A nursing-led conceptual model for virtual reality-based calm rooms in mental health care
https://doi.org/10.52235/lp.v7i4.992
Keywords:
emotion regulation, mental health services, nursing care, patient-centered care, relaxation therapy, virtual realityAbstract
This perspective paper develops a preliminary nursing-led conceptual model for using immersive virtual reality (VR) as an optional, brief calming intervention in adult psychiatric inpatient care. Supporting publications were selected purposively from the literature cited in the original manuscript and critically examined for direct relevance; no systematic search, formal evidence grading, expert consensus exercise, or empirical model validation was undertaken. A VR-based calm room is defined here as a supervised care pathway incorporating a clinically appropriate immersive calming experience, rather than a headset or dedicated room alone. Evidence from a systematic review and a small quasi-randomized psychiatric inpatient trial suggests potential short-term improvement in relaxation or well-being, but does not establish superiority over physical calm rooms or non-VR relaxation. The proposed pathway comprises triage and consent, preparation and personalization, guided use, monitoring and stopping, and debriefing with documentation and escalation. A hypothesized mechanism links presence, attentional redirection, sensory modulation, guided self-regulation, perceived control, and therapeutic nursing support to immediate distress responses. Safety checkpoints address acute clinical risk, cybersickness, falls, infection prevention, privacy, and clinical deterioration. The model has not been validated, and its feasibility, acceptability, equity, safety, comparative effectiveness, and resource requirements require prospective evaluation before implementation as routine care.
Downloads
References
Alotaibi, N., Wilson, C. B., & Traynor, M. (2025). Enhancing digital readiness and capability in healthcare : a systematic review of interventions , barriers , and facilitators
Anyshchenko, L. (2023). ef fi cacy of virtual reality and managing anxiety and depression. November. https://doi.org/10.3389/fdgth.2023.1239435
Arthur, T., Melendez-torres, G. J., Harris, D., Robinson, S., Wilson, M., & Arthur, T. (2025). Extended Reality Interventions for Health and Procedural Anxiety : Panoramic Meta-Analysis Based on Overviews of Reviews Corresponding Author : 27. https://doi.org/10.2196/58086
Bonneterre, S., Zerhouni, O., & Boffo, M. (2025). Immersive Virtual Reality for Health Promotion and Primary Prevention in Psychology : Scoping Review. 2. https://doi.org/10.2196/49923
Brelet, L., & Gaffary, Y. (2022). Stress reduction interventions : A scoping review to explore progress toward use of haptic feedback in virtual reality. October, 1–14. https://doi.org/10.3389/frvir.2022.900970
Choudhary, A., Jasrotia, A., & Kumar, A. (2024). Mental health : a stigma and neglected public health issue and time to break the barrier. 11(3), 1378–1383.
Clay, J., & Eaton, J. (2020). Core components of mental health stigma reduction interventions in low- and middle- income countries : a systematic review.
Cortez-vázquez, G., Adriaanse, M., Louis, G., Raymond, B., Panayiotou, G., & Vlemincx, E. (2024). Virtual Reality Breathing Interventions for Mental Health : A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 1–21.
Cui, Y., & Shi, W. (2026). Development and validation of a design model of virtual-reality therapeutic landscapes for anxiety reduction and emotion regulation. 12, 1–17. https://doi.org/10.1177/20552076251412624
Goharinejad, S., Goharinezhad, S., Moulaei, K., Krüger, B., & Spittler, T. (2026). Assessing the Impact of Virtual Reality , Augmented Reality , and Video Games on Improving Post-Traumatic Stress Disorder Symptoms : A Systematic Review and Meta- Analysis. https://doi.org/10.1177/00469580251413101
Haeussl, A., Zwigl, I., Lackner, H., Reiter, V., Stross, T., Fellendorf, F. T., Schönthaler, E. M. D., Huber, M., Huber, V., Schedlberger, J., Repnik, L. G., Wagner-skacel, J., Roszipal, B., Karlseder, M., Egger-lampl, S., Stijic, M., Lenger, M., Reininghaus, E. Z., & Dalkner, N. (2026). Effects of virtual reality interventions on mental health outcomes among healthcare workers in hospital settings : a systematic review. March, 1–17. https://doi.org/10.3389/frvir.2026.1720655
Ilioudi, M., Lindner, P., Ali, L., Wallstr, S., Thunstr, O., Ioannou, M., Anving, N., & Johansson, V. (2023). Physical Versus Virtual Reality – Based Calm Rooms for Psychiatric Inpatients : Quasi-Randomized Trial Corresponding Author : 25, 1–11. https://doi.org/10.2196/42365
Jadhakhan, F., Blake, H., Hett, D., & Marwaha, S. (2022). Efficacy of digital technologies aimed at enhancing emotion regulation skills : Literature review.
