Virtual Reality and Savoring to Promote Well-being of Patients With Chronic Respiratory Diseases: a Randomized Controlled Trial

Together with the 3-week traditional pulmonary rehabilitation in the hospital, the experimental group took part in the VR-based enhanced with savoring intervention. It lasted two weeks and included four 25-minute sessions, with two sessions per week. In each session, the experimental group experienced a 10-minute relaxing virtual scenario using the Oculus Quest 2 headset integrated with a narrative voice. The content of the narrative voiceover was not created specifically for this intervention. Moreover, participants completed a savoring exercise proposed through pre-recorded 5-minute audio after each virtual scenario to consolidate and amplify the positive emotions generated by the VR experience. Sessions usually took place on Mondays and Thursdays, starting in the second week of traditional pulmonary rehabilitation. They were administered by the researchers and occurred one-on-one. Direct observation was used to assess adherence to the intervention. The baseline assessment was done in a separate session earlier to avoid overloading the patients and occurred in the same week as starting the traditional pulmonary rehabilitation. In each session, participants were asked to sit down in a chair and experience the VR scenario and the following savoring exercise. In the first session, patients explored "the secret garden," guided by a relaxing narrative through a peaceful Japanese garden, including crossing a peaceful pond and passing cherry blossom trees. Following this, participants engaged in a savoring exercise, recalling positive emotions from the VR experience and savoring a positive memory where they felt similar emotions. The second session involved watching "the waterfall in the prairie," where patients enjoyed the sights and sounds of nature, including colorful flowers, quiet lakes, and distant village voices. After this, they were invited to recall the positive emotions felt in the VR experience and to savor a positive past event shared with a loved one. In the third session, participants were guided by the narrative voice along "the beach at sunset," observing the beauty of the sand, sea, and sunset hues, accompanied by the soothing sounds of waves and gentle wind. They were then prompted to recall positive emotions felt during the VR experience and imagine and savor a personal place connected to these emotions. Lastly, in the fourth session, patients chose and experienced their favorite scenario from previous sessions. Following that, they were guided through the exercises completed in the previous sessions to consolidate them.