Flourishing-Life-Of-Wish Virtual Reality Therapy (FLOW-VRT) as a novel psychological intervention in palliative care: A randomized controlled trial with mediation analysis.

The study aims to evaluate the efficacy of a virtual reality-assisted intervention for palliative care in a randomized controlled trial and examine its underlying mechanism in symptom control. One hundred twenty-eight patients with cancer from palliative care wards of a public hospital in Hong Kong were randomly assigned to either the experimental virtual reality-assisted psychological intervention or control group receiving a conventional psychological intervention. Outcomes on palliative symptoms, loneliness, peace, and engulfment were measured, with analysis of covariance conducted. Mediation analysis was performed to examine if the mechanistic outcomes of presence, flow, and restoration mediated the treatment effects. Significant group by time interaction effects were found, indicating improvement in overall palliative symptoms, physical symptoms, emotional symptoms, peace, and engulfment. However, no significant difference was found in loneliness. Mediation analyses revealed that flow, but not presence and restoration, mediated the relationship between VR-assisted psychological intervention and symptom control.