Short- and medium-term effect of a virtual reality-based intervention on the psychological health of informal caregivers of persons with Alzheimer’s disease

Virtual reality (VR) is emerging as a useful tool for improving knowledge, empathy and self-efficacy in educational programmes. Our study aims to test the short- and medium-term effect of virtual reality (VR)-based empathy training integrated into an online psycho-education programme and aimed at informal caregivers (iCGs) of people with mild-to-moderate Alzheimer’s disease. 60 iCGs were randomized in a 6-week psychoeducational program (control arm) or in the same psychoeducational program integrated with VR (experimental arm). VR consisted of 360-degree videos and lets caregivers experience dementia symptoms from the patient’s perspective. Before and after the intervention and again after 2 months, iCGs completed validate scales to assess burden (ZBI), perceived stress (PSS), anxiety (STAI-Y1&2) and perceived self-efficacy for caregiving tasks (RSCSE). Pre-post differences were tested with paired t-tests. Linear mixed models were used to test the interventions effects. 27 iCGs assigned to the control arm (age mean= 56; female:82%; children:63%) and 29 to experimental arm (age mean=54; female:79%; children:68%) concluded the intervention. The VR-based intervention decreased score of ZBI (t(28)=2.154; p=0.040; Cohen’s d =0.400), PPS (t(28)=2.177, p=0.038; Cohen’s d=0.404), STAI-Y (t(18)=2.400, p=0.23, Cohen’s d=0.446) and increase two domains of RSCS: responding to disruptive patient behaviors (RSCSE-RDB: t(28)=-2.358, p=0.026; Cohen’s d=0.438), and controlling upsetting thoughts (RSCSE-CUT: t(28)=-2.126, p=0.042; Cohen’s d=0.395). In the control arm, changes due to intervention did not reach statistical significance. According mixed models, both interventions have a positive short-term effect, significantly reducing scores of ZBI (experimental arm; p=0.026; control arm p=0.038), PSS (experimental arm; p=0.036) and STAI-Y (experimental arm; p=0.017). In the experimental arm, levels of caregiver burden (p = 0.026), perceived stress (p < 0.001) and self-efficacy (p = 0.006) were maintained even after two months. These preliminary results support the feasibility and short- to medium-term effectiveness of the VR-based psycho-education intervention.