</surname><given-names>Сергей Сергеевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>and. Sci (Med.), Senior Research Officer, Laboratory of Psychopharmacology</p></bio><bio xml:lang="ru"><p>кандидат медицинских наук, старший научный сотрудник лаборатории психофармакологии</p></bio><email>potanin_ss@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0478-1380</contrib-id><name-alternatives><name xml:lang="en"><surname>Rodkina</surname><given-names>Svetlana V.</given-names></name><name xml:lang="ru"><surname>Родкина</surname><given-names>Светлана Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Medical Psychologist</p></bio><bio xml:lang="ru"><p>медицинский психолог</p></bio><email>rodkina-svetlana@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4440-095X</contrib-id><contrib-id contrib-id-type="scopus">30267946900</contrib-id><contrib-id contrib-id-type="researcherid">B-4229-2015</contrib-id><contrib-id contrib-id-type="spin">8523-1306</contrib-id><name-alternatives><name xml:lang="en"><surname>Rupchev</surname><given-names>George E.</given-names></name><name xml:lang="ru"><surname>Рупчев</surname><given-names>Георгий Евгеньевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci (Psychol.), Scientist Researcher, Laboratory of Psychopharmacology</p></bio><bio xml:lang="ru"><p>кандидат психологических наук, научный сотрудник лаборатории психофармакологии</p></bio><email>rupchevgeorg@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8666-5019</contrib-id><contrib-id contrib-id-type="spin">6629-1774</contrib-id><name-alternatives><name xml:lang="en"><surname>Eip</surname><given-names>Margarita N.</given-names></name><name xml:lang="ru"><surname>Эип</surname><given-names>Маргарита Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Medical Psychologist</p></bio><bio xml:lang="ru"><p>медицинский психолог</p></bio><email>mrita2010@efndex.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Mental Health Research Center</institution></aff><aff><institution xml:lang="ru">ФГБНУ «Научный центр психического здоровья»</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Speech Pathology and Neurorehabilitation Center</institution></aff><aff><institution xml:lang="ru">ГБУЗ «Центр патологии речи и нейрореабилитации ДЗМ»</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2023-03-17" publication-format="electronic"><day>17</day><month>03</month><year>2023</year></pub-date><pub-date date-type="pub" iso-8601-date="2023-03-31" publication-format="electronic"><day>31</day><month>03</month><year>2023</year></pub-date><volume>4</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>38</fpage><lpage>51</lpage><history><date date-type="received" iso-8601-date="2022-10-28"><day>28</day><month>10</month><year>2022</year></date><date date-type="accepted" iso-8601-date="2023-02-14"><day>14</day><month>02</month><year>2023</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2023, Lepilkina T.А., Beniashvili A.G., Cheremin R.A., Malyukova N.G., Morozova M.A., Bogdanov M.A., Burminsky D.S., Potanin S.S., Rodkina S.V., Rupchev G.E., Eip M.N.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2023, Лепилкина Т.А., Бениашвили А.Г., Черемин Р.А., Малюкова Н.Г., Морозова М.А., Богданов М.А., Бурминский Д.С., Потанин С.С., Родкина С.В., Рупчев Г.Е., Эип М.Н.</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="en">Lepilkina T.А., Beniashvili A.G., Cheremin R.A., Malyukova N.G., Morozova M.A., Bogdanov M.A., Burminsky D.S., Potanin S.S., Rodkina S.V., Rupchev G.E., Eip M.N.</copyright-holder><copyright-holder xml:lang="ru">Лепилкина Т.А., Бениашвили А.Г., Черемин Р.А., Малюкова Н.Г., Морозова М.А., Богданов М.А., Бурминский Д.С., Потанин С.С., Родкина С.В., Рупчев Г.Е., Эип М.Н.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0/</ali:license_ref></license></permissions><self-uri xlink:href="https://consortium-psy.com/jour/article/view/221">https://consortium-psy.com/jour/article/view/221</self-uri><abstract xml:lang="en"><p><bold>BACKGROUND:</bold> Patients in general hospitals often display concomitant signs of mental maladjustment: low mood, anxiety, apathy, asthenia, all of which can have a negative impact on the course of the underlying disease and the recovery process. One of the non-pharmacological approaches that has gained wider acceptance in medical practice in recent years is the use of procedures based on virtual reality.</p> <p><bold>AIM:</bold> Assess the efficacy of the new domestic, virtual reality application Flow as relates to symptoms of anxiety and asthenia in patients undergoing inpatient treatment.