None listed
Conditions
Brief summary
In intensive care units (ICUs), patients are subject to many treatments, which may limit mobility and result in sensory overload and disorientation. More importantly, they have reduced social interaction, which can result in substantial emotional distress. The extended ICU stay often results in long-term psychological consequences, including anxiety, depression, and post-traumatic stress disorder. Although medications can be used, there is increasing uptake of non-pharmacological interventions (i.e. other than medications) to manage these stressors, with Virtual Reality (VR) emerging as a promising solution. VR offers immersive, interactive environments that temporarily distract patients from their surroundings, promoting calmness and emotional regulation. While VR has been used in healthcare (e.g. medical training, pain distraction), it has not been used in ICU. Early studies suggest that VR may reduce stress and anxiety, but its implementation is not standardised, making it difficult to make a clear stand. As such, a structured evaluation of VR’s therapeutic potential in ICUs is needed. This study will help develop standardised VR protocols for ICUs and support future innovation by involving early-career researchers across health, design, and technology. Findings will be shared at conferences and published in high-impact journals to guide future clinical adoption and large-scale implementation.
Interventions
Exposure: Adult patients (aged 18–80 years) admitted to the ICU for greater than or equal to 48 hours and requiring critical care support (e.g., vasopressors, non-invasive ventilation, high-flow nasal oxygen, renal replacement therapy, or post-extubation).
Intervention: Participants in the experimental group will engage with a gamified and interactive Virtual Reality (VR) program delivered using a Pico 4 Enterprise headset with disposable infection-control covers and noise-isolating earphones.
Exposure: Adult patients (aged 18–80 years) admitted to the ICU for greater than or equal to 48 hours and requiring critical care support (e.g., vasopressors, non-invasive ventilation, high-flow nasal oxygen, renal replacement therapy, or post-extubation). Intervention: Participants in the experimental group will engage with a gamified and interactive Virtual Reality (VR) program delivered using a Pico 4 Enterprise headset with disposable infection-control covers and noise-isolating earphones. A connected laptop will record session data and vital signs. Procedures and activities: Each session will include (1) passive visual scenes with audio, (2) narrative-guided relaxation content, and (3) light interactive modules (e.g., arranging objects, simple puzzle tasks). The content is designed to accommodate ICU patients’ limited mobility. Frequency and duration: Up to three VR sessions per day for four ICU days, depending on clinical status and tolerance. Each session will last approximately 15 minutes. Training and instructions: A short (5-minute) verbal explanation of the headset and activities will be provided by a trained research assistant or ICU nurse immediately prior to the first session. Supervision: All sessions will be supervised by ICU nurses and/or research assistants, who will assist with headset fitting, remain present to monitor patient safety and comfort, and remove the headset immediately if the participant wishes to discontinue or experiences discomfort. Choice of VR content: Participants will be offered three sets of modules: a passive experience with only the environment, ambient music, and sounds; a narrative-guided experience; an interactive experience where participants can engage with objects, activate scenes, complete puzzle challenges, and move through the story at their own pace, becoming active participants in the narrative). Participants will get a chance to choose which module suits them best, depending on their mental state, energy level, or mood that day (nature exploration, relaxation, light games). If unable to choose, a default calming narrative module will be provided. Monitoring and adherence: Session duration, frequency, and adherence will be recorded automatically by the headset and logged by research staff. Vital signs and eye-tracking will be monitored in real time to assess alertness and detect any adverse reactions.
Sponsors
Monash Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Adults aged 18–80 years. Admitted to ICU and expected to remain greater than or equal to 48 hours. Richmond Agitation-Sedation Scale (RASS) of -1 to +1 at enrolment. Fluent in English Able to provide informed consent.
Exclusion criteria
Neurological or psychiatric illness. Claustrophobia, agoraphobia. Hearing or vision impairment. Confusion or GCS <10. Non-English speaking. Anticipated ICU stay <48 hours. Refusal to participate.
Outcome results
None listed