Virtual Reality for Delirium Prevention in Intensive Care Unit Nurses and Mechanically Ventilated Patients:...

Patients in the intensive care unit (ICU) who are on mechanical ventilation are at high risk of developing delirium. Virtual reality (VR) technology, as an emerging intervention method, shows promising application prospects in delirium prevention, but its specific experience in clinical practice still requires in-depth exploration.

This study aims to explore the real experiences of ICU nurses and mechanically ventilated patients in participating in VR delirium prevention, with the aim of providing practical evidence for the optimization and application of this technology in clinical practice.

A descriptive qualitative research design was adopted. From March to June 2025, using purposive sampling, participants were selected from the internal medicine, surgery, central, and respiratory ICU departments of a tertiary hospital in Zhengzhou. A total of 73 patients on mechanical ventilation were screened. Among them, 49 were excluded due to not meeting the Richmond Agitation-Sedation Scale (RASS) or Barthel Index (BI) score criteria, 5 had delirium at the time of enrollment, 1 was excluded due to visual impairment, and 2 voluntarily withdrew during the study. Finally, 16 patients on mechanical ventilation and 16 nurses were included for semistructured interviews. Data analysis was conducted using the inductive content analysis method.

Through the analysis of the interview data, a total of 3 main themes and 14 subthemes were extracted. In terms of perceived benefits, patients experienced an immersive environment and a sense of empowerment driven by tasks, while nurses felt the convenience of resource integration, the intimacy of the nurse-patient relationship, and a sense of professional significance. In terms of perceived challenges, patients faced difficulties with the interaction interface and physical and mental obstacles, while nurses encountered difficulties in communication assessment and responsibility definition. In terms of perceived needs, patients expected personalized content design and continuity of nursing services, while nurses suggested differentiated content adjustment, comprehensive functional integration, and standardized safety management.

The participants expressed a positive attitude towards the prevention of delirium based on VR and reported various perceived benefits, challenges, and needs. Future research should prioritize content personalization, functional integration, and safety management. Meanwhile, it is necessary to recognize the limitations of this technology in specific target populations. For those who do not meet the inclusion criteria, adaptive alternative intervention measures should be developed to promote the precise and sustainable application of VR-based delirium prevention.