Background: The lifetime prevalence of auditory hallucinations among patients on the schizophrenia spectrum is 60-80%. More than half of these patients continue to experience auditory hallucinations even with regular medication adherence. The professional competence of nurses in managing auditory hallucinations affects the stability of patients' symptoms and their recovery process, highlighting the importance of nurses' capabilities in caring for patients with auditory hallucinations.
Purpose: To develop and test the effectiveness of a virtual reality auditory hallucination program on the comprehensive care competence of psychiatric nurses in managing auditory hallucinations.
Methods: This is a two-phase study conducted in four psychiatric medical institutions. The study includes a development phase, a testing phase, and a formal research phase. In the pilot phase, five participants are expected to be recruited. The first phase involves the development and testing of the virtual reality auditory hallucination program and the Objective Structured Clinical Examination (OSCE), which includes components such as auditory hallucination assessment, communication with individuals experiencing auditory hallucinations, and management of auditory hallucinations. Upon completion, content validation will be conducted by psychiatric experts. Five psychiatric nursing master's students will be invited as simulated candidates to examine the applicability of the "VR-based Auditory Hallucination Nursing OSCE" for psychiatric nurses. The second phase is the formal interventional study, which will recruit 200 psychiatric nurses through convenience sampling. Participants will be grouped by institution using block randomization software. Data will be collected at three time points using the HTC virtual human system in conjunction with Google online questionnaires. The research instruments include:
* Self-rated Confidence Questionnaire on Auditory Hallucination Assessment and Management,② Auditory Hallucination Knowledge, Attitude, and Empathy Self-awareness Scale,③ Auditory Hallucination Immersion and Empathy Scale, ④ Comprehensive Auditory Hallucination Nursing OSCE Evaluation Form, and ⑤ Nurse Auditory Hallucination Literacy Scale. Expected Results: This study is expected to enhance psychiatric nurses' capabilities in assessing and managing auditory hallucinations. The program may be routinely used in in-service education for nursing staff and may serve as a reference to assist nurses in helping patients improve their insight into auditory hallucinations.
Keywords: Auditory hallucination care competence, interventional study, virtual reality, schizophrenia, Objective Structured Clinical Examination (OSCE)
