Project Brave Heart

Project Brave Heart: Studying the Impact of Virtual Reality Preparation and Relaxation Therapy

In 2017, doctors at Lucile Packard Children's Hospital Stanford conducted a study to research the impact of a pre-procedure virtual reality (VR) experience called Project Brave Heart on the anxiety and stress of pediatric cardiology patients. The study was co-led by Anne Dubin, MD, professor of pediatrics, and Lauren Schneider, PsyD, assistant professor of child and adolescent psychiatry. They sent a VR headset home with patients who had an upcoming scheduled cardiac catheterization procedure so the patients could learn about the procedure and practice relaxation techniques before coming into the hospital for the procedure. Even though cardiac catheterizations are outpatient procedures, patients must undergo general anesthesia, and doctors find the experience can cause stress and anxiety for patients, especially if the patients are young.

Although VR technology is expanding into medical settings, research into its health care benefits is in the early stages. It is believed that no one has studied the impact of this technology on children with congenital heart diseases.

“Our goal was to determine whether using VR would help patients be more prepared, calmer and less anxious about their procedure,” said Dr. Schneider.

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The Project Brave Heart experience begins at the entrance of the hospital, where patients are met by a virtual peer who leads them on a tour of the hospital. The tour guides users along the exact path that is taken on the day of their procedure, including visits to the pre-op room where they receive anesthesia, the Cath Lab where they fall asleep and the recovery room where they wake up after the procedure. Throughout the tour, patients can access relaxation programs that spirit them away to enchanting natural settings, where they are given mindfulness techniques to soothe themselves during moments of stress or anxiety

Patients participating in the study were asked to watch the program several times during the week before their procedure. They were also encouraged to use the mindfulness techniques, if they needed them, on the day of their procedure. As part of the study, patients’ heart rates, blood pressure and cortisol (a stress hormone) levels were measured before and after the catheterization, and comprehensive questionnaires were administered to document the patients’ reported levels of stress and anxiety.

“A lot of anxiety can occur for anybody who is having a procedure done, and more anxiety probably occurs for those who are having a cardiac procedure,” said Dr. Dubin. “We wanted to determine if patients who use VR have less anxiety because they will have been exposed to a very realistic experience of what will happen when they’re at the hospital on procedure day.”

The study's findings are pending.

Doctors Dubin and Schneider received guidance from Walter Greenleaf, PhD, a visiting scholar at the Virtual Human Interaction Lab at Stanford University. The relaxation programming includes content from three companies that specialize in VR programming: Life VR, Zen Zone and Dolphin Swim Club. Virtual Ventures filmed and produced the VR program for the study, in partnership with Rebecca Mandel Ben-Artzy, founder of AlphaPresence. VR equipment for the study was donated by Oculus. Doctors Dubin and Schneider have no financial relationships with these companies.