A qualitative approach to applying virtual reality relaxation for patients with psychiatric problems: Focus group study with healthcare professionals

Virtual Reality (VR) is increasingly being used in mental healthcare settings. VR relaxation appears feasible, effective, and acceptable for reducing stress in patients with psychiatric problems. Understanding healthcare professionals' perspectives is essential for sustainable integration, as they play a key role in its adoption and use. This study explores the facilitators and barriers perceived by healthcare professionals in using VR relaxation (VRelax) while treating patients with psychiatric problems to support its implementation in mental healthcare, as part of a preliminary qualitative investigation informing the design of a subsequent randomized controlled trial (RCT) on its implementation and cost-effectiveness. From November to December 2021, three focus groups and three individual interviews were conducted with healthcare professionals who had used VRelax for four weeks in clinical practice. Participants were recruited via the researchers' professional network. Semi-structured interviews were analyzed thematically. The Consolidated Framework for Implementation Research (CFIR) guided data structuring and interpretation. Fifteen nurse specialists, psychologists, and psychiatrists were included. Six themes and seventeen subthemes emerged. Key barriers included the need for evidence-based information and technical and logistical challenges. Professionals' attitudes were shaped by their interest in technology and perceived technical skills, affecting their confidence in using VR. Healthcare professionals base VRelax use on patient characteristics rather than DSM-5 diagnoses. No themes emerged in the outer setting or implementation domains of the CFIR, suggesting underexplored systemic factors. Future implementation efforts should involve policymakers and implementation experts for a broader, multi-stakeholder approach to address these gaps. Structured guidance and clear workflows are recommended to support scalable and context-sensitive integration of VR relaxation in mental healthcare.