An online psychoeducation programme integrated with a virtual reality-based training for informal caregiver of persons with Alzheimer’s disease: preliminary findings

Introduction: 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 VR-based empathy training integrated into an online psycho-education programme. Methods: 60 informal caregivers (iCGs) of people with mild-to-moderate Alzheimer’s disease were randomised into a 6-week psychoeducational programme (control arm) or into the same psychoeducational programme integrated with a VR experience (experimental arm). During each two-hour psychoeducation session, the ICGs experience dementia symptoms from their loved one’s perspective through the enjoyment of short VR videos. The VR-based experience is used to promote an empathic attitude. 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). Linear mixed models were used to test the interventions effects. Results: 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 levels of burden (ZBI: t(28)=2.154; p=0.040; Cohen’s d =0.400), stress (PPS: t(28)=2.177, p=0.038; Cohen’s d=0.404), state anxiety (STAI-Y1= t(18) =2.400, p=0.23, Cohen’s d = 0.446) and increase two domains of caregiving self-efficacy: responding to disruptive patient behaviours (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. In the experimental arm, levels of caregiver burden (p = 0.026), perceived stress (p < 0.001) and self-efficacy (p = 0.006) were maintained after two months. Discussion: These preliminary results support the feasibility and the short- to medium-term effectiveness of an ehealth intervention integrating psychoeducation and VR experience. The intervention significantly reduces caregiver burden levels, perceived stress and state anxiety.