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Randomized Controlled Trial
. 2025 Feb 5;29(1):62.
doi: 10.1186/s13054-025-05281-2.

Effect of an intensive care unit virtual reality intervention on relatives´ mental health distress: a multicenter, randomized controlled trial

Denzel L Q Drop  1 , Johan H Vlake  1   2 , Evert-Jan Wils  2 , Jasper Van Bommel  1 , Christian Jung  3   4 , Denise E Hilling  5 , O Joseph Bienvenu  6 , Tim I M Korevaar  7 , Anna F C Schut  8 , Margo M C van Mol  1 , Diederik Gommers  1 , Michel E van Genderen  9
Affiliations
Randomized Controlled Trial

Effect of an intensive care unit virtual reality intervention on relatives´ mental health distress: a multicenter, randomized controlled trial

Denzel L Q Drop et al. Crit Care. .

Abstract

Background: Relatives of intensive care unit (ICU) patients often endure symptoms of post-traumatic stress, anxiety, and depression during and after treatment of a family member's hospitalization. The aim of this study was to evaluate the effect of ICU-specific virtual reality (ICU-VR) on mental health among relatives, 6 months after patient's ICU discharge.

Methods: This multicenter, randomized controlled trial included relatives of ICU patients who were assigned to receive either standard care or standard care plus ICU-VR, by randomizing the ICU patients. Relatives were assessed up to 6 months after patient discharge from the ICU for post-traumatic stress, anxiety, depression, quality of life, relatives' understanding of ICU care, and appreciation of ICU-VR.

Results: One hundred relatives of 81 patients and 89 relatives of 80 patients were randomized to the intervention and control groups, respectively. Relatives' median age was 48 years and 53% were female. Compared to the control group, relatives who received ICU-VR did not experience a decrease in post-traumatic stress (23% vs. 18%; p = 0.99), anxiety (22% vs. 30%; p = 0.35), or depression (17% vs. 23%; p = 0.44). There was no significant difference between median mental quality of life (50.2 vs. 52.6; p = 0.51), physical quality of life (56.1 vs. 54.3; p = 0.16), or understanding of ICU care between groups. Patients in the intervention group highly endorsed ICU-VR (90%), favoring it over traditional informational brochures and the majority (82%) stated it improved their understanding of ICU treatment.

Conclusion: ICU-VR did not significantly improve mental health distress symptoms among relatives 6-months after a patient's discharge. Relatives highly endorsed ICU-VR and self-reported that it improved their understanding of ICU treatment.

Keywords: Intensive care; Mental health; Post-intensive Care syndrome; Quality of life; Virtual reality.

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Conflict of interest statement

Declarations. Ethics approval: The study received ethical approval from the Medical Ethics Committee of the Erasmus MC and the institutional review boards of the participating centers (protocol number NL73670.078.20, approved on December 14, 2020). Consent to participate: All participants gave their informed consent. Consent for publication: Not applicable. Availability of data and materials: The data that support the findings of this study are available on request via the corresponding author MvG. Competing interest: M.M.C.V.M. declares to have received a personal grant from ZonMW for Intensive Care follow-up service studies, a multi-disciplinary award from the European Society of Intensive Care Medicine (ESICM) resulting in payments that were made to conduct a study internationally, and a personal re-imbursement from ESICM for attending a meeting and congress. The funders had no role in this study. Additionally, M.M.C.V.M. is member of the Family and patient centered Intensive Care (FCIC) foundation, board member N&AHP committee ESICM, and board member of the Dutch Nursing Society V&VN-IC.

Figures

Fig. 1
Fig. 1
Flowchart of the study. ICU, Intensive care unit; ICU-LOS, Intensive care unit length of stay; VR, virtual reality; ICU-VR, Intensive care unit-specific virtual reality
Fig. 2
Fig. 2
Mental health distress and quality of life. Time points: T0 (retrospective at ICU admission for anxiety, depression, mental HRQoL, and physical HRQoL), T1 (at ICU discharge for ASD/PTSD-related symptoms, T2 (1 month), T3 (3 months), T4 (6 months). IES-R, Impact of Event Scale-Revised; ASD, acute stress disorder; PTSD, Post-traumatic stress disorder; HADS, Hospital Anxiety and Depression Scale; HADS-A, Hospital Anxiety and Depression Scale-Anxiety; HADS-D, Hospital Anxiety and Depression Scale-Depression; HRQoL, health-related quality of life; MCS-36, Mental Component Score -36; PCS-36, Physical Component Score-36
Fig. 3
Fig. 3
Quality Consumer Index. ICU, Intensive Care Unit; IV, intravenous
Fig. 4
Fig. 4
Perspectives on ICU-VR: statements. ICU-VR-Family, Intensive care unit-specific virtual reality-family; ICU, Intensive care unit; VR, virtual reality
See this image and copyright information in PMC

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