Exploring virtual reality for stress and anxiety management in intensive care settings: perspectives from intensive care professionals

Tjasa Savoric; Nik Savoric; Kaja Antlej; Sylvester Arnab; Sushma Ashwin; Brittany Cann; Jonathan Devine; Amanda Hirst; Kerrianne  Huynh; Karena Watson; Ashwin Subramaniam

doi:10.1111/imj.70453

Exploring virtual reality for stress and anxiety management in intensive care settings: perspectives from intensive care professionals

Tjasa Savoric
, Nik Savoric
, Kaja Antlej
, Sylvester Arnab
, Sushma Ashwin
, Brittany Cann
, Jonathan Devine
, Amanda Hirst
, Kerrianne Huynh
, Karena Watson
, Ashwin Subramaniam

Research Centre for Arts and Creative Cultures

Deakin University
VRmadillo Ltd.
Peninsula Health
The Australian College of Critical Care Nurses
Monash Health
Cabrini Health
Epworth HealthCare
Monash University
Maroondah Hospital
Dandenong Hospital
Epworth Hospital

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
Psychological distress is highly prevalent among patients in intensive care units (ICUs), yet current management remains predominantly pharmacological and often insufficient to address emotional and cognitive wellbeing. Virtual reality (VR) is emerging as a potential non-pharmacological adjunct for stress and anxiety reduction in critical care.

Aims
To explore ICU professionals' perspectives on the design, feasibility and clinical integration of a gamified, art-based VR prototype intended to support psychological wellbeing and reduce stress and anxiety in ICU patients.

Methods
Qualitative study using a semi-structured focus group and thematic analysis.

Interventions
Seven ICU participants (three doctors, three nurses, one allied health clinician) trialled an early-stage VR prototype designed for ICU patients that included narrative-driven content, artistic environments and planned accessibility features such as eye-tracking and multiple modes of engagement.

Outcome Measures
ICU professionals' perspectives on VR's therapeutic potential, recommended content features, perceived facilitators and barriers to implementation and strategies for clinical integration.

Results
Seven themes emerged. Participants viewed VR as a calming, purposeful form of diversional therapy offering emotional escape, cognitive engagement and restoration of patient agency. Flexible content modes and opportunities for personalisation were valued, as were accessibility features such as eye-tracking. For implementation, participants emphasised clear infection-control workflows, reliable device-management processes and basic staff training. A phased introduction, beginning with carefully selected patient groups, was recommended before broader clinical adoption.

Conclusions
ICU professionals consider VR a promising adjunct to support emotional wellbeing in ICU, provided it is purpose-built, flexible, personalised and integrated smoothly into clinical routines. Their insights offer actionable guidance for refining and piloting this VR intervention within ICU settings.

Original language	English
Pages (from-to)	1051-1058
Number of pages	8
Journal	Internal Medicine Journal
Volume	56
Issue number	6
Early online date	4 May 2026
DOIs	https://doi.org/10.1111/imj.70453
Publication status	Published - Jun 2026

Bibliographical note

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium,provided the original work is properly cited and is not used for commercial purposes.

Funding

The authors would like to thank Professor Ben Horan, Professor Louise Moody and Dr. Bahareh Nakisa for their valuable input on the focus group design and constructive feedback during the development and presentation of this study. The authors would also like to thank ACCCN for endorsing the focus group and distributing it to their respective members. Special thanks are extended to the staff of VRmadillo Ltd. for their contribution to the design and technical development of the VR intervention. We wish to thank all the participants for sharing their experiences. Open access publishing facilitated by Deakin University, as part of the Wiley - Deakin University agreement via the Council of Australasian University Librarians

Funders
Council of Australasian University Librarians

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

anxiety
intensive care unit
non-pharmacological interventions
stress
virtual reality

Access to Document

10.1111/imj.70453Licence: CC BY-NC

Savoric2026VoRFinal published version, 1.16 MBLicence: CC BY-NC

Cite this

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title = "Exploring virtual reality for stress and anxiety management in intensive care settings: perspectives from intensive care professionals",

abstract = "Background Psychological distress is highly prevalent among patients in intensive care units (ICUs), yet current management remains predominantly pharmacological and often insufficient to address emotional and cognitive wellbeing. Virtual reality (VR) is emerging as a potential non-pharmacological adjunct for stress and anxiety reduction in critical care. Aims To explore ICU professionals' perspectives on the design, feasibility and clinical integration of a gamified, art-based VR prototype intended to support psychological wellbeing and reduce stress and anxiety in ICU patients. Methods Qualitative study using a semi-structured focus group and thematic analysis. Interventions Seven ICU participants (three doctors, three nurses, one allied health clinician) trialled an early-stage VR prototype designed for ICU patients that included narrative-driven content, artistic environments and planned accessibility features such as eye-tracking and multiple modes of engagement. Outcome Measures ICU professionals' perspectives on VR's therapeutic potential, recommended content features, perceived facilitators and barriers to implementation and strategies for clinical integration. Results Seven themes emerged. Participants viewed VR as a calming, purposeful form of diversional therapy offering emotional escape, cognitive engagement and restoration of patient agency. Flexible content modes and opportunities for personalisation were valued, as were accessibility features such as eye-tracking. For implementation, participants emphasised clear infection-control workflows, reliable device-management processes and basic staff training. A phased introduction, beginning with carefully selected patient groups, was recommended before broader clinical adoption. Conclusions ICU professionals consider VR a promising adjunct to support emotional wellbeing in ICU, provided it is purpose-built, flexible, personalised and integrated smoothly into clinical routines. Their insights offer actionable guidance for refining and piloting this VR intervention within ICU settings.",

