People living with obesity (PlwO) face many challenges, not the least of which is equity in health services. Researchers Caz Hales and Brian Robinson from Victoria University of Wellington (VUW) are leading an early-stage project using virtual reality (VR) to improve those services.
“PlwO are under-served in healthcare, from how body size and shape affect mobility through to support for procedures such as bariatric surgery,” Hales says. She works with both PlwO and staff across quality of care, patient experiences, and patient and staff safety. Hales also works closely with PlwO, whānau/family, and communities to develop equitable obesity care health services.
Robinson, a Senior Lecturer at VUW’s School of Nursing, Midwifery and Health Practice, brings his expertise in clinical skills education, and medical equipment and design from his time at the southern hemisphere’s first patient simulation facility, in Wellington. He established the facility and led it for 15 years.
“Serving PlwO is much more than just weight prevention, management or loss. It’s about how PlwO experience their care, safety issues, and the role healthcare professionals play in creating positive social experiences during healthcare interactions,” says Hales.
“For example, we’re seeing incidents with bariatric patients where their weight is a contributing factor to care and that can also affect staff safety, so we need to think about how we’re training staff and what tools we’re giving them to help work with these patients.”
“At the simulation centre we trained nurses to use hoists – but it was nurses hoistingnurses rather than PlwO. The real challenge is how to train nurses to move a much larger person who may also be self-conscious about their weight and the hoisting procedure,” says Robinson.
Hales and Robinson have RAP1 funding from Te Tītoki Mataora for their project which is hosted by the University of Auckland on behalf of the Consortium for Medical Devices and Technology. RAP1 is a contestable acceleration programme for very early-stage technology projects working towards clinical application and commercialisation.
“RAP1 funding enabled us to cast a broad net across interested groups and develop an ideation of what this project might look like. We were stunned when we listened – there were issues with beds, operating theatres, weight bias, PlwO felt embarrassment and shame, they worried they’d be hurt, paramedics said, ‘You have to include us because we transport PlwO to and from hospital’,” says Robinson.
The team also heard how hospitals are structurally stigmatising for PlwO. “Often there is no chair for them to sit in, and they’re weighed in a public space,” says Hales.
Robinson says it became clear the need extended beyond the hospital and into the home, into aged care and into the hospice environment.
VR training has a role but also throws up a new challenge. “How do you use VR technology to teach someone for a task that requires touch. Is it a viable way to teach moving and handling?” says Robinson.
They hope to find out with this project. “We’re developing two VR prototypes. One is about empathy for PlwO, the second is a blank room and how this would be set up to support a PlwO,” says Hales.
“If those prove useful, the next step would be a bigger platform, something that is more interactive, somewhere we could test three different clinical areas: upgrading skills for healthcare professionals such as ambulance crew, upskilling the health workforce and identifying essential healthcare equipment for PlwO,” says Hales.
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