Lived and Self-Reported Experiences of Immersive Virtual Nature Environments Among Patients and Spouses in Palliative Home Care: An Exploratory Mixed-Methods Feasibility Study

Objectives: To explore lived and self-reported experiences of using immersive virtual reality with natural environments (IVR-N) among patients and their spouses in a palliative home care context. Methods: An exploratory mixed-methods feasibility design with purposive sampling was used. Data were collected through self-reported questionnaires, semi-structured interviews, and registrations from the VR headsets. Patients rated their symptoms and spouses rated their mental state, before and after using IVR-N. Descriptive analyses were used for quantitative data. Interviews were analyzed using qualitative content analysis. Quantitative and qualitative data were analyzed separately and subsequently integrated to provide a comprehensive understanding of the study findings. Results: The sample consisted of seven patients in palliative home care and four spouses, with a mean age of 76 years in both groups. Patients preferred natural environments that contained elements of activity or movement. There was a tendency towards lower symptom ratings in patients and more favorable ratings of mental state in spouses after IVR-N. Analysis of the interviews identified three themes: being in a place where tranquility becomes possible, connecting to nature via past experiences, and being prevented from engaging fully with nature. No adverse effects were reported by the participants. Conclusions: IVR-N may contribute to relieved symptoms in patients receiving palliative home care and improve mental state in spouses. The participants appreciated the feeling of being in another world and finding calmness, but they also preferred virtual environments that included some activity, to provide them with distraction. Larger randomized studies are warranted to confirm the results from this feasibility study in palliative home care.