keywords = "anxiety, intensive care unit, non-pharmacological interventions, stress, virtual reality",

author = "Tjasa Savoric and Nik Savoric and Kaja Antlej and Sylvester Arnab and Sushma Ashwin and Brittany Cann and Jonathan Devine and Amanda Hirst and Kerrianne Huynh and Karena Watson and Ashwin Subramaniam",

note = "This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium,provided the original work is properly cited and is not used for commercial purposes.",

year = "2026",

month = jun,

doi = "10.1111/imj.70453",

language = "English",

volume = "56",

pages = "1051--1058",

journal = "Internal Medicine Journal",

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T1 - Exploring virtual reality for stress and anxiety management in intensive care settings

T2 - perspectives from intensive care professionals

AU - Savoric, Tjasa

AU - Savoric, Nik

AU - Antlej, Kaja

AU - Arnab, Sylvester

AU - Ashwin, Sushma

AU - Cann, Brittany

AU - Devine, Jonathan

AU - Hirst, Amanda

AU - Huynh, Kerrianne

AU - Watson, Karena

AU - Subramaniam, Ashwin

N1 - This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium,provided the original work is properly cited and is not used for commercial purposes.

PY - 2026/6

Y1 - 2026/6

N2 - Background Psychological distress is highly prevalent among patients in intensive care units (ICUs), yet current management remains predominantly pharmacological and often insufficient to address emotional and cognitive wellbeing. Virtual reality (VR) is emerging as a potential non-pharmacological adjunct for stress and anxiety reduction in critical care. Aims To explore ICU professionals' perspectives on the design, feasibility and clinical integration of a gamified, art-based VR prototype intended to support psychological wellbeing and reduce stress and anxiety in ICU patients. Methods Qualitative study using a semi-structured focus group and thematic analysis. Interventions Seven ICU participants (three doctors, three nurses, one allied health clinician) trialled an early-stage VR prototype designed for ICU patients that included narrative-driven content, artistic environments and planned accessibility features such as eye-tracking and multiple modes of engagement. Outcome Measures ICU professionals' perspectives on VR's therapeutic potential, recommended content features, perceived facilitators and barriers to implementation and strategies for clinical integration. Results Seven themes emerged. Participants viewed VR as a calming, purposeful form of diversional therapy offering emotional escape, cognitive engagement and restoration of patient agency. Flexible content modes and opportunities for personalisation were valued, as were accessibility features such as eye-tracking. For implementation, participants emphasised clear infection-control workflows, reliable device-management processes and basic staff training. A phased introduction, beginning with carefully selected patient groups, was recommended before broader clinical adoption. Conclusions ICU professionals consider VR a promising adjunct to support emotional wellbeing in ICU, provided it is purpose-built, flexible, personalised and integrated smoothly into clinical routines. Their insights offer actionable guidance for refining and piloting this VR intervention within ICU settings.

AB - Background Psychological distress is highly prevalent among patients in intensive care units (ICUs), yet current management remains predominantly pharmacological and often insufficient to address emotional and cognitive wellbeing. Virtual reality (VR) is emerging as a potential non-pharmacological adjunct for stress and anxiety reduction in critical care. Aims To explore ICU professionals' perspectives on the design, feasibility and clinical integration of a gamified, art-based VR prototype intended to support psychological wellbeing and reduce stress and anxiety in ICU patients. Methods Qualitative study using a semi-structured focus group and thematic analysis. Interventions Seven ICU participants (three doctors, three nurses, one allied health clinician) trialled an early-stage VR prototype designed for ICU patients that included narrative-driven content, artistic environments and planned accessibility features such as eye-tracking and multiple modes of engagement. Outcome Measures ICU professionals' perspectives on VR's therapeutic potential, recommended content features, perceived facilitators and barriers to implementation and strategies for clinical integration. Results Seven themes emerged. Participants viewed VR as a calming, purposeful form of diversional therapy offering emotional escape, cognitive engagement and restoration of patient agency. Flexible content modes and opportunities for personalisation were valued, as were accessibility features such as eye-tracking. For implementation, participants emphasised clear infection-control workflows, reliable device-management processes and basic staff training. A phased introduction, beginning with carefully selected patient groups, was recommended before broader clinical adoption. Conclusions ICU professionals consider VR a promising adjunct to support emotional wellbeing in ICU, provided it is purpose-built, flexible, personalised and integrated smoothly into clinical routines. Their insights offer actionable guidance for refining and piloting this VR intervention within ICU settings.

KW - anxiety

KW - intensive care unit

KW - non-pharmacological interventions

KW - stress

KW - virtual reality

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DO - 10.1111/imj.70453

M3 - Article

SN - 1445-5994

VL - 56

SP - 1051

EP - 1058

JO - Internal Medicine Journal

JF - Internal Medicine Journal

IS - 6

ER -

Exploring virtual reality for stress and anxiety management in intensive care settings: perspectives from intensive care professionals

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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Perspectives of intensive care professionals on psychological stressors, support strategies, and the potential of virtual reality in critical care

Systematic review: The impact of virtual reality interventions on stress and anxiety in intensive care units

Cite this