Feasibility, effectiveness and patient experience of virtual reality technology in intensive care units patients: A mixed-methods systematic review.

Background: Adults in critical care units endure intense anxiety, pain and functional decline; novel adjunctive therapies are urgently needed. Virtual reality has shown promise as a non-pharmacological intervention, yet its feasibility, effectiveness and patient experience require comprehensive synthesis. Objective: To integrate quantitative and qualitative evidence on the feasibility, effectiveness and experience of virtual reality among critically ill adults. Methods: Adhering to PRISMA guidelines, we systematically searched multiple databases from inception to March 19, 2025, for quantitative, qualitative, and mixed-methods studies on virtual reality interventions in adult intensive care unit patients. A convergent segregated approach was employed: quantitative data were narratively synthesized, qualitative data were thematically analyzed, and both sets of evidence were integrated to develop an in-depth understanding of virtual reality application. Results: Nineteen studies were included. Quantitative evidence indicated that virtual reality was generally safe, with no serious adverse events reported. Regarding effectiveness, virtual reality interventions effectively alleviate patient anxiety, improve sleep quality, and show positive effects in promoting early functional recovery and cognitive function. However, the effect of virtual reality on pain was heterogeneous. Qualitative data revealed high patient acceptance and satisfaction with the virtual reality experience, noting that it provided relaxation and pleasure, and enhanced a sense of autonomy and environmental control. Nevertheless, some patients reported issues such as device discomfort and the need for optimization in intervention duration and content. Conclusion: Virtual reality technology serves as a useful adjunct tool for improving psychological distress and functional recovery in intensive care unit patients, with overall good safety and patient acceptance. However, its successful implementation is not merely a technical issue but a complex process requiring precise alignment with individual needs and overcoming human-device interaction barriers. Future research should focus on developing personalized virtual reality interventions and exploring optimal implementation strategies in real-world intensive care unit settings.