Effect of Virtual Reality and Relaxation Technique on Nurses' Fatigue, Burnout, and Satisfaction in Critical Care Units: A Factorial, Randomized Controlled Trial

To compare the effects of the Jacobson Relaxation Technique on satisfaction, fatigue, and burnout in nurses working in critical care units with a virtual reality to compare the results.

A factorial, Randomized control trial design, to determine the effect of the three intervention groups and one control group on nurse satisfaction, fatigue, and burnout in critical care units.

Critical care units in Teaching Hospitals in Baghdad city, Iraq.

Inclusion : nurses who work in critical care units and have one year of experience or more in the same critical care unit. Exclusion: Physical Health Issues: Individuals with significant physical disabilities or chronic illnesses that could impair their ability to participate in (VR sessions or the Jacobson Relaxation Technique) or that may be exacerbated by the intervention are also excluded.

Participants will exposed to one session per week regularly over eight weeks. After the last session in the eighth week, participants will give the Questionnaire format again to conduct the post-test assessment to determine the extent of the impact of each intervention and compare between groups The intervention will be done through virtual reality sessions for group (A) at a rate of one session per week, with each session lasting from 5-10 minutes in a natural environment for a period of 8 weeks. The intervention will be done on group (B) by exposing them to Jacobson's relaxation techniques for a period of 20 minutes, at a rate of one session per week for a period of 8 weeks. The third group (AB) will be intervened using both methods together: a virtual reality nature simulation session and exposing them to Jacobson's relaxation techniques, respectively, for a period of 8 weeks.

Minimizing level of fatigue, burnout for nurses.

The simple random sample selection by using electronic dice draw to select the sample size. The draw was conducted using an electronic dice application on the tablet device. The electronic dice contains six serial numbers from (1-6). The odd numbers were determined for the nurses who will participate in the research sample, while the even numbers were determined for the nurses who was excluded from the research sample. Then it was presented to each individual in the sample population to be tested. To sample assign groups by using a random wheel of fortune draw (picker wheel) was used. The draw was conducted using an electronic wheel spinning application on a tablet device containing a wheel divided into twelve parts, every three parts scattered in the wheel have the same color, and it was spun up electronically randomly to ensure the best random selection and to avoid bias. Blue parts represented (A group) virtual reality sessions, red parts for (B group) Jacobson's relaxation techniques, green parts for (AB group) Jacobson's relaxation techniques and virtual reality sessions together, and yellow parts for (C group) control group. Then it was presented to each individual in the research sample to be tested. No allocation concealment will be carried out.

To achieve single blind in this trial, the participant is kept blinded to their group assignment (interventions and control groups) throughout the study. The data collector administers the assigned intervention (Jacobson's relaxation techniques, virtual reality sessions , and together groups ) without revealing the participant's group assignment. The researcher retains knowledge of group allocation to ensure Single blind. Interventions are randomized, and assess to level fatigue, burnout, and satisfaction without knowing the type of maneuvers received, ensuring that participants' expectations do not influence the results. These procedures reduce the influence of prior expectations and ensure an effective study.

The researcher is acknowledging the scientific community to have verifiable findings of the study. Sharing plan includes making all the related data available through publishing the study report in peer-reviewed reputable journals.

God willing, once finishing the process of data collection, analysis, and successful publishing of the manuscript, all the related files will become available for five months after the publications, after you are approved to register on the Iranian clinical trials website

All the related files will be shared with any scientific interested parties.

It may be used after seeking the author's permission and acknowledging his contribution

The author's professional e-mail that will be available with the published manuscript can be used to contact the author. E-Mail: alaaj@conursing.uobaghdad.edu.iq

The processes involved in accessing this documentation are possible via email: alaaj@conursing.uobaghdad.edu.iq, the first and last name of authors, trial' title variable and the trial Id.

Profound appreciations are due to the IRCT members for their genuine efforts in helping researchers fulfilling their academic endeavors. The four groups were added individually in each field. We hope that the modifications will be appropriate to the design of the experiment. With many thanks and appreciation for your patience.