Virtual Reality Games and the Role of Body Involvement in Enhancing Positive Emotions and Decreasing Anxiety: Within-Subjects Pilot Study

Examining the Mechanisms of Virtual Reality Tourism's Impact on the Mental Well-Being of Long-Term Care Facility Residents: Perspectives on Presence and Flow

This study investigates the mechanisms of virtual reality (VR) tourism's impact on the well-being of residents in long-term care facilities (LTCFs). It aims to understand how presence and flow during VR experiences can enhance well-being. This experimental study used a quantitative approach with structured questionnaires to investigate VR experiences among LTCF residents in Taiwan. After obtaining ethical approval, 145 eligible participants from four LTCFs completed a full five-week VR tourism experience. Data collection took place from June to November 2022. This study employed Partial Least Squares Structural Equation Modeling (PLS-SEM) with Smart PLS software to analyze the causal relationships between latent variables. The results confirm that the more vivid the virtual reality image (β = 0.240, p < 0.05), the more immersive the experience (β = 0.267, p < 0.05), the greater the ability to control the experience (β = 0.465, p < 0.001), and the greater the ability to stimulate curiosity during the experience (β = 0.290, p < 0.05), the greater the sense of presence. Increased presence leads to user engagement and a state of flow (β = 0.556, p < 0.001), which is essential for personal hedonia (β = 0.453, p < 0.001) and eudaimonia (β = 0.220, p < 0.001). This study elucidates the mechanisms through which VR tourism experiences enhance well-being among LTCF residents, emphasizing the critical roles of presence and flow in promoting both hedonic and eudaimonic dimensions of well-being.

Self-Assessed Experience of Emotional Involvement in Sensory Analysis Performed in Virtual Reality

Virtual reality (VR) technology has gained significant attention in various fields, including education for health professionals, sensory science, psychology, and consumer research. The first aim of the paper is to explore the self-assessed experience of emotional involvement in sensory analysis performed in VR. The Positive and Negative Affect Schedule (PANAS) is a widely used self-report measure that assesses positive and negative affective states. VR sensory analysis involves the use of immersive, interactive, and multi-sensory environments to evaluate sensory perception and emotional responses. By synthesizing relevant literature, this paper provides insights into the impact of VR on affective states, the effectiveness of VR in eliciting emotions, and the potential applications of the PANAS in VR sensory analysis. Furthermore, the second aim of the paper is to uncover the effect of VR sensory evaluation on the participant's emotional states, as it has a significant effect on their evaluations. The results suggest an increase in the sum of positive effects and a decrease in the negative ones. Although these results are promising, the relationship between the PANAS and VR sensory analysis is still underexplored, with limited research investigating the specific effects of VR on affective states measured using the PANAS. Further research is needed to better understand the potential of the PANAS in assessing emotional responses in VR environments and its implications for sensory analysis.

Virtual Exercise in Medicine: A Proof of Concept in a Healthy Population

BACKGROUND

Science is beginning to establish the benefits of the use of virtual reality (VR) in health care. This therapeutic approach may be an appropriate complementary treatment for some mental illnesses. It could prevent high levels of morbidity and improve the physical health of patients. For many years, the literature has shown the health benefits of physical exercise. Physical exercise in a VR environment may improve the management of mild to moderate mental health conditions. In this context, we developed a virtual environment combined with an ergocycle (the augmented physical training for isolated and confined environments [APTICE] system).

OBJECTIVE

This study aims to investigate the impact of physical exercise in a VR environment.

METHODS

A total of 14 healthy participants (11 men and 3 women; mean age 43.28, SD 10.60 years) undertook 15 minutes of immersive physical exercise using the system. Measures included mindfulness and immersion disposition, subjective perceptions of sensory information, user experience, and VR experience (ie, psychological state, flow, and presence).

