A mechanism-oriented immersive virtual reality intervention for psychological distress and helplessness-related processes in hospitalized older adults: study protocol for a multicenter randomized controlled trial
6 affiliations
- 1Future Care Lab, Moholy-Nagy University of Art and Design, Budapest, Hungary
- 2Mental Health Sciences Division, Doctoral College, Semmelweis University, Budapest, Hungary
- 3Department of Rehabilitation Medicine, Semmelweis University, Budapest, Hungary
- 4Department of Geriatrics and Nursing Science, Semmelweis University, Budapest, Hungary
- 5Department of Neurosurgery, University of Szeged, Szeged, Hungary
- 6Uzsoki Hospital, Budapest, Hungary
Abstract
BackgroundProlonged hospitalization in older adults may contribute to reduced autonomy, passivity, diminished perceived control, and psychological distress. Although hospitalization does not necessarily lead to learned helplessness, it may create conditions that increase vulnerability to helplessness-related processes in some patients, particularly when opportunities for self-directed action and visible action–outcome contingencies are limited. Immersive virtual reality (VR) may offer opportunities for safe, accessible, and meaningful interaction in otherwise constrained hospital environments; however, the added value of interactive, agency-supporting VR components remains insufficiently studied in hospitalized older adults.ObjectiveThis study aims to evaluate the effectiveness of Zenctuary VR+, a mechanism-oriented, nature-based immersive VR intervention, in reducing psychological distress among hospitalized older adults compared with a passive VR control condition. Secondary aims are to explore changes in helplessness-related constructs, including self-efficacy, self-esteem, hopelessness, depressive symptoms, and learned helplessness.Methods and analysisThis is a multicenter, parallel-group, assessor-blinded randomized controlled trial conducted in inpatient hospital settings in Hungary. A total of 100 hospitalized adults aged 60 years or older will be randomly assigned in a 1:1 ratio to either the active Zenctuary VR+ intervention or a passive VR control condition. Both groups will receive six VR sessions over three weeks, delivered twice weekly using the same head-mounted display and the same nature-based virtual environments. The active intervention includes optional low-cognitive-load interactive activities designed to support agency, perceived control, and successful action, whereas the control condition involves passive observation of the same virtual environments without interactive elements. Assessments will be conducted at baseline, post-intervention, and four-week follow-up. The primary outcome is psychological distress measured by the Hospital Anxiety and Depression Scale total score. The primary analysis will use a linear mixed model to examine group-by-time effects. Secondary and mechanism-related analyses will be considered exploratory.Ethics and disseminationThe study has received national ethical and regulatory approval in Hungary from the National Centre for Public Health and Pharmacy. The trial has been registered at ClinicalTrials.gov (NCT07712549). Results will be disseminated through peer-reviewed publications, conference presentations, and project-related dissemination activities.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT07712549, ClinicalTrials.gov: NCT07712549.
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BibTeX
@article{szabo2026mechanismoriented,
title = {{A mechanism-oriented immersive virtual reality intervention for psychological distress and helplessness-related processes in hospitalized older adults: study protocol for a multicenter randomized controlled trial}},
author = {Pál Tamás Szabó and Beáta Réka Vásárhelyi and Beáta Réka Vásárhelyi and Patrícia Lajkó and Patrícia Lajkó and Mona Stankovic and Márta Fekete and Beáta Pintérné Sosity and Samuel Chovanec and Ágnes Karolina Bakk},
journal = {Frontiers in Medical Technology},
year = {2026},
month = oct,
doi = {10.3389/fmedt.2026.1940940},
url = {https://doi.org/10.3389/fmedt.2026.1940940},
note = {CC BY},
}
RIS
TY - JOUR
TI - A mechanism-oriented immersive virtual reality intervention for psychological distress and helplessness-related processes in hospitalized older adults: study protocol for a multicenter randomized controlled trial
AU - Pál Tamás Szabó
AU - Beáta Réka Vásárhelyi
AU - Beáta Réka Vásárhelyi
AU - Patrícia Lajkó
AU - Patrícia Lajkó
AU - Mona Stankovic
AU - Márta Fekete
AU - Beáta Pintérné Sosity
AU - Samuel Chovanec
AU - Ágnes Karolina Bakk
PY - 2026
DA - 2026/10/26
JO - Frontiers in Medical Technology
DO - 10.3389/fmedt.2026.1940940
UR - https://doi.org/10.3389/fmedt.2026.1940940
AB - BackgroundProlonged hospitalization in older adults may contribute to reduced autonomy, passivity, diminished perceived control, and psychological distress. Although hospitalization does not necessarily lead to learned helplessness, it may create conditions that increase vulnerability to helplessness-related processes in some patients, particularly when opportunities for self-directed action and visible action–outcome contingencies are limited. Immersive virtual reality (VR) may offer opportunities for safe, accessible, and meaningful interaction in otherwise constrained hospital environments; however, the added value of interactive, agency-supporting VR components remains insufficiently studied in hospitalized older adults.ObjectiveThis study aims to evaluate the effectiveness of Zenctuary VR+, a mechanism-oriented, nature-based immersive VR intervention, in reducing psychological distress among hospitalized older adults compared with a passive VR control condition. Secondary aims are to explore changes in helplessness-related constructs, including self-efficacy, self-esteem, hopelessness, depressive symptoms, and learned helplessness.Methods and analysisThis is a multicenter, parallel-group, assessor-blinded randomized controlled trial conducted in inpatient hospital settings in Hungary. A total of 100 hospitalized adults aged 60 years or older will be randomly assigned in a 1:1 ratio to either the active Zenctuary VR+ intervention or a passive VR control condition. Both groups will receive six VR sessions over three weeks, delivered twice weekly using the same head-mounted display and the same nature-based virtual environments. The active intervention includes optional low-cognitive-load interactive activities designed to support agency, perceived control, and successful action, whereas the control condition involves passive observation of the same virtual environments without interactive elements. Assessments will be conducted at baseline, post-intervention, and four-week follow-up. The primary outcome is psychological distress measured by the Hospital Anxiety and Depression Scale total score. The primary analysis will use a linear mixed model to examine group-by-time effects. Secondary and mechanism-related analyses will be considered exploratory.Ethics and disseminationThe study has received national ethical and regulatory approval in Hungary from the National Centre for Public Health and Pharmacy. The trial has been registered at ClinicalTrials.gov (NCT07712549). Results will be disseminated through peer-reviewed publications, conference presentations, and project-related dissemination activities.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT07712549, ClinicalTrials.gov: NCT07712549.
SN - 2673-3129
ER -