[Feasibility of a virtual reality (VR)-supported mindfulness intervention for patients with cancer during...

Psychological interventions delivered during chemotherapy can help cancer patients reduce their subjective distress. The use of virtual reality (VR) may enhance their effectiveness. This study aimed to evaluate the feasibility and acceptability of a VR-based mindfulness intervention during outpatient chemotherapy.In a monocentric, three-arm randomized controlled trial, patients with cancer undergoing treatment in the outpatient chemotherapy unit of an oncology center were randomized to one of three groups: (a) VR-based mindfulness intervention, (b) receptive music intervention, or (c) control group. Interventions were delivered during two consecutive chemotherapy sessions. Feasibility was assessed through standardized screening information collected prior to recruitment and structured participant observation during the interventions; acceptability was measured using a post-intervention questionnaire.Of 3,072 patients approached, 1,590 formally met the inclusion criteria, and N=85 were enrolled (participation rate: 5.4%). Common reasons for non-participation included wearing a cooling cap, language barriers, lack of interest, and reliance on personal coping strategies. Both interventions were feasible; disruptions during sessions were common. The VR-based mindfulness intervention required substantial personnel support. Despite overall positive ratings from participants, VR mindfulness did not show higher acceptability than music.The high proportion of non-participating patients may indicate that an active VR-based mindfulness intervention during chemotherapy infusion is not well aligned with patient needs and may be experienced as potentially overwhelming. Its benefits might be better realized at a different point in the care trajectory (e. g., at home, between sessions) or later after treatment completion (survivorship phase). For immediate relief during chemotherapy, music interventions appear to be a simpler, more easily implemented alternative.Integrating digital psychological interventions into routine oncology care requires stronger consideration of patients' specific needs and the situational and organizational contexts in which these interventions are delivered.