Experience of heart failure patients in mobilization with virtual reality: mixed methods study

Caballero, Larissa Gussatschenko; Fraga, Iasmin Borges; Tremea, Carlos Eduardo Maciel; Perin, Gabrielle; Prates, Janaína dos Santos; Lago, Pedro Dal; Oliveira, João Lucas Campos de; Rabelo-Silva, Eneida Rejane

doi:10.1590/1980-220X-REEUSP-2025-0114en

person Larissa Gussatschenko Caballero

schoolUniversidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Enfermagem, Porto Alegre, RS, Brazil.

0000-0002-4932-9216

person Iasmin Borges Fraga

schoolUniversidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares, Porto Alegre, RS, Brazil.

0000-0002-9874-5646

person Carlos Eduardo Maciel Tremea

schoolUniversidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Fisioterapia, Porto Alegre, RS, Brazil.

0009-0009-0750-0255

person Gabrielle Perin

schoolUniversidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.

0009-0001-2823-5595

person Janaína dos Santos Prates

schoolUniversidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil.

0000-0003-3257-9988

person Pedro Dal Lago

schoolUniversidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Fisioterapia, Porto Alegre, RS, Brazil.

0000-0001-9907-7689

person João Lucas Campos de Oliveira

schoolUniversidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Enfermagem, Porto Alegre, RS, Brazil.

0000-0002-1822-2360

person Eneida Rejane Rabelo-Silva

schoolUniversidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Enfermagem, Porto Alegre, RS, Brazil.

0000-0002-4374-4419

Corresponding author: Eneida Rejane Rabelo da Silva, R. São Manoel, 963 – Rio Branco, 90620-110 – Porto Alegre, RS, Brasil,
eneidarabelo@gmail.com

*

Manuscript extracted from the doctoral dissertation defended by Larissa Gussatschenko Caballero in 2024. The dissertation is entitled “Pacientes com insuficiência cardíaca em protocolo de mobilização com realidade virtual melhoram sua experiência sem impacto na sensação de dispneia: um estudo de métodos mistos complexos”, related to the Postgraduate Program in Nursing at the Universidade Federal do Rio Grande do Sul.

ASSOCIATE EDITOR

Lilia de Souza Nogueira

Variables	All (n = 60) n (%)	IG (n = 30) n (%)	CG (n = 30) n (%)	p value
Age (years)	59.7 ± 12.2	62.0 ± 11.2	57.4 ± 12.8	0.144†
Age range‡	–	–	–	0.438§
18 – 59 years old	28 (26.9)	12 (40.0)	16 (53.3)	–
≥ 60 years	32 (53.3)	18 (60.0)	14 (46.7)	–
Sex (Male)	44 (73.3)	22 (73.3)	22 (73.3)	1,000§
Ethnicity (White)‡	42 (70.0)	18 (60.0)	24 (80.0)	0.272§
NYHA classification‡	–	–	–	0.665§
I	1 (1.7)	1 (3.3)	0 (0.0)	–
II	21 (35.0)	9 (30.0)	12 (40.0)	–
III	29 (48.3)	15 (50.0)	14 (46.7)	–
IV	9 (15.0)	5 (16.7)	4 (3.8)	–
Charlson Index \|\|	3 (2 – 5)	3 (2 – 5)	3 (2 v 4)	0.574¶
Ejection Fraction*	26.7 ± 12.4	26.2 ± 11.1	27.1 ± 13.8	0.781†
SAK scale‡	–	–	–	0.606§
Low risk	29 (48.3)	13 (43.3)	16 (53.3)	–
Moderate risk	18 (30.0)	9 (30.0)	9 (30.0)	–
High risk	13 (21.7)	8 (26.7)	5 (16.7)	–
Barthel Functional Independence Scale‡	–	–	–	0.313§
Little or no disability	19 (31.7)	9 (30.0)	10 (33.3)	–
Moderate disability	33 (55.0)	13 (50.0)	18 (60.0)	–
Severe disability	8 (13.3)	6 (20.0)	2 (6.7)	–

Variables	All (n = 60) n (%)	IG (n = 30) n (%)	CG (n = 30) n (%)	p value
Mobilization experience	–	–	–	0.421*
Good/excellent	54 (90.0)	28 (93.3)	26 (86.7)	–
Reasonable	3 (5.0)	0 (0.0)	3 (10.0)	–
Bad/terrible	3 (5.0)	2 (6.7)	1 (3.3)	–
Procedure Recommendation	–	–	–	1.000*
Promoters	47 (78.3)	23 (76.7)	24 (80.0)	–
Passive/Neutral	9 (15.0)	5 (16.7)	4 (3.8)	–
Detractors	4 (6.7)	2 (6.7)	2 (6.7)	–

Quantitative Data	Qualitative Data	Metainference
• Age (years): 59.7 ± 12.2 • Sex (Male)†: 44 (73.3%) • Ethnicity (White): 42 (70.0%) • Charlson Index‡: 3 (2 – 5) • New York Heart Association: 29(48.3) Class III Risk of falls – SAK scale* ➢ 48.3% of patients with low risk Functional independence – Barthel Scale ➢ 55% of patients with moderate disability. Sensation of dyspnea – Borg ➢ 31 (51.7%) Better/same ➢ IG 16 (53.3%) ➢ CG 15 (50%) Net Promoter Score – Procedure recommendation ➢ 47 (78.3%) promoters ➢ IG 23 (76.7%) ➢ CG 24 (80%) Likert Scale – Patient Experience ➢ 54(90%) “Good/Excellent” ➢ IG 28 (93.3%) ➢ CG 26 (86.7%)	Categorization after analysis of interviews with open questions: Psychological Effects ➢ Intervention group reports more pronounced psychological benefits. Physical Performance ➢ Improvements observed in both groups, with emphasis on the intervention group. Innovation Innovative aspects highlighted in the intervention group.	The integration of quantitative and qualitative data reveals that the intervention studied was safe and well accepted by patients. The high recommendation rate of the procedure indicates that, even without a significant difference between the groups, the perceived benefits enhanced the patients’ experience. The qualitative analysis reinforces these findings, highlighting the subjective benefits, such as the improvement in psychological well-being and physical performance, in addition to the perception of innovation in the intervention group.

[T1FN1] * Value presented as mean and ± standard deviation (SD)

[T1FN2] † Student’s t-test

[T1FN3] ‡ The numbers refer to the frequency expressed in absolute numbers and percentage (%), as in some cases there was more than one indication, the tables were considered more than once

[T1FN4] § Pearson’s Chi-square tests

[T1FN5] || Value presented as median (25th percentile - 75th percentile)

[T1FN6] ¶ Mann-Whitney test.

Experience of heart failure patients in mobilization with virtual reality: mixed methods study^*

ABSTRACT

Experience of heart failure patients in mobilization with virtual reality: mixed methods study*

ABSTRACT

Experience of heart failure patients in mobilization with virtual reality: mixed methods study^*