title: Occupational therapists' views on using a virtual reality interior design application within the pre-discharge home visit process.
abstract: BACKGROUND
  A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment in order to enable patients to function independently after hospital discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement, and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualize changes prior to implementing them. Customized VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration, if developed effectively and integrated into the PHV process.
  
  
  OBJECTIVE
  The intent of the study was to explore the perceptions of OTs with regard to using VRIDAs as an assistive tool within the PHV process.
  
  
  METHODS
  Task-oriented interactive usability sessions, utilizing the think-aloud protocol and subsequent semi-structured interviews were carried out with seven OTs who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centering around the parameters that impact upon the acceptance, adoption, and use of this technology in practice as indicated by the Technology Acceptance Model (TAM).
  
  
  RESULTS
  OTs' perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential to increase understanding, enrich communication and patient involvement, and improve patient/practitioner shared understanding. However, it was unlikely that VRIDAs would be suitable for use with cognitively impaired patients. For PEoU, all OTs were able to use the software and complete the tasks successfully; however, participants noted numerous specialist equipment items that could be added to the furniture library. AU perceptions were positive regarding use of the application across a range of clinical settings including children/young adults, long-term conditions, neurology, older adults, and social services. However, some "fine tuning" may be necessary if the application is to be optimally used in practice.
  
  
  CONCLUSIONS
  Participants perceived the use of VRIDAs in practice would enhance levels of patient/practitioner collaboration and provide a much needed mechanism via which patients are empowered to become more equal partners in decisions made about their care. Further research is needed to explore patient perceptions of VRIDAs, to make necessary customizations accordingly, and to explore deployment of the application in a collaborative patient/practitioner-based context.
authors.affiliation: Brunel University, School of Health Sciences and Social Care, Brunel University, London, United Kingdom.
authors.forename: Anita
authors.identifier: http://orcid.org/0000-0001-6158-7237
authors.initials: A
authors.lastname: Atwal
authors.forename: Arthur
authors.identifier: http://orcid.org/0000-0003-1063-3680
authors.initials: A
authors.lastname: Money
authors.forename: Michele
authors.identifier: http://orcid.org/0000-0003-0958-7525
authors.initials: M
authors.lastname: Harvey
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D005160:Facility Design and Construction / Q000295:instrumentation*; D005260:Female; D006301:Health Services Needs and Demand; D006792:House Calls; D006801:Humans; D008297:Male; D009788:Occupational Therapy / Q000379:methods* / Q000523:psychology*; D010351:Patient Discharge; D010465:Perception; D014584:User-Computer Interface; D055815:Young Adult
keywords: 3D; empowerment; occupational therapy; patient collaboration; patient engagement; patient perceptions; pre-discharge home visits; technology assisted care; virtual reality