RESULTS

First, the APTICE system appears to be a useful tool because the user experience is positive (subscales in the AttrakDiff questionnaire: pragmatic quality=0.99; hedonic quality-stimulation=1.90; hedonic quality-identification=0.67; attractiveness=1.58). Second, the system can induce a positive psychological state (negative emotion, P=.06) and an experience of flow and presence (P values ranging from <.001 to .04). Third, individual immersive and mindful disposition plays a role in the VR experience (P values ranging from <.02 to .04). Finally, our findings suggest that there is a link between the subjective perception of sensory information and the VR experience (P values ranging from <.02 to .04).

CONCLUSIONS

These results indicate that the device is well accepted with positive psychological and exteroceptive outcomes. Overall, the APTICE system could be a proof of concept to explore the benefits of virtual physical exercise in clinical medicine.

The role of online game usage in the relationship between initial daily negative moods and subsequent positive moods: The moderating role of hedonistic motivation

This study explores the relationship between initial daily negative mood, online game usage and subsequent positive mood; and examine the moderating roles of hedonistic motivation on the perspective of mood regulation theory. To gather data over five consecutive workdays, this study used the experience sampling method. We then obtained 800 valid daily data from 160 participants. The results of multilevel path analysis show that: (i) initial daily negative mood increases the usage of online games and further enhances subsequent positive mood; (ii) students with higher hedonic motivation will show a stronger positive correlation between initial daily negative mood and online game usage; (iii) students with higher hedonic motivation will show a stronger positive correlation between online game usage and subsequent positive mood. Theoretical and practical implications are also investigated in this study.

Health Implications of Virtual Architecture: An Interdisciplinary Exploration of the Transferability of Findings from Neuroarchitecture

Virtual architecture has been increasingly relied on to evaluate the health impacts of physical architecture. In this health research, exposure to virtual architecture has been used as a proxy for exposure to physical architecture. Despite the growing body of research on the health implications of physical architecture, there is a paucity of research examining the long-term health impacts of prolonged exposure to virtual architecture. In response, this paper considers: what can proxy studies, which use virtual architecture to assess the physiological response to physical architecture, tell us about the impact of extended exposure to virtual architecture on human health? The paper goes on to suggest that the applicability of these findings to virtual architecture may be limited by certain confounding variables when virtual architecture is experienced for a prolonged period of time. This paper explores the potential impact of two of these confounding variables: multisensory integration and gravitational perception. This paper advises that these confounding variables are unique to extended virtual architecture exposure and may not be captured by proxy studies that aim to capture the impact of physical architecture on human health through acute exposure to virtual architecture. While proxy studies may be suitable for measuring some aspects of the impact of both physical and virtual architecture on human health, this paper argues that they may be insufficient to fully capture the unintended consequences of extended exposure to virtual architecture on human health. Therefore, in the face of the increasing use of virtual architectural environments, the author calls for the establishment of a subfield of neuroarchitectural health research that empirically examines the physiological impacts of extended exposure to virtual architecture in its own right.

Acceptance and use of virtual reality games: an extension of HMSAM

Virtual reality (VR) is considered as one of the technological megatrends of 2020s, and today, VR systems are used in various settings, digital gaming being among the most popular ones. However, there has been a dearth of understanding regarding the central factors behind VR gaming acceptance and use. The present study therefore aimed to explain the factors that drive the use and acceptance of VR games. We extended the hedonic-motivation system acceptance model with utilitarian and inconvenience factors to capture the pertinent features of VR systems more holistically. We proposed a theoretical model and analyzed it through covariance-based structural equation modeling using an online survey sample of 473 VR gamers. Our findings help explain the role of different antecedents behind VR gaming acceptance and demonstrate that VR gaming is driven more by the hedonic gaming aspects than by the utilitarian health and well-being aspects of VR games, enjoyment being the strongest driver behind VR gaming intention and immersion. Moreover, findings also suggested that use intentions and immersion levels are not significantly diminished by physical discomfort and VR sickness. The findings, which potentially extend to other VR systems as well, also pose important implications for the providers of VR games. As the main contribution, based on our empirical findings, we provide a greater theoretical understanding on VR gaming acceptance and use.