</p> <p><bold>METHODS:</bold> The study was open-label and had a comparison group; the patients were assigned to the experimental or control group using a randomization table. The patients were assessed using the Spielberger State Anxiety Inventory; the Fatigue Symptom Rating Scale; the Well-being, Activity, Mood questionnaire; the Depression Anxiety Stress Scale; and the Clinical Global Impression Scale. Physical parameters were measured before and after each virtual reality session. The obtained data were statistically processed.</p> <p><bold>RESULTS:</bold> The study involved 60 patients. In 40 patients, the treatment program included a course of five daily relaxation sessions in virtual reality; the control group consisted of 20 patients, who were treated in accordance with the usual practice of the institution. The addition of virtual reality sessions to the standard treatment course yielded significant advantage in terms of affective symptoms reduction in patients both after a single session and as a result of undergoing the full course, and several days after its completion. The patients in the experimental group also showed a significant decrease in blood pressure after the sessions, and this was most pronounced in individuals who initially had elevated and high blood pressure.</p> <p><bold>CONCLUSION:</bold> The use of relaxation program courses in the virtual reality application Flow is an effective and promising means of non-pharmacological care for non-psychiatric inpatients showing symptoms of anxiety, apathy, depressive mood, as well as hypertension.</p></abstract><trans-abstract xml:lang="ru"><p><bold>ВВЕДЕНИЕ:</bold> Пациенты соматических стационаров нередко демонстрируют сопутствующие признаки психической дезадаптации — сниженное настроение, тревогу, апатию, астению, которые могут оказывать негативное влияние на течение основного заболевания и процессы восстановления. Одним из нелекарственных подходов, в последние годы все шире внедряемых в медицинскую практику, является использование методик на основе технологии виртуальной реальности.</p> <p><bold>ЦЕЛЬ:</bold> Оценить эффективность нового отечественного приложения виртуальной реальности Flow в отношении симптомов тревоги и астении у пациентов, проходящих стационарное лечение.</p> <p><bold>МЕТОДЫ:</bold> Исследование было открытым, с группой сравнения; определение пациента в экспериментальную либо контрольную группу происходило с использованием рандомизационной таблицы. Состояние пациентов оценивалось при помощи шкалы ситуативной тревожности Спилбергера, шкалы оценки симптома усталости, опросника «Самочувствие, активность, настроение», шкалы депрессии, тревоги, стресса и шкал общего клинического впечатления. До и после каждой сессии виртуальной реальности проводилось измерение физикальных показателей. Полученные данные обрабатывались статистически.</p> <p><bold>РЕЗУЛЬТАТЫ:</bold> В исследовании приняли участие 60 пациентов. У 40 пациентов в программу лечения был включен курс из пяти ежедневных релаксационных сессий в виртуальной реальности; контрольную группу составили 20 пациентов, которые проходили лечение в соответствии с рутинной практикой учреждения. Добавление к стандартному лечению курса сессий в виртуальной реальности создавало значимое преимущество в редукции у пациентов аффективных жалоб как после одного занятия, так и в результате прохождения курса и через несколько дней после его завершения. Пациенты экспериментальной группы также демонстрировали достоверное снижение показателей артериального давления после прохождения сессий, причем наиболее выраженным оно было у лиц с изначально повышенным и высоким давлением.</p> <p><bold>ЗАКЛЮЧЕНИЕ:</bold> Курсовое использование релаксационной программы в технологии виртуальной реальности Flow является эффективным и перспективным методом нелекарственной помощи пациентам соматического стационара в отношении жалоб на тревогу, апатию, снижение настроения, а также симптомов гипертонии.</p></trans-abstract><kwd-group xml:lang="en"><kwd>virtual reality</kwd><kwd>non-pharmacological therapy</kwd><kwd>comorbid mental symptoms</kwd><kwd>maladjustment reaction</kwd><kwd>lowering blood pressure</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>виртуальная реальность</kwd><kwd>нефармакологическая терапия</kwd><kwd>коморбидные психические симптомы</kwd><kwd>реакция дезадаптации</kwd><kwd>снижение артериального давления</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Medeiros GC, Roy D, Kontos N, Beach SR. Post-stroke depression: a 2020 updated review. Gen Hosp Psychiatry. 