Robbemond Lisanne M, Nijland Jwh Mathijs, Alma Manna, Veling Wim, van Driel Catheleine Mg
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Med Internet Res. 2025 Jun 11;27:e65308. doi: 10.2196/65308.
Stress is a key transdiagnostic factor in the onset and recurrence of psychiatric disorders. Virtual reality (VR) in mental health care, particularly virtual natural environments, shows promising results in promoting relaxation, as evidenced by tools such as VRelax. While initial studies have demonstrated the efficacy of VRelax, further implementation in routine mental health care requires a systematic exploration of its use by patients. Understanding these perspectives can help tailor VR tools to meet the needs of users better and enhance their effectiveness in clinical settings.
This study aims to identify patient-perceived barriers to and facilitators of using VR relaxation as a self-management relaxation tool to support its implementation in mental health care.
Four focus groups were conducted with 19 participants with a wide range of psychiatric problems, including burnout, attention-deficit/hyperactivity disorder, anxiety disorder, depressive disorder, bipolar disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Participants were recruited via a network of people with lived experience, health care professionals, and social media. Semistructured interview guides with open-ended questions were used to investigate barriers and facilitators. People with psychiatric problems were instructed to use VRelax at home at least 3 times before the focus group discussions. Thematic analysis was conducted to identify barriers and facilitators.
The focus group discussions generated 7 themes with various subthemes. The sense of autonomy was identified as a facilitator, indicating users' experience of feeling in control and independent, which allowed them to manage and operate VRelax on their own. On the other hand, participants indicated that for optimal long-term use, there should be a balance between autonomy and structured guidance and integration into therapy. Perceived usefulness, ease of use, and immersive factors were identified as both barriers and facilitators. Participants had positive initial experiences with VRelax but also reported that the effects of virtual natural environments might diminish with continued use. Usefulness might vary by the phase of psychiatric problems and the individual's momentary emotional state. Participants saw the plug-and-play design of VRelax as helpful but also indicated the importance of easy navigation within the program, including the ability to quickly find specific natural environments. Three barriers were identified: shortcomings in user guidance; perceived problems in transitioning back to reality; and physical hindrances, such as the discomfort caused by the VR glasses.
For optimal implementation of VR relaxation in mental health care, personalized VR experiences should be facilitated, such as offering a specific selection of virtual natural environments based on the momentary emotional state, while fostering user autonomy. Integration of VR tools into ongoing treatment is important, aligning with shared decision-making principles. In addition, reducing the steps required during the starting and the closing processes is crucial, alongside addressing challenges such as physical discomfort and inadequate instructions.
压力是精神疾病发作和复发的关键跨诊断因素。心理健康护理中的虚拟现实（VR），尤其是虚拟自然环境，在促进放松方面显示出有前景的结果，如VRelax等工具所证明的那样。虽然初步研究已经证明了VRelax的有效性，但在常规心理健康护理中的进一步实施需要系统地探索患者对其的使用情况。了解这些观点有助于定制VR工具，以更好地满足用户需求并提高其在临床环境中的有效性。
本研究旨在确定患者感知到的使用VR放松作为自我管理放松工具的障碍和促进因素，以支持其在心理健康护理中的实施。
对19名有广泛精神问题的参与者进行了四个焦点小组讨论，这些问题包括职业倦怠、注意力缺陷多动障碍、焦虑症、抑郁症、双相情感障碍、强迫症和创伤后应激障碍。参与者通过有生活经验的人群网络、医疗保健专业人员和社交媒体招募。使用带有开放式问题的半结构化访谈指南来调查障碍和促进因素。有精神问题的人在焦点小组讨论前被要求在家中至少使用3次VRelax。进行主题分析以确定障碍和促进因素。
焦点小组讨论产生了7个主题及各种子主题。自主性被确定为一个促进因素，表明用户有掌控感和独立感，这使他们能够自行管理和操作VRelax。另一方面，参与者表示，为了实现最佳长期使用，自主性与结构化指导以及融入治疗之间应保持平衡。感知有用性、易用性和沉浸因素既被确定为障碍，也被确定为促进因素。参与者对VRelax有积极的初始体验，但也报告说虚拟自然环境的效果可能会随着持续使用而减弱。有用性可能因精神问题的阶段和个人的瞬时情绪状态而异。参与者认为VRelax的即插即用设计很有帮助，但也指出了程序内易于导航的重要性，包括快速找到特定自然环境的能力。确定了三个障碍：用户指导方面的不足；感知到的回归现实的问题；以及身体障碍，如VR眼镜造成的不适。
为了在心理健康护理中最佳地实施VR放松，应促进个性化的VR体验，例如根据瞬时情绪状态提供特定的虚拟自然环境选择，同时培养用户自主性。将VR工具整合到正在进行的治疗中很重要，这符合共同决策原则。此外，减少开始和结束过程中所需的步骤至关重要，同时要解决身体不适和指导不足等挑战。
