Patient input on the design of a social virtual reality environment for hospitalized older adult trauma patients: Phase 1 of a usability, acceptability, and feasibility pilot study

Background Older adults (65 and above) represent a significant portion of trauma admissions in U.S. hospitals, primarily due to falls and motor vehicle accidents. Managing pain effectively and mitigating social isolation in this population is crucial. Traditional opioid treatments, while common, pose risks such as addiction, delirium, and constipation, leading to extended hospital stays and increased costs. Social isolation is another common problem faced by this population that can also exacerbate pain. Nonpharmacological interventions are thus highly recommended. Objective This pilot study explores the feasibility and acceptability of employing social virtual reality (SVR) as a novel, nonpharmacological approach to address both pain and social isolation among older adult trauma patients. Methods The study employs a two-phase design to evaluate SVR's potential. This article describes Phase 1, which employed a user-centered, iterative design approach to enhance SVR's feasibility, acceptability, and usability in the target population. We presented existing versions of SVR applications using three platforms, VTimeXR, Spatial, and Engage, to 10 hospitalized older adult trauma patients and used in-depth interviews to gain patient feedback. We made iterative refinements based on this feedback. Results We present the results of Phase 1, which employed a user-centered, iterative design approach to develop a test environment for use in the second phase of the study. Participants who completed the study indicated environments could serve as effective distractions, facilitate social interaction, and evoke calming emotions. Participants suggested enhancing the realism of nature elements and offering more interactive features, such as tasks, games, or narratively compelling videos. Conclusion We successfully developed an SVR environment for older adult trauma patients, and early feasibility indicators showed interest and engagement from participants, providing insights to guide refinements for Phase 2 deployment.