2020;66:70-80. doi: 10.1016/j.genhosppsych.2020.06.011.</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Walker J, van Niekerk M, Hobbs H, et al. The prevalence of anxiety in general hospital inpatients: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2021;72:131-40. doi: 10.1016/j.genhosppsych.2021.08.004.</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Janeczek P. Coexistence of mental and somatic diseases and difficulties in diagnosis and working with mentally ill people. J Educ Health Sport. 2022;12(7):649-59. doi: 10.12775/JEHS.2022.12.07.065.</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Sikter A. Hypocapnia and mental stress can trigger vicious circles in critically ill patients due to energy imbalance: a hypothesis presented through cardiogenic pulmonary oedema. Neuropsychopharmacol Hung. 2018;20(2):65-74.</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000;160(14):2101-7. doi: 10.1001/archinte.160.14.2101.</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Sobel RM, Markov D. The impact of anxiety and mood disorders on physical disease: the worried not-so-well. Curr Psychiatry Rep. 2005;7(3):206-12. doi: 10.1007/s11920-005-0055-y.</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Johnson HM. Anxiety and hypertension: is there a link? A literature review of the comorbidity relationship between anxiety and hypertension. Curr Hypertens Rep. 2019;21(9):66. doi: 10.1007/s11906-019-0972-5.</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Michelini S, Cassano GB, Frare F, Perugi G. Long-term use of benzodiazepines: tolerance, dependence and clinical problems in anxiety and mood disorders. Pharmacopsychiatry. 1996;29(4):127-34. doi: 10.1055/s-2007-979558.</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Jain S, Shapiro SL, Swanick S, et al. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med. 2007;33(1):11-21. doi: 10.1207/s15324796abm3301_2.</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Barrett CJ. Mindfulness and rehabilitation: teaching yoga and meditation to young men in an alternative to incarceration program. Int J Offender Ther Comp Criminol. 2017;61(15):1719-38. doi: 10.1177/0306624X16633667.</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Amarasekera AT, Chang D. Buddhist meditation for vascular function: a narrative review. Integr Med Res. 2019;8(4):252-6. doi: 10.1016/j.imr.2019.11.002.</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Anderson JW, Liu C, Kryscio RJ. Blood pressure response to transcendental meditation: a meta-analysis. Am J Hypertens. 2008;21(3):310-6. doi: 10.1038/ajh.2007.65.</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Geiger C, Cramer H, Dobos G, Kohl-Heckl WK. A systematic review and meta-analysis of mindfulness-based stress reduction for arterial hypertension. J Hum Hypertens. 2022. doi: 10.1038/s41371-022-00764-z.</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Prakhinkit S, Suppapitiporn S, Tanaka H, Suksom D. Effects of Buddhism walking meditation on depression, functional fitness, and endothelium-dependent vasodilation in depressed elderly. J Altern Complement Med. 2014;20(5):411-6. doi: 10.1089/acm.2013.0205.</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Pascoe MC, Thompson DR, Jenkins ZM, Ski CF. Mindfulness mediates the physiological markers of stress: systematic review and meta-analysis. J Psychiatr Res. 2017;95:156-78. doi: 10.1016/j.jpsychires.2017.08.004.</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Ponte Márquez PH, Feliu-Soler A, Solé-Villa MJ, et al. Benefits of mindfulness meditation in reducing blood pressure and stress in patients with arterial hypertension. J Hum Hypertens. 2019;33(3):237-47. doi: 10.1038/s41371-018-0130-6.</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Shi L, Zhang D, Wang L, et al. Meditation and blood pressure: a meta-analysis of randomized clinical trials. J Hypertens. 2017;35(4):696-706. doi: 10.1097/HJH.0000000000001217.</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Barnes VA, Pendergrast RA, Harshfield GA, Treiber FA. Impact of breathing awareness meditation on ambulatory blood pressure and sodium handling in prehypertensive African American adolescents. Ethn Dis. 2008;18(1):1-5.</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Adams ZW, Sieverdes JC, Brunner-Jackson B, et al. Meditation smartphone application effects on prehypertensive adults’ blood pressure: dose-response feasibility trial. Health Psychol. 2018;37(9):850-60. doi: 10.1037/hea0000584.