Integrating Immersive Virtual Reality With Savoring to Promote the Well-Being of Patients With Chronic Respiratory Diseases: Pilot Randomized Controlled Trial

Background: Chronic respiratory diseases (CRDs) are widespread pathologies that cause nonreversible airflow limitations as well as extrapulmonary adverse effects. These pathologies are related to frequent hospitalizations and consequently high levels of anxiety, depression, and stress. In this respect, immersive virtual reality (IVR) relaxation integrated with savoring, which is the ability to generate and amplify positive emotions, can enhance well-being and relaxation in patients with CRDs. Objective: This pilot randomized controlled trial aimed to investigate the effectiveness of a 2-week IVR-based relaxation intervention integrated with savoring in patients with CRDs for increasing emotional and psychological well-being, positive emotions, relaxation, and peripheral oxygen saturation (SpO2), and decreasing negative emotions. Methods: This study included 45 hospitalized patients with CRDs from the Pulmonary Rehabilitation Unit of Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale di Ricovero e Cura per Anziani (INRCA) Casatenovo. Alongside traditional pulmonary rehabilitation, the experimental group (n=23) took part in a 4-session IVR-based intervention, while the active control group (n=22) listened to relaxing music. In each session, the experimental group experienced a relaxing virtual scenario followed by a savoring exercise. Both groups completed self-reported questionnaires at 3 time points —preintervention/baseline (T0), postintervention (T1), and 1-month follow-up (T2)—as well as before and after each session. The experimental group’s IVR acceptance and sense of presence were also measured. Results: Regarding the primary outcomes, taking T0 and T1 into account, repeated measures analysis of covariance revealed significant increases for the experimental group in emotional well-being (P<.001; partial η2=0.398), psychological well-being (P<.001; partial η2=0.559), positive emotions (P<.001; partial η2=0.407), and relaxation (P<.001; partial η2=0.598), and a significant decrease in negative emotions (P<.001; partial η2=0.456) compared to the control group. Moreover, 2-tailed paired t tests, considering T0 and T2, revealed significant long-term psychological changes at T2 for the experimental group in emotional well-being (P=.046), psychological well-being (P=.03), and positive emotions (P=.005), whereas the control group reported no significant changes. Concerning secondary outcomes, no significant differences in SpO2 between the 2 groups were found, and patients in the experimental group reported high IVR acceptance and sense of presence. Conclusions: These results suggest that relaxing IVR integrated with savoring may promote well-being not only after the intervention but also in the long term. Savoring may have played a role in enhancing the positive effects of the IVR experience by helping patients focus on and amplify positive experiences, thereby mitigating the negative psychological impact of CRDs. However, the study design (control group was exposed only to relaxing music without a savoring component) precludes the ability to determine the specific contribution of each element (IVR and savoring). Future research should aim to disentangle these components in order to clarify their individual and combined effects.