PIONEERING XR TECHNOLOGY FOR THE PROMOTION OF RESILIENCE AND MENTAL HEALTH OF THE HEALTHCARE WORKFORCE
XR2ESILIENCE
A Pragmatic Randomized Controlled Trial Study Protocol: XR2ESILIENCE - PIONEERING XR TECHNOLOGY FOR THE PROMOTION OF RESILIENCE AND MENTAL HEALTH OF THE HEALTHCARE WORKFORCE
1 other identifier
interventional
232
5 countries
8
Brief Summary
This study investigates the effectiveness of an extended reality (XR) based resilience training program designed to support the mental health and well-being of nurses working in hospital settings. Nurses are exposed to high emotional, cognitive, and organizational demands and show elevated levels of work-related stress and stress-associated mental health problems. Strengthening resilience and coping capacities is therefore an important preventive approach to support nurses' well-being and sustain quality of care. The study is conducted as a pragmatic randomized controlled trial with a waitlist control group and includes approximately 232 nurses from hospitals in several European countries. Participants are randomly assigned either to an XR-based resilience training group or to a waitlist control group that continues with care as usual during the waiting period. The XR-based intervention consists of eight immersive training sessions delivered over approximately ten weeks using a head-mounted display. The training focuses on behavioral, cognitive, and emotional coping strategies and aims to enhance key resilience factors such as problem-solving, cognitive reappraisal, emotion regulation, and positive self-care. The primary outcome is perceived stress, assessed using the Perceived Stress Scale. Secondary outcomes include resilience, occupational self-efficacy, quality of life, psychological distress, burnout symptoms, coping strategies, work-related rumination, and turnover intentions. Assessments are conducted at baseline, post-intervention, and at a 20-week follow-up. In addition, a subgroup of participants will optionally provide physiological data during selected XR sessions to explore digital biomarkers related to stress and recovery. The findings of this study will provide evidence on the effectiveness, feasibility, and acceptance of XR-based resilience training for nurses and inform future implementation of digital mental health interventions in healthcare workplaces.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Sep 2026
8 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
April 15, 2026
CompletedFirst Posted
Study publicly available on registry
April 22, 2026
CompletedStudy Start
First participant enrolled
September 1, 2026
ExpectedPrimary Completion
Last participant's last visit for primary outcome
March 1, 2028
Study Completion
Last participant's last visit for all outcomes
March 1, 2028
April 22, 2026
December 1, 2025
1.5 years
April 15, 2026
April 15, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Perceived Stress
Perceived stress measured using the 10-item Perceived Stress Scale (PSS-10). The PSS-10 assesses the degree to which situations in one's life are appraised as stressful during the past month. Scores range from 0 to 40, with higher scores indicating higher perceived stress.
Baseline and 10 weeks post-randomization
Secondary Outcomes (8)
Resilience
Baseline, 10 weeks post-randomization and 20 weeks post-randomization
Occupational self-efficacy
Baseline and 10 weeks post-randomization
Psychological distress
Baseline and 10 weeks post-randomization
Burnout symptoms
Baseline 10 weeks post-randomization and 20 weeks post-randomization
Coping strategies
Baseline 10 weeks post-randomization and 20 weeks post-randomization
- +3 more secondary outcomes
Study Arms (2)
XR-based Resilience Training
EXPERIMENTALParticipants in this arm receive an XR-based resilience training consisting of eight immersive sessions delivered over approximately ten weeks using a head-mounted display. The training focuses on behavioral, cognitive, and emotional coping strategies and aims to strengthen resilience and stress management skills. Each session lasts approximately 20 to 30 minutes and is completed individually.
Waitlist Control
NO INTERVENTIONParticipants in this arm are assigned to a waitlist control condition and continue with care as usual during the waiting period. They do not receive the XR-based resilience training during the first ten weeks of the study but are offered access to the intervention after completion of the post-intervention assessment.
Interventions
The XR-based resilience training is delivered via a standalone extended reality head-mounted display and consists of eight immersive sessions over approximately ten weeks. The training addresses behavioral coping strategies such as problem solving, cognitive coping strategies such as appraisal and reappraisal of stressors, and emotional coping strategies including emotion regulation and positive self-care. Sessions last approximately 20 to 30 minutes and are completed individually with technical support available if needed.