</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Liaw SY, Choo T, Wu LT, et al. “Wow, woo, win” — healthcare students’ and facilitators’ experiences of interprofessional simulation in three-dimensional virtual world: a qualitative evaluation study. Nurse Educ Today. 2021;105:105018. doi: 10.1016/j.nedt.2021.105018.</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Zhang M, Ding H, Naumceska M, Zhang Y. Virtual reality technology as an educational and intervention tool for children with autism spectrum disorder: current perspectives and future directions. Behav Sci (Basel). 2022;12(5):138. doi: 10.3390/bs12050138.</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Taneja A, Vishal SB, Mahesh V, Geethanjali B. Virtual reality based neuro-rehabilitation for mental stress reduction. In: 2017 fourth international conference on signal processing, communication and networking (ICSCN); 2017 March 16-18; Chennai, India. IEEE; 2017. p. 1-5. doi: 10.1109/ICSCN.2017.8085665.</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Georgiev DD, Georgieva I, Gong Z, et al. Virtual reality for neurorehabilitation and cognitive enhancement. Brain Sci. 2021;11(2):221. doi: 10.3390/brainsci11020221.</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Carl E, Stein AT, Levihn-Coon A, et al. Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. J Anxiety Disord. 2019;61:27-36. doi: 10.1016/j.janxdis.2018.08.003.</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Wechsler TF, Kümpers F, Mühlberger A. Inferiority or even superiority of virtual reality exposure therapy in phobias? — A systematic review and quantitative meta-analysis on randomized controlled trials specifically comparing the efficacy of virtual reality exposure to gold standard in vivo exposure in agoraphobia, specific phobia, and social phobia. Front Psychol. 2019;10:1758. doi: 10.3389/fpsyg.2019.01758.</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Clus D, Larsen ME, Lemey C, Berrouiguet S. The use of virtual reality in patients with eating disorders: systematic review. J Med Internet Res. 2018;20(4):e157. doi: 10.2196/jmir.7898.</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Khanin YuL. Kratkoe rukovodstvo k shkale reaktivnoi i lichnostnoi trevozhnosti Ch.D. Spilbergera. Leningrad: LNIIFK; 1976. 40 p. Russian.</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Fisk JD, Doble SE. Construction and validation of a fatigue impact scale for daily administration (D-FIS). Qual Life Res. 2002;11(3):263-72. doi: 10.1023/a:1015295106602.</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Burlachuk LF, Morozov SM. Slovar’-spravochnik po psikhodiagnostike. 2nd ed. Saint Petersburg: Piter; 2003. 528 p. Russian.</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. 2nd ed. Sydney: Psychology Foundation of Australia; 1995. 42 p.</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>Guy W. ECDEU assessment manual for psychopharmacology. Rockville: US department of health and human services, public health service, alcohol drug abuse and mental health administration, NIMH, psychopharmacology research branch; 1976. 028 Clinical global impressions (CGI); p. 218-22.</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Donnelly MR, Reinberg R, Ito KL, et al. Virtual reality for the treatment of anxiety disorders: a scoping review. Am J Occup Ther. 2021;75(6):7506205040. doi: 10.5014/ajot.2021.046169.</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Smith V, Warty RR, Sursas JA, et al. The effectiveness of virtual reality in managing acute pain and anxiety for medical inpatients: systematic review. J Med Internet Res. 2020;22(11):e17980. doi: 10.2196/17980.</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Ridout B, Kelson J, Campbell A, Steinbeck K. Effectiveness of virtual reality interventions for adolescent patients in hospital settings: systematic review. J Med Internet Res. 2021;23(6):e24967. doi: 10.2196/24967.</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Saposnik G, Cohen LG, Mamdani M, et al.; Stroke outcomes research Canada. efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial. Lancet Neurol. 2016;15(10):1019-27. doi: 10.1016/S1474-4422(16)30121-1.</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>Sarkar U, Lee JE, Nguyen KH, et al. Barriers and facilitators to the implementation of virtual reality as a pain management modality in academic, community, and safety-net settings: qualitative analysis. J Med Internet Res. 2021;23(9):e26623. doi: 10.2196/26623.</mixed-citation></ref></ref-list></back></article>