Kandeel, M. E., Hamza, E. G. A., Abouahmed, A., Mohamed, G., & Eldakak, A. (2026). AI Applications Integrating Legal and Regulatory Perspectives in Mental Health : Systematic Review. 5. https://doi.org/10.2196/84305
Kang, X., Zhang, Y., Sun, C., Zhang, J., Che, Z., & Zang, J. (2025). Effectiveness of Virtual Reality Training in Improving Outcomes for Dialysis Patients : Systematic Review and Meta-Analysis Corresponding Author : 27. https://doi.org/10.2196/58384
Ladakis, I., Filos, D., Chouvarda, I., & Equivital, E. V. (2024). Virtual reality environments for stress reduction and management : a scoping review. Virtual Reality, 28(1), 1–26. https://doi.org/10.1007/s10055-024-00943-y
Lee, J., Kim, J., & Ory, M. G. (2024). The impact of immersive virtual reality meditation for depression and anxiety among inpatients with major depressive and generalized anxiety disorders. October, 1–10. https://doi.org/10.3389/fpsyg.2024.1471269
Lundin, R. M., Yeap, Y., & Menkes, D. B. (2023). Adverse Effects of Virtual and Augmented Reality Interventions in Psychiatry : Systematic Review Corresponding Author : 10, 1–8. https://doi.org/10.2196/43240
Mccabe, C., Newbutt, N., Hutchinson, A., & Loetscher, T. (2025). Insights into Sensory and Relaxation Preferences to Inform the Design of Calming Spaces and Sensory Rooms for Autistic Adults. 00(00), 1–15. https://doi.org/10.1089/aut.2024.0088
Navas-medrano, S., Soler-dominguez, J. L., & Pons, P. (n.d.). Mixed Reality for a collective and adaptive mental health metaverse. 2024, 4.
Pallavicini, F., Orena, E., Santo, S., & Greci, L. (2021). MIND-VR : Design and Evaluation Protocol of a Virtual Reality Psychoeducational Experience on Stress and Anxiety for the Psychological Support of Healthcare Workers Involved in the COVID-19 Pandemic. 2(February), 1–15. https://doi.org/10.3389/frvir.2021.620225
Pancini, E., Flavia, A., Natale, D., & Villani, D. (2025). Breathing in virtual reality for promoting mental health : a scoping review.
Pedram, S., & Piatkowski, T. (2025). Exploring the potential of virtual reality ( VR ) in mental healthcare : a systematic literature review.
Perkis, A. (2020). Increasing User Engagement in Virtual Reality : The Role of Interactive Digital Narratives to Trigger Emotional Responses.
