The impact of a 360° virtual tour on the reduction of psychological stress caused by COVID-19

Finding Peace in Pixels: Exploring the Therapeutic Mechanisms of Virtual Nature for Young Adults' Mental Well-Being

Background: This investigation examines the phenomenological dimensions of young adults' engagement with virtual natural environments for psychological stress amelioration through rigorous thematic analysis. Contemporary epidemiological data reveal a concerning prevalence of stress among young adults aged 18 to 29 years, with approximately 30% reporting moderate to severe manifestations. Despite virtual reality (VR)'s emergence as a promising modality for mental well-being interventions, a significant lacuna exists regarding the qualitative understanding of these immersive experiences. Methods: Through semi-structured interviews with 35 young adults following a four-week VR nature intervention, we constructed a conceptual framework comprising five interconnected strata: intervention, experience, process, context, and outcome. Results: Our analysis illuminated intricate bidirectional relationships among sensory elements, emotional responses, immersion depth, interactive affordances, post-session effects, psychological development, implementation challenges, individual variability, and comparative efficacy. The findings demonstrate congruence with both Attention Restoration Theory and Stress Recovery Theory while necessitating consideration of technology-specific mediators. Notably, the identified "stress barrier" phenomenon temporarily inhibited intrusive cognitions, suggesting promising therapeutic mechanisms. Pronounced heterogeneity in environmental preferences and psychophysiological responsiveness underscores the imperative for personalized implementation strategies. Conclusions: These insights provide substantive guidance for VR nature applications across therapeutic, occupational, and educational domains, potentially augmenting our repertoire for addressing stress-related sequelae in contemporary society.

How telepresence and perceived enjoyment mediate the relationship between interaction quality and continuance intention: Evidence from China Zisha-ware Digital Museum

The rapid development of digital technologies and the diversification of user needs have made digital museums significant platforms for cultural dissemination and education, attracting unprecedented attention. This study aims to investigate how interaction quality influences users' psychological responses and their continuance intention to use digital museums. By integrating the Stimulus-Organism-Response (S-O-R) model and telepresence theory, this study proposes a novel model to examine users' continuance intention. A questionnaire survey of visitors to the China Zisha-ware Digital Museum (CZDM) yielded 414 valid responses, which were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results indicate that: 1) The interaction quality of digital museums (i.e., interactivity, vividness, and authenticity) and users' psychological responses (i.e., telepresence, perceived enjoyment) significantly affect users' continuance intention to varying degrees. 2) Telepresence significantly mediates the relationship between interaction quality and continuance intention. 3) Perceived enjoyment serves as an important mediator between interactivity, vividness, and continuance intention, while its mediating role between authenticity and continuance intention is not significant. This study offers theoretical and practical insights for optimizing digital museum user experience design to enhance continuance intention, while also promoting the dissemination of digital culture and supporting educational efforts.

The effects of digital nature and actual nature on stress reduction: A meta-analysis and systematic review

Objectives

The study aims to conduct a systematic literature review and meta-analysis to assess the effects of digital nature and actual nature on stress reduction.

Methods

In August 2023, Web of Science, Scopus, ProQuest, PubMed, and EBSCOhost databases were used, and ten articles were in the analysis, with a total sample size of 886 participants. Studies within- or between-subjects design conducted in either a randomized controlled trial or a quasi-experimental design were included. No restriction was put on the year of publication or geographical region. Conference papers and dissertations were also included whereas, book chapters were excluded. Participants included those who were exposed to at least one form of digital nature exposure, such as static images, videos, 360° pictures, and 360° videos. The risk of bias determined through Review Manager 5.4 was used to assess the quality of the studies. STATA software package version 16 was used for visual analysis of funnel plots. For the assessment of potential publication bias, Egger's test was implemented.

Results

Digital natural environments had the same level of stress recovery compared to actual environmental exposures with the same intervention content (SMD = -0.01; 95% CI: -0.15, 0.12). Subgroup analyses and meta-regression indicated that subjective or physiological stress measures, level of immersion, and data extraction method were not associated with pooled effect stress recovery. All subgroups showed comparable stress levels in both conditions. In addition, all included studies had different levels of risk of bias (low, moderate, and high).

Conclusions

The present study concludes that previous research has generally shown that stress levels are reduced in both digital and actual natural environments. The results of the meta-analysis support this conclusion with no significant differences between the two modes of stress recovery through nature viewing.

