Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot Study

Abstract BackgroundVirtual reality (VR) has emerged as a promising, low-risk strategy to manage many forms of psychological stress and may be a modality to improve cardiovascular health. Recent scientific statements on the mind-heart-body connection call for better adherence t...

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Main Authors: Katherine E Makaroff, Christopher Van, Vincent Grospe, Lynae Edmunds, Marcella A Calfon-Press, Karol E Watson, Tamara Horwich
Format: Article
Language:English
Published: JMIR Publications 2025-08-01
Series:JMIR Cardio
Online Access:https://cardio.jmir.org/2025/1/e66557
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author Katherine E Makaroff
Christopher Van
Vincent Grospe
Lynae Edmunds
Marcella A Calfon-Press
Karol E Watson
Tamara Horwich
author_facet Katherine E Makaroff
Christopher Van
Vincent Grospe
Lynae Edmunds
Marcella A Calfon-Press
Karol E Watson
Tamara Horwich
author_sort Katherine E Makaroff
collection DOAJ
description Abstract BackgroundVirtual reality (VR) has emerged as a promising, low-risk strategy to manage many forms of psychological stress and may be a modality to improve cardiovascular health. Recent scientific statements on the mind-heart-body connection call for better adherence to psychological screening and adoption of more holistic “behavioral cardiology” interventions that improve the overall health of patients with or at risk for cardiovascular disease (CVD). ObjectiveThe aim of this study is to assess safety and preliminarily explore how a VR experience can aid in stress reduction among patients with or at risk for CVD. MethodsA convergent mixed methods approach was used for this single-arm prospective pilot study. In total, 20 patients were recruited from the University of California Los Angeles adult cardiology clinics and cardiac rehabilitation. Surveys and physiologic parameters were collected before, during, and after a 30-minute VR experience aimed at relaxation. The primary outcome was the State-Trait Anxiety Inventory-State (STAI-S) scale. They participated in a 90-minute visit, during which they completed surveys, including the STAI-S scale, before and after a 30-minute VR experience. Physiological parameters were also collected before, during, and after the experience. Visits concluded with semistructured interviews analyzed with inductive thematic analysis to add depth and nuance to our analysis. ResultsSTAI-S scale scores after the VR experience were significantly decreased from baseline (median 31, IQR 28-38 vs median 24, IQR-29.25; PPPPP ConclusionsThis sample of patients with CVD or risk of CVD had above-average stress, consistent with epidemiological data; the statistically and clinically significant decrease in subjective perception of stress partially converged with physiologic data. Overall, the VR intervention was a safe and feasible stress reduction method. Future research is needed to evaluate the effectiveness of this immersive therapy in reducing cardiovascular risk profiles.
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spelling doaj-art-d09d2290064048acbb7caef53b7fce242025-08-20T04:00:51ZengJMIR PublicationsJMIR Cardio2561-10112025-08-019e66557e6655710.2196/66557Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot StudyKatherine E Makaroffhttp://orcid.org/0000-0001-9354-5656Christopher Vanhttp://orcid.org/0009-0001-0311-8798Vincent Grospehttp://orcid.org/0009-0001-1465-2742Lynae Edmundshttp://orcid.org/0009-0004-7385-8443Marcella A Calfon-Presshttp://orcid.org/0000-0002-4708-389XKarol E Watsonhttp://orcid.org/0000-0003-3658-6165Tamara Horwichhttp://orcid.org/0000-0002-3208-1023 Abstract BackgroundVirtual reality (VR) has emerged as a promising, low-risk strategy to manage many forms of psychological stress and may be a modality to improve cardiovascular health. Recent scientific statements on the mind-heart-body connection call for better adherence to psychological screening and adoption of more holistic “behavioral cardiology” interventions that improve the overall health of patients with or at risk for cardiovascular disease (CVD). ObjectiveThe aim of this study is to assess safety and preliminarily explore how a VR experience can aid in stress reduction among patients with or at risk for CVD. MethodsA convergent mixed methods approach was used for this single-arm prospective pilot study. In total, 20 patients were recruited from the University of California Los Angeles adult cardiology clinics and cardiac rehabilitation. Surveys and physiologic parameters were collected before, during, and after a 30-minute VR experience aimed at relaxation. The primary outcome was the State-Trait Anxiety Inventory-State (STAI-S) scale. They participated in a 90-minute visit, during which they completed surveys, including the STAI-S scale, before and after a 30-minute VR experience. Physiological parameters were also collected before, during, and after the experience. Visits concluded with semistructured interviews analyzed with inductive thematic analysis to add depth and nuance to our analysis. ResultsSTAI-S scale scores after the VR experience were significantly decreased from baseline (median 31, IQR 28-38 vs median 24, IQR-29.25; PPPPP ConclusionsThis sample of patients with CVD or risk of CVD had above-average stress, consistent with epidemiological data; the statistically and clinically significant decrease in subjective perception of stress partially converged with physiologic data. Overall, the VR intervention was a safe and feasible stress reduction method. Future research is needed to evaluate the effectiveness of this immersive therapy in reducing cardiovascular risk profiles.https://cardio.jmir.org/2025/1/e66557
spellingShingle Katherine E Makaroff
Christopher Van
Vincent Grospe
Lynae Edmunds
Marcella A Calfon-Press
Karol E Watson
Tamara Horwich
Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot Study
JMIR Cardio
title Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot Study
title_full Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot Study
title_fullStr Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot Study
title_full_unstemmed Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot Study
title_short Novel Virtual Reality Intervention for Stress Reduction Among Patients With or at Risk for Cardiovascular Disease: Mixed Methods Pilot Study
title_sort novel virtual reality intervention for stress reduction among patients with or at risk for cardiovascular disease mixed methods pilot study
url https://cardio.jmir.org/2025/1/e66557
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