Effectiveness of Nature-Based Immersive Virtual Reality on Health Outcomes in Breast Cancer Patients: A Systematic...

Breast cancer patients frequently experience psychological burdens such as anxiety, depression, and distress, alongside physical symptoms like fatigue. Immersive virtual reality (IVR), particularly nature-based experiences, may provide a scalable, nonpharmacological adjunct to promote well-being by fostering relaxation, distraction, and positive affect. However, the effectiveness of nature-based IVR in this population remains uncertain.

To evaluate the effectiveness of nature-based immersive virtual reality trials on psychological and physical health outcomes in breast cancer patients.

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted in seven databases from inception to July 31, 2025. Two reviewers independently screened articles, extracted data, and assessed study quality. RevMan 5.3 was used for risk of bias assessment and meta-analysis. The review was registered with PROSPERO (CRD420251123651).

Eleven studies were included; nine contributed data to the meta-analysis (n = 1037). Interventions employed two primary formats: exposure to static, nature-based environments (e.g., forests) accompanied by calming music, and interactive experiences that allowed patients to virtually explore the natural environment. The findings revealed several benefits, including reduced anxiety (n = 7; SMD = -1.76, 95% CI -2.61 to -0.91; I² = 94%, p < 0.01; low certainty) and distress (n = 3; SMD = -0.83, 95% CI -1.30 to -0.36; I² = 83%, p < 0.01; low certainty).

For breast cancer patients, nature-based IVR may be considered as a promising supportive care intervention to reduce anxiety and distress. Clinicians may offer brief sessions (5-20 min) during chemotherapy infusion, radiotherapy waiting periods, perioperative recovery, and survivorship visits using head-mounted displays with calming, nature content.