Effects of Virtual Reality Therapy for Patients With Breast Cancer During Chemotherapy: Randomized Controlled Trial

Background

Patients with breast cancer endure high levels of psychological and physical pain. Virtual reality (VR) may be an acceptable, safe intervention to alleviate the negative emotions and pain of patients with cancer.

Objective

We aimed to test the long-term effects of VR on psychological distress and quality of life (QOL) with traditional care in Chinese patients with breast cancer. We also explored the intervention mechanism and the acceptability of VR.

Methods

A total of 327 eligible participants were randomly assigned to a VR intervention group or a control group. The Distress Thermometer, QLQ-C30 (Quality of Life Questionnaire version 3.0), and Virtual Reality Symptom Questionnaire were assessed at baseline, postintervention (3 mo), and follow-up (6 mo). Analysis followed the intention-to-treat (ITT) principle. The generalized estimating equations model was used to analyze the longitudinal data, and the PROCESS macro was used to analyze the mediating effect.

Results

Compared with the control group, patients with breast cancer in the VR group had lower distress scores (P=.007), and higher health-related QOL scores (physical, role, emotional, cognitive, and social functioning) after 6 months (P<.05). Psychological distress had mediating effects on the longitudinal association between VR and the health-related QOL (indirect effect=4.572-6.672, all P<.05).

Conclusions

VR intervention technology may help reduce distress and improve QOL for patients with breast cancer over time. By incorporating a mediating analysis, we showed that the QOL benefits of VR intervention was manifested through positive effects on psychological distress risk factors.

The Use of Immersive Virtual Reality in Sensory Sessions on a Specialist Dementia Unit: Service Evaluation of Feasibility and Acceptability

This service evaluation reviewed inclusion of Immersive Virtual Reality (iVR) relaxation activities as part of routine occupational therapy sensory sessions on a specialist dementia unit. Twenty-five sessions were completed over 13 wk with 14 participants. Nine participants chose to engage in multiple sessions. Feasibility was assessed through participant engagement and tolerability. Modal first session length was in the range 30 s to 2 min. This increased to over 2 min on second sessions. There was a lack of significant adverse effects measured by direct questioning, neuropsychiatric assessment before vs. after sessions and adverse incident reporting. Acceptability was assessed via structured review of user and staff feedback which noted positive experiences such as relaxation, openness to discussion, reminiscence, wider engagement and interest in future use. Further work is required to explore efficacy and use in other settings.

360° Digital Travel to Improve Emotional State and Well-Being During the COVID-19 Pandemic: The Role of Presence and Sense of Place

The continuation of the COVID-19 pandemic has caused a decline in people's subjective well-being and emotional states. Digital travel based on 360° videos provides an alternate way for people to improve their mental health at home during this specific period. Yet, how to construct effective digital travel content that improves emotions remains an issue. This investigation assessed the impact of people's perceived presence and sense of place (SOP) on emotional improvement during a 360° digital travel experience. A total of 156 undergraduate students volunteered to participate, and anxiety, emotion levels, and life satisfaction were measured before and after the digital travel experience; presence and SOP ratings were also collected after the experience. A Latent Change Score model was then developed, and the results indicated that the greater presence and SOP individuals experienced during their digital travel, the better their digital travel experience and emotional improvement. Furthermore, the current data highlight that SOP has a greater impact on emotional improvement than presence. This result provides a novel understanding that how SOP is generated may be more critical to digital travel than presence. This new understanding should help improve relevant applications in the field of digital travel, such as the possibility of providing meaningful narrative context in a virtual environment to induce SOP more effectively, and improve the digital travel experience. Overall, the findings of this study expand our understanding of the digital travel experience and lay the groundwork for future research on SOP and digital travel.

Hope, Belief in Just World and Trust in Government: An Interaction Amidst Covid-19 Pandemic in India

The outbreak of COVID 19 has brought about changes in all spheres of human life. In the present times of pandemic, human life has suffered not only from physical stresses but also encountered and endured several mental stresses. In recent times people adopted several measures to bring positivity to their life. The present study explores the relationship between- Hope, Belief in Just World, Covid -19, and Trust in the Government in India, during the Covid-19 Pandemic. Data was collected online from young adults, via Google forms, using the tools- Adult Hope scale, Covid Anxiety scale, Belief in Just world scale, and Trust in Government. Results showed a significant correlation between the three variables. Hope, Belief in Just World, and Trust in government. Regression analysis found these three variables to significantly impact Covid anxiety. Further, Belief in Just World was found to mediate the relationship between Hope and Covid anxiety. During challenging times, it is important to boost mental health in the right direction. Implications have been further discussed in the article.

