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.