Exceptional medical care from first responders, nurses and doctors routinely saves the lives of patients with critical illnesses. But many of those patients will suffer from anxiety, depression and PTSD after they return home.
A team of UCF researchers is confident that exposure therapy featuring virtual reality with real sounds and smells, all mimicking the patients’ intensive care experience, will help those patients — just as it has for veterans, first responders and others treated by UCF RESTORES, a nationally recognized PTSD clinic on campus.
Assistant Professor Brian Peach in UCF’s College of Nursing — and an ICU nurse for 17 years — is leading the study of patients who endure post-intensive care syndrome, known as PICS. Studies show PICS can affect as many as 80% of patients who are in intensive care. About one-third of intensive care patients are unable to return to work in the first year.
While there are other studies examining the impacts of PICS, Peach says what makes his study unique is the exposure therapy — which has proven to be highly successful with first responders, military personnel and veterans treated at UCF RESTORES. They overcome PTSD at much higher rates than the national standard.
During treatments, patients wear a virtual reality headset and see images of a simulated hospital room while recounting the traumatic event in the presence of the therapist. The room can be customized to mimic the patient’s experiences, including the colors of the bedding and whether the nurse was male or female. The therapist also inserts sounds and smells that are triggers for that particular patient.
“The exposure therapy totally saved me,” says a 41-year-old Orlando teacher who has completed the two-week treatment program. “I was in a dark place as far as being consumed by trauma. I still can think about my hospital stay, but it’s not excessively on my mind anymore and I don’t have severe emotions attached to it. It’s changed my life so much for the better.”
She spent weeks in intensive care following cardiac arrest. When she returned home, she had trouble falling asleep because she felt like she needed to constantly check her vital signs and make sure she would not go back in the hospital. Everyday sounds such as lawn mowers and weed whackers reminded her of sounds from her hospital room, and she could not drive by a hospital without it triggering major anxiety.
“UCF RESTORES’ exposure therapy program has helped more than 1,400 people with PTSD, and we are confident their highly skilled therapists also will help critical illness survivors regain their lives,” Peach says. “We are determined to help survivors enjoy a good quality of life with their families and in their careers after they leave the hospital.”
Peach is recruiting patients who were previously hospitalized in intensive care due to critical illnesses and who believe they are suffering from PTSD. The study involves ten two-hour sessions on weekdays over two weeks. Patients, who must be 18 or older, would undergo an initial screening for PTSD at UCF RESTORES to see if they qualify. Participants who qualify are eligible for two $100 Wawa gift cards to help with travel expenses. Patients who want to be considered for the study should contact Peach at brian.peach@ucf.edu or 407-823-5460.
Peach says patients who are on ventilators while in the hospital are more prone to PTSD and anxiety both while they are hospitalized and after they return home. Interventions that can help to reduce PTSD and anxiety in hospital intensive care units include getting patients off of ventilators more quickly if possible, helping them get up and move around when they can, and having family members present who can support and engage with them.
Peach has an ongoing study enrolling survivors of acute respiratory distress syndrome, or ARDS, who had been in intensive care on a ventilator. That study has found moderate to high rates of PTSD in most of the 25 patients who have enrolled to date. Common triggers for anxiety and flashbacks include seeing hospitals and healthcare equipment, such as wheelchairs, stretchers and gloves; medical television shows; seeing or hearing helicopters; loud beeping noises similar to machines in the ICU; the smells of bleach and other cleaning supplies; and seeing or touching medical scars. While ARDS is a risk factor for PICS, Peach wants to help a larger variety of patients who have experienced any critical illness.
The virtual reality software used in the exposure therapy was developed by UCF RESTORES with help from UCF’s School of Modeling, Simulation and Training and the Nicholson School of Communication with a $3 million U.S. Department of Defense grant. The software allows therapists to customize treatments with images specific to each patient.
“So many veterans, first responders and military personnel are thriving in their careers and family lives after they completed our innovative exposure therapy,” says Deborah Beidel, trustee chair, Pegasus Professor of psychology and executive director of UCF RESTORES. “We’re excited that we can adapt our program to help patients with critical illnesses overcome their trauma and lead fulfilling lives.”