Effects of Low-Immersive vs. High-Immersive Exercise Environment on Postural Stability and Reaction and Motor Time of Healthy Young Adults

(1) Background: Many young adults spend their time playing games and watching television. This type of spending time should be used effectively, so it's worth adding exercise and immersion to them. Bearing in mind that the video games and physical exercise also improve postural stability, motor time (MT) and reaction time (RT), it is worth reaching for new technologies with immersion that are widely available and can be used, for example, as a remote intervention. This study aimed to compare the effects of a low vs. high-immersive exercise environment on postural stability, RT and MT in young adults. (2) Methods: Ninety-three participants were randomly divided into a control group (CG; n = 48) and experimental group (EG; n = 45). The CG exercised according to the Tabata self-made video display on a television set, and the EG exercised according to the Audio Trip exergame. In addition to the postural stability, RT and MT, we monitored the heart rate, breath rate and energy expenditure for safety reasons and to note any differences. (3) Results: Significant differences were observed for both groups in RT (F(2.182) = 3.14, p = 0.046, η² = 0.03) and MT (F(2.182) = 3.07, p = 0.049, η² = 0.03) and in postural stability in eyes closed (EC): F(2.182) = 3.66, p = 0.028, η² = 0.04 and eyes open in one leg (EO-OL): F(2.182) = 5.814, p = 0.04, η² = 0.07. (4) Conclusions: The inclusion of a higher immersion produces greater improvements in RT, MT. Additionally, after a low-immersive exercise environment, participants have higher center of pressure (COP) path length values with EC and EO-OL tests, which testifies to less postural stability. Regarding COP trajectory, a smaller area surface means better performance for high-immersive participants after 30 min of exercise.

Distance Learning in Pandemic Age: Lessons from a (No Longer) Emergency

For the first time in the history of the global school system, the adoption of distance education modalities became necessary in response to the measures and restrictions implemented to stem the global pandemic generated by COVID-19. Online learning is not a new topic in education; it refers to studying for a certificate using online platforms that offer online courses rather than visiting lectures. Distance learning is a type of training that involves online learning under the supervision of a classroom teacher, but it can still be a little-known modality for both teachers and students. Preparing students for interactions and emotion management is essential in any teaching mode to maximize the learning and participation of the entire class group. This issue becomes even more critical in distance learning because it lacks those aspects of immediacy and concreteness typical of face-to-face interaction. The present article attempts to review the impact of distance learning versus traditional education brought about by the forced experience of distance learning due to the pandemic. In summary, this research has provided some initial findings about distant learning research during the pandemic age. To have a successful learning experience, students must be aware of their responsibilities and master their areas of autonomy, emotions, and feelings. Teaching at a distance is a challenge. As a general rule, learning activities that are successful in a traditional classroom may be adapted to the distance learning setting, but this will take more than a few minor tweaks to the slides or handouts. In order to engage pupils and maintain their attention and motivation levels, these techniques will probably call for more imaginative and inventive ways.

Handheld Weights as an Effective and Comfortable Way To Increase Exercise Intensity of Physical Activity in Virtual Reality: Empirical Study

BACKGROUND

In recent years, there has been a growing interest in active virtual reality games (AVRGs) that provide entertainment and encourage more physical activity (PA). Since playing AVRGs involves primarily arm movements, the intensity of this form of PA may not be sufficient for health benefits. Therefore, it is worth looking for virtual entertainment solutions that are comfortable for users and at the same time increase physical exercise.

OBJECTIVE

The main objective of this study was to evaluate the effect of external loading of the arms in the form of handheld weights (HHWs) on exercise intensity in users playing a popular AVRG. The results obtained in the study were compared with the PA recommendations for health. The study also assessed the perceptions of the users about the attractiveness and usefulness of this type of exercise and discomfort caused by additional load on the arms.