Participants assigned to the waitlist control condition receive no active intervention during the initial study period and continue with care as usual. After completion of the post-intervention assessment, participants are offered access to the XR-based resilience training.
Eligibility Criteria
You may qualify if:
- working as a nurse in direct patient care within a clinical setting;
- working at least 10h/week in their profession;
- speaking the language in which the RCT is conducted sufficiently well;
- able and willing to participate in all aspects of the study;
- understanding and signing the appropriate informed consent form.
You may not qualify if:
- a diagnosed severe mental disorder associated with alterations in reality perception (e.g., delusions, hallucinations, derealization, depersonalization, or dementia), including in particular schizophrenia, bipolar disorder, severe major depressive disorder, or other psychotic disorders (lifetime);
- a current major depressive episode or a current post-traumatic stress disorder (PTSD);
- an acute or clinically significant medical condition that may interfere with the safe use of an XR headset or study participation, including but not limited to epilepsy, pronounced dizziness, balance disorders, or acute cardiovascular conditions;
- an acute eye infection (e.g., conjunctivitis);
- unstable medication related to a mental health condition, defined as recent changes in dosage or class of psychotropic medication;
- initiation of psychotherapy or any structured stress-management training within the past three months.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Medical University of Grazlead
- MINDCONSOLE GMBHcollaborator
- Medizinische Privatuniversität Burgenlandcollaborator
- Central Institute of Mental Health, Mannheimcollaborator
- St. Pölten University of Applied Sciencescollaborator
- University of Évoracollaborator
- Leibniz Institute for Resilience Research (LIR), Mainz, Germanycollaborator
- Leuphana Universität Lünenbergcollaborator
- University of Lisboncollaborator
- Sveti Ivan Psychiatric Hospitalcollaborator
- mindconsolecollaborator
- PREDICTBY RESEARCH AND CONSULTING S.L.collaborator
- Servicio Madrileño de Salud (SERMAS)collaborator
Study Sites (8)
Medical University of Graz, Clinical Division of Psychiatry and Psychotherapeutic Medicine
Graz, Styria, 8036, Austria
Klinika za psihijatriju Sveti Ivan
Zagreb, 10000, Croatia
University Medical Center of Johannes Gutenberg University Mainz
Mainz, Rhineland-Palatinate, 55131, Germany
Hospital José Joaquim Fernandes
Beja, Beja District, 7801-849, Portugal
Del Henares University Hospital
Coslada, Madrid, 28822, Spain
Summa 112
Madrid, Madrid, 28005, Spain
Infanta Leonor University Hospital
Madrid, Madrid, 28031, Spain
Infanta Sofía University Hospital
San Sebastián de los Reyes, Madrid, 28702, Spain
Related Links
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Nina Dalkner Research Prof. Priv.-Doz. Mag. rer.nat. Dr. rer.nat.
CONTACT
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Masking Details
- This is an open-label trial. Due to the nature of the XR-based intervention and the waitlist control design, blinding of participants and study personnel is not feasible.
- Purpose
- PREVENTION
- Intervention Model
- CROSSOVER
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
April 15, 2026
First Posted
April 22, 2026
Study Start (Estimated)
September 1, 2026
Primary Completion (Estimated)
March 1, 2028
Study Completion (Estimated)
March 1, 2028
Last Updated
April 22, 2026
Record last verified: 2025-12
Data Sharing
- IPD Sharing
- Will share
- Time Frame
- Beginning 6 months after publication of the primary results and ending 5 years thereafter
- Access Criteria
- Researchers must submit a written request including a study proposal statistical analysis plan and intended use of the data. Approval by the study steering committee and a signed data use agreement are required prior to data access.
De-identified individual participant data that underlie the results reported in publications will be made available upon reasonable request. Data will be shared in a pseudonymized form to qualified researchers for purposes of academic research and secondary analyses that are consistent with the original study objectives. Requests will be reviewed by the study steering committee and require a methodologically sound proposal and a data use agreement. Data sharing will be subject to applicable data protection regulations and ethical approvals.