Effects of diffusion of innovations, spatial presence, and flow on virtual reality shopping

Virtual reality (VR) has developed rapidly, drawing more businesses to such development. Based on the diffusion of innovations theory (DIT), the study combines the flow theory and the satisfaction perspective to explore purchase intention influencing customers' adoption of the VR shopping platform system. This study found that satisfaction and flow experience enhance their purchase intention. In technological characteristics, relative advantage, service compatibility, spatial presence, and complexity are important in satisfaction. Among them, both relative advantage and spatial presence impact flow experience. Additionally, a cluster analysis based on gender was conducted, and the study found a significant difference between relative advantages, service compatibility, and complexity in women and men users. The flow experience is an important factor affecting women users' shopping intention, while insignificant for male users. The implications of these findings are discussed.

Virtual Reality (VR) Technology for Treatment of Mental Health Problems during COVID-19: A Systematic Review

There was a surge in psychological distress and emotional burnout during the COVID-19 pandemic. Virtual reality (VR) is helpful as a psychological intervention whilst maintaining physical or social distancing. The present systematic review assessed the role of VR as a psychological intervention tool for mental health problems during the COVID-19 pandemic. We conducted a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study used the search-related terms: (Virtual reality OR simulated-3D-environment OR VR) AND (covid! or corona!) AND (mental* OR psychologic* OR well* OR health*) AND (intervention) on six databases, i.e., MEDLINE, PsycINFO, Ovid Medline, EMBASE, ACM digital library, and Cochrane Central Register of Controlled Trials (CENTRAL) from the inception date until 23 June 2021. We finally included four studies in the systematic review out of the 379 references imported for screening. These studies reveal that VR is beneficial as a psychological tool for intervention in individuals with mental health problems. Immersed in the telepresence, interacting in a 3-D format compared to a 2-D layout, having a sense of enjoyment and engagement, activating an affective-motivational state, “escaping” to a virtual from the real world are pivotal faucets of VR as a psychological tool for intervention.

The Role of Virtual Reality as a Psychological Intervention for Mental Health Disturbances during the COVID-19 Pandemic: A Narrative Review

The COVID-19 pandemic spread throughout the world and created many problems. The COVID-19 pandemic caused an increase in mortality and morbidity, including mental health problems. Around the world, the movement control order (MCO) was strictly enforced, but the spread of the infection epidemic was still rampant. The magnitude of the increase in mental health illnesses has caused many individuals to suffer. Given that face-to-face interventions are challenging to carry out during an outbreak, we need to address this critical problem through an online approach, such as virtual reality (VR). This approach is vital to helping patients deal with their existing problems in more pragmatic, practical, and customer-friendly ways. Thus, in the present review, we proposed the development of a virtual digital device for this noble purpose. Various challenges, improvements, and expectations for VR applications were outlined and discussed in this narrative review.

Rethinking the Impact of Theme Park Image on Perceived Value and Behavioral Intention: The Case of Chimelong Ocean Kingdom, China

The emergence of theme parks is enriching the tourist experience in the COVID-19 period. This study rethinks the impact of theme park image on tourist-perceived value (functional, social, and emotional value) and behavioral intention during COVID-19. Data were collected from 304 respondents who visited Chimelong Ocean Kingdom during COVID-19. This study results indicated that theme park destination image (cognitive and affective) positively predicts tourist-perceived value (functional, social, and emotional) during COVID-19. Moreover, this study also indicated that although social and emotional value positively predict tourist behavioral intention, functional value does not positively predict tourist behavioral intention during COVID-19. Theoretical and managerial implications are presented.

How Fear of COVID-19 Affects the Behavioral Intention of Festival Participants-A Case of the HANFU Festival

The recovery of the tourism industry is an important issue that has attracted much attention during the COVID-19 pandemic. Sustainable and safe festival tourism is considered an effective way of aiding in the recovery of the industry. A face-to-face survey of participants in the Guangzhou Hanfu Festival was conducted to examine the relationship between fears of COVID-19, perceived risks, perceptual evaluations, festival attitudes, behavioral intentions, and crowding during this difficult time. Results clarified how fear affects behavioral intentions in festival research, and the mediation role of perceived risk and the moderation role of crowding was confirmed. A timely set of recommendations was provided to festival operators and local governments.