METHODS

The study covered 17 young adults aged 18 to 25 years playing an AVRG (Beat Saber) with no arm load and with HHWs (0.5 kg). A PlayStation 4 PRO console (Sony) with accessories including a head-mounted display and controllers was used in the study. PA intensity was evaluated using a heart rate monitor based on the percentage of maximal heart rate (% HRmax). The usability, attractiveness, and comfort perceived during exercise by users were evaluated using a survey questionnaire.

RESULTS

The measurements showed that the mean % HRmax in participants playing Beat Saber without HHWs was significantly lower (P<.001; Cohen d=1.07) than that observed when playing with HHWs. It should be emphasized that with no additional load, the intensity of PA was low (mean 63.7% HRmax, SD 9.3% HRmax), while with the upper limb load, it increased to a moderate level (mean 67.1% HRmax, SD 10.3% HRmax), which is recommended for health benefits. The survey conducted in the study showed that HHWs (0.5 kg) attached to the wrists did not disturb Beat Saber players.

CONCLUSIONS

Since PA in most of the modern AVRGs primarily involves upper limb movements, the use of HHW seems to be a simple and effective way to increase exercise intensity, especially because, as reported by the study participants, such a procedure does not cause discomfort while using the application.

A virtual reality home-based training for the management of stress and anxiety among healthcare workers during the COVID-19 pandemic: study protocol for a randomized controlled trial

Background

Healthcare workers represent one of the most affected categories by the adverse effects of the COVID-19 pandemic on mental health. Excessive stress and anxiety are critical factors that could compromise work performance. Besides, high levels of stress and anxiety may have long-term physical and psychological consequences. Recent studies investigated virtual reality to reduce stress and anxiety among healthcare workers during the COVID-19 pandemic. However, the proposed virtual reality interventions have important limitations related to their location (i.e., research lab and hospitals) and content (i.e., virtual experiences only for relaxation). Within this context, this randomized controlled trial aims to investigate the efficacy and acceptability of a brief home-based virtual reality training for managing stress and anxiety during the COVID-19 crisis in a sample of Italian healthcare workers.

Methods

The study is a randomized controlled trial. It includes two groups of 30 individuals recruited from healthcare workers: (1) the experimental group and (2) the control group. Participants in the experimental group will receive a training consisting of three home sessions performed in a week. In each session, participants will try through an immersive virtual reality standalone system (i.e., Oculus Quest 2) a virtual psychoeducation experience on stress and anxiety (i.e., MIND-VR). Subsequently, they will try the virtual relaxation content (i.e., The Secret Garden). The control group will receive no training and will be reassessed one week and one month after the initial evaluation.

Discussion

If the proposed brief home-based virtual reality training will result helpful and easy to use, it could become an empirically assessed viable option for protecting healthcare workers’ mental health both during the COVID-19 pandemic and once it will be over. Furthermore, the intervention might be easily adapted for other categories of people who need support in managing stress and anxiety.

Trial registration

ClinicalTrials.gov NCT04611399.

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review

During the initial phases of the COVID-19 pandemic, playing video games has been much more than just a pastime. Studies suggested that video games for many individuals have helped to cope with such difficult life experience. However, other research indicates that gaming may have had harmful effects. Within this context, this systematic review aimed to describe the literature on the effects of video games during the early stages of the COVID-19 crisis on stress, anxiety, depression, loneliness, and gaming disorder (GD), examining the study characteristics and outcomes. A systematic search of the literature was made following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202180053. The search databases were PsycINFO, Web of Science, and Medline. The search string was: [("video game*") OR ("computer game*") OR ("gaming")] AND [("COVID-19")]. Twenty-four studies met the inclusion criteria. Four research explored the effects of playing video games during the COVID-19 pandemic on stress, anxiety, and depression. Four studies investigated loneliness, while 18 research investigated game disorder. Video games, especially augmented reality and online multiplayer ones, mitigated stress, anxiety, depression, and loneliness among adolescents and young adults during stay-at-home restrictions. However, in the case of at-risk individuals (i.e., particularly male youths), playing video games had detrimental effects.

