Virtual Reality-Based Stabilization for Health Care Workers with Post-Traumatic Stress Symptoms: A Preliminary Randomized Controlled Trial

Health care workers (HCWs) are particularly vulnerable to mental health challenges during public health crises such as pandemics. Subthreshold post-traumatic stress disorder (PTSD) is prevalent among frontline HCWs and may progress to full-blown PTSD without timely intervention. This study aimed to evaluate the safety, feasibility, and effectiveness of a newly developed virtual reality (VR)-based stabilization (VRS) program for frontline HCWs with above-subthreshold PTSD. A randomized controlled trial compared VRS with a mobile application-based stabilization (MAS) program, both using identical stabilization techniques. The trial was conducted at a COVID-19-designated hospital in South Korea. Thirty-six HCWs with above-subthreshold PTSD completed a 5-week stabilization program, with 18 participants in the VRS group and 18 in the MAS group. Primary outcomes were post-traumatic stress symptoms (PTSS), assessed via self-report (PTSD Checklist-5) and clinician rating (Clinician-Administered PTSD Scale for DSM-5). Secondary outcomes included depressive symptoms (Beck Depression Inventory-II, Hamilton Depression Rating Scale-17), anxiety (State-Trait Anxiety Inventory-Y), and quality of life (the World Health Organization Quality of Life Scale-Abbreviated Version). Concentration, immersion, task load, and cybersickness were also measured. Both interventions demonstrated satisfactory safety and feasibility. Immersion was significantly higher with VRS. Significant pre-post improvements in PTSS, self-reported depression, and anxiety were observed in both groups. However, the VRS group showed greater improvements in quality of life. These results suggest the potential of immersive VR-based stabilization interventions as a useful tool for protecting the mental health of vulnerable populations, including HCWs, in public health emergencies during and beyond pandemics, when the traditional face-to-face delivery of intervention is limited.