Porras-garcia, B., Gómez-hernández, J., Ariza, M., Mora, T., Roche, D., & Porras-garcia, B. (2024). A multimodal group-based immersive virtual reality intervention for improving cognition and mental health in patients with post-covid-19 condition . A quasi-experimental design study. July, 1–15. https://doi.org/10.3389/fpsyg.2024.1441018
Ra, S., Santa, K., Honey, N., Tully, D., & Mezes, B. (2025). Evaluating a virtual reality – delivered mindfulness intervention for anxiety : a mixed-methods study in real-world community and school settings. December, 1–14. https://doi.org/10.3389/fpsyt.2025.1669287
Reese, G., Stahlberg, J., Menzel, C., & Reese, G. (2022). Digital shinrin ‑ yoku : do nature experiences in virtual reality reduce stress and increase well ‑ being as strongly as similar experiences in a physical forest ? Virtual Reality, 26(3), 1245–1255. https://doi.org/10.1007/s10055-022-00631-9
Riches, S., Jeyarajaguru, P., Taylor, L., Fialho, C., Little, J., Ahmed, L., Brien, A. O., Driel, C. Van, Veling, W., & Valmaggia, L. (2023). Virtual reality relaxation for people with mental health conditions : a systematic review. Social Psychiatry and Psychiatric Epidemiology, 58(7), 989–1007. https://doi.org/10.1007/s00127-022-02417-5
Robbemond, L. M., Noordzij, M. L., Driel, C. M. G. van, & Veling, W. (2026). Physiological Responses to Virtual Reality ‐ Based Stress Regulation and Relaxation Interventions : A Systematic. 1–32. https://doi.org/10.1002/smi.70164
Shankar, R., Bundele, A., & Mukhopadhyay, A. (2025). The Effectiveness of Virtual Reality – Based Mindfulness Interventions for Managing Stress , Anxiety , and Depression : Protocol for a Systematic Review and Meta-Analysis of Randomized Controlled Trials Corresponding Author : 14, 1–11. https://doi.org/10.2196/68231
Sharma, P., Wagani, R., & Varghese, M. A. (2025). Bibliometric analysis of research in ethical concerns and dilemmas of digital mental health care in the last two decades. January. https://doi.org/10.3389/fhumd.2024.1502432
Strauch, H., Schuil, I., Simm, S., Grubert, J., & Kalamkar, S. (2026). Virtual Reality Interventions for Stress Reduction in the General Population : Systematic Review and Meta-Analysis of Randomized Controlled Trials. 28. https://doi.org/10.2196/78212
Tan, P., Wu, Y., Chen, X., Chen, J., Guo, Z., Lu, X., & Chen, J. (2026). A systematic review on mindfulness- based immersive interventions in depressive disorders.
Torous, J., Linardon, J., Goldberg, S. B., Sun, S., Bell, I., Nicholas, J., Hassan, L., & Hua, Y. (2025). The evolving field of digital mental health : current evidence and implementation issues for smartphone apps , generative artificial intelligence , and virtual reality. June, 156–174. https://doi.org/10.1002/wps.21299
Toussaint, L., Nguyen, Q. A., Roettger, C., Dixon, K., Offenb, M., Kohls, N., Hirsch, J., & Sirois, F. (2021). Effectiveness of Progressive Muscle Relaxation , Deep Breathing , and Guided Imagery in Promoting Psychological and Physiological States of Relaxation. 2021. https://doi.org/10.1155/2021/5924040
Wang, L., Chen, T., Ou, J., Li, G., & Luo, H. (2024). Promoting mental health in children and adolescents through digital technology : a systematic review and meta-analysis. March, 1–13. https://doi.org/10.3389/fpsyg.2024.1356554
Wanniarachchi, V. U., & Greenhalgh, C. (2025). Personalization variables in digital mental health interventions for depression and anxiety in adolescents and youth : a scoping review. May. https://doi.org/10.3389/fdgth.2025.1500220
Wieczorek, A., Schrank, F., Renner, K., & Wagner, M. (2024). Psychological and physiological health outcomes of virtual reality-based mindfulness interventions : A systematic review and evidence mapping of empirical studies. https://doi.org/10.1177/20552076241272604
Yang, Q., Zhang, L., Chang, F., Yang, H., & Chen, B. (2025). Virtual Reality Interventions for Older Adults With Mild Cognitive Impairment : Systematic Review and Meta-Analysis of Randomized Controlled Trials Corresponding Author : 27, 1–20. https://doi.org/10.2196/59195
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jawiah Jawiah, Ira Kusumawaty, Yunike Yunike, Sumitro Adi Putra, Ovi Eliani
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
