Interactive Nature-Based Virtual Reality to Reduce Anxiety, Low Mood, and Feelings of Helplessness in Hospitalized Older Adults With Chronic Illness (Zenctuary VR+)

NCT07712549 | Not Yet Recruiting

• 2 other identifiers: NNGYK/27626-8/20262024-1.2.3-HU-RIZONT202400103
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 3

Brief Summary

Prolonged hospitalization can reduce opportunities for independent activity, choice, and control and may contribute to passivity, low mood, anxiety, and distress in some older adults. Zenctuary VR+ is a seated, nature-based virtual reality program that combines calming environments with simple, low-demand activities. The active program allows participants to make choices, move between predefined locations, and influence elements of the virtual environment. Trained staff supervise every session and provide support when needed. The trial evaluates whether the interactive version of Zenctuary VR+ reduces psychological distress more than passive exposure to the same virtual environments. A total of 100 hospitalized adults aged 60 years or older will be randomly assigned to the interactive VR condition or the passive VR condition. Eligible participants are expected to remain hospitalized for at least four weeks following enrolment. Both groups will receive six sessions over three weeks. Psychological distress and related psychological factors will be assessed before the first session, immediately after the three-week intervention period, and four weeks after the final session.

Conditions

Psychological Distress; Chronic Disease; Learned Helplessness

Keywords

Virtual reality; Randomized controlled trial; Digital health intervention; Nature exposure; Self-efficacy; Older adults; Learned helplessness; Psychological distress

Outcome Measures

Primary Outcomes (1)

• Change From Baseline in Psychological Distress as Measured by the Hospital Anxiety and Depression Scale Total Score

  The Hospital Anxiety and Depression Scale is a 14-item self-report measure comprising seven anxiety items and seven depression items. The total score ranges from 0 to 42, with higher scores indicating greater psychological distress.

  Baseline; immediately after completion of the three-week intervention period; and four weeks after the final intervention session

Secondary Outcomes (4)

• Change From Baseline in Self-Esteem as Measured by the Rosenberg Self-Esteem Scale

  Baseline; immediately after completion of the three-week intervention period; and four weeks after the final intervention session

• Change From Baseline in General Self-Efficacy as Measured by the General Self-Efficacy Scale

  Baseline; immediately after completion of the three-week intervention period; and four weeks after the final intervention session

• Change From Baseline in Depressive Symptoms as Measured by the Geriatric Depression Scale

  Baseline and immediately after completion of the three-week intervention period

• Change From Baseline in Hopelessness as Measured by the Beck Hopelessness Scale

  Baseline and immediately after completion of the three-week intervention period

Other Outcomes (4)

• Change From Baseline in Anxiety Symptoms as Measured by the Hospital Anxiety and Depression Scale Anxiety Subscale

  Baseline; immediately after completion of the three-week intervention period; and four weeks after the final intervention session

• Change From Baseline in Depressive Symptoms as Measured by the Hospital Anxiety and Depression Scale Depression Subscale

  Baseline; immediately after completion of the three-week intervention period; and four weeks after the final intervention session

• Change From Baseline in Learned Helplessness as Measured by the Learned Helplessness Scale

  Baseline and immediately after completion of the three-week intervention period

Study Arms (2)

Active Zenctuary VR+ Intervention

EXPERIMENTAL

Participants receive six sessions of the interactive, nature-based Zenctuary VR+ program over three weeks (twice weekly), delivered via head-mounted display (Meta Quest 3). The intervention includes low cognitive load interactive tasks (simple choices, navigation between virtual locations, and environmental interaction) designed to support agency, perceived control, and successful action while participants remain seated and supported by trained personnel.

Device: Interactive nature-based virtual reality intervention

Passive VR Control

ACTIVE COMPARATOR

Participants are exposed to the same nature-based virtual environments and head-mounted display (Meta Quest 3) as the active arm, following the same six-session, three-week schedule, but without interactive elements. Participants passively observe the virtual scenery, controlling for VR exposure and nature content while isolating the added effect of interactivity and agency-supporting features.

Device: Passive nature-based virtual reality exposure

Interventions

Passive nature-based virtual reality exposure DEVICE

An immersive, head-mounted-display-delivered virtual reality experience presenting the same nature-based virtual environments as the active intervention, without interactive elements. Participants passively observe the virtual scenery while seated, with no opportunity for choice, navigation, or environmental interaction. Delivered in six sessions over three weeks (twice weekly), matching the active intervention in schedule, apparatus, and visual content, differing only in the absence of interactivity.

Passive VR Control

Interactive nature-based virtual reality intervention DEVICE

An immersive, head-mounted-display-delivered virtual reality intervention presenting nature-based virtual environments with interactive, low cognitive load tasks. Participants make simple choices, navigate between virtual locations, and influence elements of the environment while seated, with the goal of supporting agency, perceived control, and successful action. Delivered in six sessions over three weeks (twice weekly), each guided by a trained operator using a standardized least-assistance approach.

Active Zenctuary VR+ Intervention

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged 60 years or older
• Diagnosed with at least one chronic medical condition
• Currently receiving inpatient hospital care
• Expected to remain hospitalized for at least four weeks following enrolment
• Physically able to use a head-mounted virtual reality device, as determined by the treating clinical team
• Able to provide written informed consent
• Able to complete study assessments and participate in the intervention procedures

You may not qualify if:

• Cognitive impairment, defined as a score below 18 on the Montreal Cognitive Assessment (MoCA)
• Impaired consciousness or reduced alertness that would prevent meaningful participation
• Current or previous diagnosis of a psychotic disorder
• Current substance use disorder that would interfere with participation in the study procedures
• Current treatment with antipsychotic medication
• Untreated epilepsy
• Severe vestibular dysfunction or recurrent vertigo
• Any medical condition judged by the treating physician to make participation unsafe or inappropriate

Sponsors & Collaborators

• Moholy-Nagy University of Art and Design: lead

Study Sites (3)

Center for Geriatric Care and Nursing Science (Semmelweis University)

Budapest, 1097, Hungary

Location

Rehabilitation Clinic (Semmelweis University)

Budapest, 1121, Hungary

Location

Department of Neurosurgery (University of Szeged)

Szeged, 6725, Hungary

Location

Related Links

• ZenctuaryVR+ project No. 2024-1.2.3-HU-RIZONT-2024-00103, supported by the National Research, Development and Innovation Fund of the Ministry of Culture and Innovation, financed under the 2024-1.2.3-HU-RIZONT call for proposals.

MeSH Terms

Conditions

Chronic Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Ágnes Bakk, PhD

  Moholy-Nagy University of Art and Design

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Pál Tamás Szabó, PhD

CONTACT

+36301292315; szabo.pal@mome.hu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 14, 2026
• First Posted: July 17, 2026
• Study Start (Estimated): November 1, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): March 31, 2028
• Last Updated: July 21, 2026

Record last verified: 2026-07

Locations

HU (3)