The psychological impact of quarantine due to COVID-19: A systematic review of risk, protective factors and interventions using socio-ecological model framework

Background

Though quarantine is a pertinent control measure for the spread of COVID-19, it is equally important to consider its negative impacts, as it causes severe psychological, emotional, and financial problems not only for those who are quarantined but also for many others who are directly or indirectly connected to those who are quarantined. There appears to be a need to synthesise the available literature evidence on the psychological impact of quarantine experience, especially the multilevel risk factors that make individuals vulnerable to psychological impact and the protective factors to deal with the negative effects of quarantine.

Objective

This systematic review attempted to identify the various psychological impacts associated with the experience of quarantine, the risk and protective factors and list out various psycho-social interventions that can minimise the risks and facilitate the protective factors associated with the experience of quarantine.

Methods

A systematic search adhering to the PRISMA guidelines was performed in four databases PubMed, Scopus, PsycNet, Web of Science and 10518 articles related to COVID-19 and quarantine were obtained. After screening processes and quality assessment using standard checklist 74 articles that fulfilled the eligibility criteria were chosen for the final review.

Findings

Individuals subjected to quarantine had anxiety, depression, post-traumatic stress symptoms, sleep problems, and somatic difficulties. Some of the key risk factors during quarantine are young age, female gender, low money, fear of infection, poor sleep quality, reduced physical activity, increased sedentary behaviours, and a lack of social support. Financial difficulties and stigma remained risk factors even after the quarantine period had ended. Key protective factors were coping skills, home based exercise, leisure, recreational activities, maintaining relationships using social media and availability of mental health services. The findings also highlight the necessity for tele mental health interventions to address the psychological effects of quarantine.

Conclusion

Multilevel interventions are required to minimise the impact of risk factors and enhance protective factors.

Human-Computer Interaction in Digital Mental Health

Human-computer interaction (HCI) has contributed to the design and development of some efficient, user-friendly, cost-effective, and adaptable digital mental health solutions. But HCI has not been well-combined into technological developments resulting in quality and safety concerns. Digital platforms and artificial intelligence (AI) have a good potential to improve prediction, identification, coordination, and treatment by mental health care and suicide prevention services. AI is driving web-based and smartphone apps; mostly it is used for self-help and guided cognitive behavioral therapy (CBT) for anxiety and depression. Interactive AI may help real-time screening and treatment in outdated, strained or lacking mental healthcare systems. The barriers for using AI in mental healthcare include accessibility, efficacy, reliability, usability, safety, security, ethics, suitable education and training, and socio-cultural adaptability. Apps, real-time machine learning algorithms, immersive technologies, and digital phenotyping are notable prospects. Generally, there is a need for faster and better human factors in combination with machine interaction and automation, higher levels of effectiveness evaluation and the application of blended, hybrid or stepped care in an adjunct approach. HCI modeling may assist in the design and development of usable applications, and to effectively recognize, acknowledge, and address the inequities of mental health care and suicide prevention and assist in the digital therapeutic alliance.

Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review (Preprint)

Background

Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings.

Objective

This systematic review aimed to describe the literature on health care–targeted virtual reality applications during the COVID-19 crisis.

Methods

We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: “[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)].” Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias.

Results

Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials.

Conclusions

Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama.

Trial Registration

International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY202190108; https://inplasy.com/inplasy-2021-9-0108/

Virtual Reality for Supporting the Treatment of Depression and Anxiety: Scoping Review

BACKGROUND

Mental health conditions pose a major challenge to health care providers and society at large. The World Health Organization predicts that by 2030, mental health conditions will be the leading cause of disease burden worldwide. The current need for mental health care is overwhelming. In New Zealand, 1 in 6 adults has been diagnosed with common mental disorders, such as depression and anxiety disorders, according to a national survey. Cognitive behavioral therapy (CBT) has been shown to effectively help patients overcome a wide variety of mental health conditions. Virtual reality exposure therapy (VRET) might be one of the most exciting technologies emerging in the clinical setting for the treatment of anxiety and depression.

