Effectiveness of Virtual Reality on the Caregiving Competence and Empathy of Caregivers for Elderly with Chronic Diseases: A Systematic Review and Meta-Analysis

Abstract

Aims. To synthesize evidence on the effectiveness of virtual reality-based training of caregivers for the elderly with chronic diseases. Background. With a growing number of elderly suffering from chronic diseases, caregivers who lack the necessary caregiving skills and competence need practical training. Nowadays, virtual reality in training is a promising approach due to technological advancements. Evaluation. We did a comprehensive search in the following six electronic databases (Web of Science, EMBASE, PubMed, SCOPUS, MEDLINE, and CINAHL) from their inception to April 2022 for original studies. We searched clinical trial registries of Clinical Trials.gov, International Standard Randomized Controlled Trial Number (ISRCTN) Registry, and the International Clinical Trials Registry Platform (ICTRP), for clinical trials. Key Issues. 7610 searched records were yielded, of which nine studies (four randomized controlled trials and five nonrandomized controlled trials) met the eligibility criteria and were included with 1090 caregivers. There was a small but significant overall effect of virtual reality-based interventions on caregivers’ caregiving competence (effect size = 0.362, 95% CI 0.181–0.543, $p<0.001$ , I2 = 25.636). The subgroup analysis results showed significant improvement in caregiving competence in caregivers trained by the Dementia LiveTM program (effect size = 0.322, 95% CI 0.046–0.597, $p=0.022$ ). Regarding empathy, we did not find a statistically significant overall effect. The subgroup analysis results indicated that caregivers showed improvement in empathy after exposure to the Into D’mentia program (effect size = 0.265, 95% CI 0.015–0.515, $p=0.037$ ). Conclusions. Findings of our meta-analysis demonstrated that virtual reality could have merits for improving the caregiving competence of caregivers taking care of the elderly with chronic diseases. Implications for Nursing Management. Virtual reality may be a training alternative for caregivers to improve their caregiving competence. However, empowering the embodiment of virtual reality programs remains a technological challenge that needs to be addressed in the future.