Acute Effects of a Five-Minute Virtual Reality Nature Microbreak on Autonomic Function and Mood in Healthcare Workers

Objective The objective of this study is to investigate the acute effects of a five-minute virtual reality (VR) nature microbreak on autonomic function and mood in healthcare workers (HCWs). Methods Seventeen HCWs from an orthopedic outpatient clinic (mean ± SD age, 30.9 ± 7.9 years) completed a single-group crossover pilot study. Participants performed (i) a VR-guided paced breathing session displaying 360° natural scenery (VR condition) and (ii) an eyes-closed (EC) paced breathing session using an eye mask (EC condition) on separate days, at least 24 hours apart, during the same time slot (15:00-16:00). Breathing tempo was fixed at six breaths · min⁻¹ (four-second inhalation and six-second exhalation) using an auditory metronome. Five-minute photoplethysmographic heart rate variability (lnRMSSD, lnHF, lnTP, and lnLF/HF) and the short form of the Two-Dimensional Mood Scale (TDMS ST: Vitality, Stability, Pleasure, and Arousal) were recorded pre- and post-intervention. Post-pre differences were compared between conditions using paired t-tests. Effect sizes are expressed as Hedges' g or Wilcoxon's r. Results VR produced small, nonsignificant increases in autonomic indices (HF 0.17 ± 0.67 vs -0.05 ± 0.71 log ms²; t(16) = 1.35, p = 0.20, g = 0.31). Significant improvements were observed in the following TDMS subscales: Vitality (0.88 ± 3.22 vs -1.88 ± 3.98; p = 0.015, g = 0.63), Stability (4.53 ± 3.59 vs 2.12 ± 1.83; p = 0.025, g = 0.57), and Pleasure (5.41 ± 5.11 vs 0.24 ± 3.65; p = 0.005, g = 0.75). Arousal showed no significant difference (Z = -0.20, p = 0.84, r = 0.05). Conclusions A brief VR nature microbreak with paced breathing elicited medium-to-large improvements in subjective vitality, stability, and pleasure compared to conventional EC breathing, while producing only small, nonsignificant enhancements in parasympathetic HRV. VR microbreaks represent a feasible, low-cost, low-time intervention to boost immediate well-being in HCWs; however, larger and longer-term trials are warranted to confirm their physiological benefits and sustainability.