Inducing Emotional Stress from the Intensive Care Context Using Storytelling in VR

Nurses in intensive care units are exposed to permanent stress. Emotional stress contributes to psycho-physiological exhaustion symptoms such as chronic sleep disturbances, restlessness or burnout, which negatively affects the quality of care and interaction with patients. A promising method for learning coping strategies to deal with stress is Stress Inoculation Training, which involves practicing stressors in a controlled environment at increasing intensity. In this work, using virtual reality, the stressor of having to comply with the patient's or family's wishes, even if one does not agree with them, was selected. The stressor was defined based on a literature review and interviews with experts which was then implemented in three intensity levels. In a Wizard-of-Oz trial, participants interacted with virtual characters using natural speech. The stress response of the induced stress was measured using objective (heart rate, time between R peaks, skin conductance, and respiratory rate) and subjective measures (Perceived Stress Questionnaire and a 7-point Likert item). While objective results do not show significant differences between intensity levels, a significant increase is detected in the subjective measures. We show that emotional stress can be induced by increasing the intensity of a stressor in VR using virtual characters.