Psychophysiological restorative potential in cancer patients by virtual reality (VR)-based perception of natural environment

Virtual cycling in urban green and blue vs gray spaces: The efficacy of mental health and physical activity

OBJECTIVES

An urban environment may be stressful, potentially leading to poor mental health. Natural elements are important in urban environments with many restorative and potential health benefits compared to artificial elements. Virtual reality can simulate an urban environment in a digital world. The purpose of this study was to compare the different effects on mental health and physical activity outcomes between cycling in virtual urban green-blue and gray spaces.

STUDY DESIGN

A randomized controlled trial conducted from September 2021 to June 2022.

METHODS

In total, 62 participants were randomly assigned to either the green-blue or gray group. All participants received a virtual cycling intervention for 30 min per session, once a week for 12 weeks. Different 360° videos of urban views were shown on head-mounted display headsets between the two groups. Virtual green and blue spaces consisted of bike trails that passed through natural elements with landscapes and waterscapes, while virtual gray spaces consisted of bike trails that passed through more-artificial elements in cities. Outcomes at the baseline and post-intervention were measured by self-reported questionnaires and objective instruments.

RESULTS

Participants in the green-blue group had improved positive affect, perceived stress, and light-intensity physical activity compared to the gray group. Participants in the green-blue group had lower perceived exertion and virtual reality sickness, and higher enjoyment than those in the gray group.

CONCLUSIONS

Virtual reality cycling in the urban green and blue spaces is recommended for mental health and PA promotion for urban adult populations.

A nature-immersive virtual reality intervention to support hospice family caregivers: Qualitative findings from a pilot study

Objective

Family caregivers (FCGs) of cancer patients who are in hospice experience psychological challenges and poor quality of life (QOL) as a consequence of caregiving demands and anticipatory loss. Supportive interventions are needed. Exposure to nature offers a source of relaxation; however, FCGs are often homebound and have limited opportunities for respite. Technology-mediated nature experiences delivered via virtual reality (VR) may be an alternative. The purpose was to explore the perspectives of hospice FCGs who completed a nature-immersive VR intervention for the enhancement of their emotional health and QOL.

Methods

Nine scenes, including a tropical beach, green meadow, underwater ocean, and red savanna, were offered. Participants were asked to select one scene to view for a minimum of 10 minutes for five consecutive days at home. Semi-structured interviews were conducted via videoconferencing software and audio-taped, then transcribed, coded, and analyzed using content analysis.

Results

Nine participants (aged 33-76 years old) were interviewed. Two content categories included 1) feasibility and 2) acceptability. Participants reported ease-of-use and denied encountering difficulties. Scenes were relaxing and calming, providing mindfulness and escapism elements. Participants enjoyed the interactive, multisensory experience, offering views of wildlife and nature sounds. Two reported motion sickness and eye strain with longer use. Suggestions included extending the study duration and the option to explore other scenes.

Conclusions

Findings provide preliminary evidence for the efficacy of a nature-based VR intervention. Larger, diverse samples, with group randomization, are warranted. Technology-mediated nature experiences offer support for the emotional health and QOL of hospice FCGs.

Examining the audiovisual therapy effects on hospital groups of varying linear canopy landscapes and those with hydrodynamic forces

Recent research has highlighted the beneficial effects of urban green spaces on physical and mental health. This study focused on the hospital population and innovatively subdivided the population into four groups: doctors, caregivers, patients and nurses. A total of 96 volunteers participated in this virtual reality experiment to assess the restoration of a linear canopy landscape and a landscape with different levels of hydrodynamics through interactive audiovisual immersion. We utilized pre-research method, brainwave monitoring technique, psychological scales, observation and interviews in this experiment. The research identified five key findings. First, both linear canopy landscapes and those with low to medium hydrodynamic forces significantly enhance physiological and psychological restoration for all groups, with the most substantial physiological benefits observed in doctors and patients, and the greatest psychological relief noted in caregivers. Second, landscapes with medium hydrodynamic forces yield higher restorative effects than those with low forces in hospital settings. Third, green landscapes with medium and low-density canopies prove more conducive to patient recovery compared to those with high-density canopies. Fourth, the inclusion of bird songs does not markedly affect physiological restoration across the hospital groups. Finally, landscapes that incorporate elements of water dynamics, open skies, and lightly foliated canopies draw significant interest from all groups involved. This study advocates for the integration of natural blue and green elements into hospital environments as complementary therapeutic interventions, aiming to alleviate stress and promote health recovery among hospital communities.

Actual and Virtual Parks Benefit Quality of Life and Physical Activity: A Cluster Trial

Urban parks provide connectedness to nature as a health resilience environment for promoting health. Virtual reality can provide opportunities for urban citizens to be exposed to natural elements with health benefits. The purpose was to explore the effects of actual and virtual parks on the quality of life and physical activity of urban residents. The study design was a cluster trial. Participants were healthy adults aged 20-50 years, recruited from three college campuses, and randomly assigned to two experimental groups (n = 30, 32) and one control group (n = 30). The intervention with virtual or actual parks was conducted for 30 min a session once a week for 12 weeks. Outcomes were measured using self-reported questionnaires, including the World Health Organization Quality-of-Life Scale-BREF and International Physical Activity Questionnaire-Short Form. In total, 84 participants completed the interventions and post-intervention measures. Results showed that participants who experienced actual parks had significant increases in the social quality of life and light-intensity physical activity and had decreased body weight. Participants who experienced the virtual parks experienced a significant increase in their mental quality of life. Participants in the experimental groups of both kinds of parks had significant improvements in their self-rated health, physical and environmental quality of life, and sedentary time after the intervention. Urban parks are an important natural resource for citizens' health and physical activity promotion. Virtual parks can simulate actual parks and have similar health benefits and are thus are recommended for citizens who lack opportunities and motivation to go to actual parks.

Improving immersive experiences in virtual natural setting for public health and environmental design: A systematic review and meta-analysis of randomized controlled trials

In recent years, virtual reality (VR) technology has emerged as a powerful tool in the field of therapeutic landscapes. For hospitalized patients or individuals with limited mobility, VR provides highly personalized therapy by simulating authentic natural environments within a safe, convenient, and engaging setting. This study investigated the effectiveness of immersing patients in virtual natural environments for health recovery and compared the varying impacts of different types of landscapes on patients' recovery levels. The aim was to complement traditional medical approaches and enhance environmental design in the field of public health. Researchers systematically reviewed databases (January 2018 to August 2, 2023) to identify randomized controlled trials comparing the efficacy of virtual nature immersion with other treatments. The inclusion/exclusion criteria were established based on the population, intervention, comparison, outcomes, study design, and other aspects (expanded PICO) framework. The Cochrane tool was employed to assess the risk of bias. Meta-analysis was conducted by pooling the mean differences with a 95% confidence interval. Among 30 trials, a total of 2123 patients met the inclusion criteria, with 15 studies included in the meta-analysis. 30 trials met the criteria. Results show significant improvements in pain, anxiety, fear, and some physiological indicators with virtual nature-based treatments. On the other hand, natural scenes incorporating blue and green elements have been applied more extensively and have shown more significant effects. In comparison to conventional methods, this study strongly advocates that virtual reality environments are a crucial tool in bridging the gap between patients and nature, demonstrating their potential to reshape medical interventions and improve environmental design in the field of public health.