The show must go on: The mediating role of self-assessment in the relationship between performers' technology acceptance and satisfaction level with remote performances in Korea during the COVID-19 pandemic

To cope with the COVID-19 pandemic, the performing arts industry created new formats for delivering content via digital technology in the form of remote performances. This study examined the effect of remote performances on performers' satisfaction through the lens of the technology adoption model. Additionally, it investigated whether the performers' self-assessment of performance quality mediates the relationship between their technology acceptance and satisfaction. To this end, we collected the data from performers (N = 124) who experienced remote performances in Korea. Results showed that their satisfaction was a function of perceived usefulness and ease of use of the technology. However, the mediation effect by self-assessment was detected only on the relationship between the perceived ease of use and satisfaction. The results of the study suggest that event organizers offer an easy-to-operate technology allowing performers to better engage in remote performances. This also enables performers to self-assess their performances, which will enhance performance quality.

Factors That Influence Virtual Tourism Holistic Image: The Moderating Role of Sense of Presence

The COVID-19 pandemic has dramatically restricted domestic and foreign travel; thus, virtual tourism has become a new option for traveling. As regards virtual tourism, the present study seeks to investigate the effect of tourist involvement on the three components of holistic image, namely cognitive, affective, and conative images; the influence of cognitive, affective, and conative images on the construction of the holistic image; and the moderating effect of sense of presence on the relationships between cognitive, affective, and conative images on the holistic image. Prospective tourists were chosen as research subjects in the present study on non-immersive virtual reality (VR) tourism, or virtual tourism. Participants first watched the 360° VR tour video of AirPano. Afterward, they filled out an online questionnaire, of which 386 valid samples were collected for analyses. Results show that tourist involvement considerably affects cognitive, affective, and conative images, which significantly influence the holistic image. Furthermore, a sense of presence was found to positively moderate the relationships between (1) cognitive and holistic, (2) affective and holistic, and (3) conative and holistic images. These results may allow tourism marketing organizations to better understand how to strengthen the holistic image in the context of virtual tourism.

Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review (Preprint)

Background

Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings.

Objective

This systematic review aimed to describe the literature on health care–targeted virtual reality applications during the COVID-19 crisis.

Methods

We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: “[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)].” Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias.

Results

Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials.

Conclusions

Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama.

Trial Registration

International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY202190108; https://inplasy.com/inplasy-2021-9-0108/

Understanding the impact of information sources on COVID-19 related preventive measures in Finland

The COVID-19 pandemic amplified the influence of information reporting on human behavior, as people were forced to quickly adapt to a new health threatening situation by relying on new information. Drawing from protection-motivation and cognitive load theories, we formulated a structural model eliciting the impact of the three online information sources: (1) social media, (2) official websites, and (3) other online news sources; on motivation to adopt recommended COVID-19 preventive measures. The model was tested with the data collected from university employees and students (n = 225) in March 2020 through an online survey and analyzed using partial least square structural equation modeling (PLS-SEM). We observed that social media and other online news sources increased information overload amongst the online information sources. This, in turn, negatively affected individuals' self-isolation intention by increasing perceived response costs and decreasing response efficacy. The study highlights the role of online information sources on preventive behaviors during pandemics.

Spiritual Well-Being and Mental Health During the COVID-19 Pandemic in Italy

During the COVID-19 pandemic in Italy, people and families experienced a new and sudden situation that forced them to stay in their homes for a long period (February 25- May 26). In this context, many people found themselves in great difficulty, not only because of the fear of contagion or the economic problems deriving from the closure of production activities but also because the virus profoundly changed the way of life in society. The "Social distancing" concept became central in all personal relationships, including close family relationships. In this situation, our paper seeks to understand the role of spirituality and religiosity in reacting to this difficult situation and in particular on the physical and psychological health of the people involved. The data we present here are part of a multidisciplinary research with a quantitative theoretical framework. As the data was collected during the first Italian lockdown, a total of 1,250 adults from all over Italy participated in the on-line questionnaire. Among the main results it emerged that the participants perceived lower levels of spiritual well-being and mental health than the pre-pandemic situation with a significant gender difference; in fact, women perceived lower mental health than men. At the same time, it is evident that spirituality and religious practices are a protective factor connected not only with psychological and mental but also physical health. Finally, it appears evident that the family is a protective factor with respect to mental health, even in a period so full of stress factors, those who did not live alone and especially those who had to take care of small children reported higher perceived mental health and a greater ability to activate coping resources.