OBJECTIVE

This study aims to investigate the virtual reality (VR) technologies currently being used to help support the treatment of depression and anxiety. We also aim to investigate whether and how CBT is included as part of VRET and look at the VR technologies and interventions that have been used in recent studies on depression and anxiety.

METHODS

We performed a scoping review. To identify significant studies, we decided to use already aggregated sources from the Google Scholar database. Overall, the goal of our search strategy was to limit the number of initial results related to VR in mental health to only a relevant minimum.

RESULTS

Using our defined keywords, Google Scholar identified >17,300 articles. After applying all the inclusion and exclusion criteria, we identified a total of 369 articles for further processing. After manual evaluation, 34 articles were shortlisted; of the 34 articles, 9 (26%) reported the use of CBT with VR. All of the articles were published between 2017 and 2021. Out of the 9 studies, CBT was conducted within a VR environment in 5 (56%) studies, whereas in the remaining 4 (44%) studies, CBT was used as an addition to VRET. All 9 studies reported the use of CBT either in vivo or in a virtual environment to be effective in supporting the treatment of anxiety or depression.

CONCLUSIONS

Most studies demonstrated the use of VR to be effective for supporting the treatment of anxiety or depression in a range of settings and recommended its potential as a tool for use in a clinical environment. Even though standalone headsets are much easier to work with and more suitable for home use, the shift from tethered VR headsets to standalone headsets in the mental health environment was not observed. All studies that looked at the use of CBT either in vivo or in a virtual environment found it to be effective in supporting the treatment of anxiety or depression.

Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review

BACKGROUND

Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games.

OBJECTIVE

The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play).

METHODS

A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [("video game*") OR ("computer game*")] AND [("stress") OR ("anxiety") OR ("relaxation")] AND [("study") OR ("trial") OR ("training")].

RESULTS

A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety.

CONCLUSIONS

Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety.

TRIAL REGISTRATION

International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081.

Could virtual reality applications pose real risks to children and adolescents? A systematic review of ethical issues and concerns

Virtual reality technologies (VRTs) are high-tech human-computer interfaces used to develop digital content and can be applied to multiple different areas, often offering innovative solutions to existing problems. A wide range of digital games is being also developed with VRTs and together with their components, the games' structural elements are appealing to children and engaging them more in virtual worlds. Our research interest is directed towards children's development and the effects of VRTs within gaming environments. Contemporary psychology studies perceive human development as a holistic and lifelong process with important interrelationships between physical, mental, social and emotional aspects. For the objectives and scope of this work, we examine children development across three domains: physical, cognitive and psychosocial. In this context, the authors review the literature on the impact of VRTs on children, in terms of software and hardware. Since research requires an wide-ranging approach, we study the evidence reported on the brain and neural structure, knowledge, behaviour, pedagogy, academic performance, and wellness. Our main concern is to outline the emerging ethical issues and worries of parents, educators, ophthalmologists, neurologists, psychologists, paediatricians and all relevant scientists, as well as the industry's views and actions. The systematic review was performed on the databases Scopus, IEEE Xplore, PubMed, and Google Scholar from 2010 to 2020 and 85 studies were selected. The review concluded that findings remain contradictory especially for the psychosocial domain. Official recommendations from organizations and well-documented researches by academics on child well-being are reassuring if health and safety specifications and particularly the time limit are met. Research is still ongoing, constantly updated and consist of a priority for the scientific community given that technology evolves.

Gaming Your Mental Health: A Narrative Review on Mitigating Symptoms of Depression and Anxiety Using Commercial Video Games

Globally, depression and anxiety are the two most prevalent mental health disorders. They occur both acutely and chronically, with various symptoms commonly expressed subclinically. The treatment gap and stigma associated with such mental health disorders are common issues encountered worldwide. Given the economic and health care service burden of mental illnesses, there is a heightened demand for accessible and cost-effective methods that prevent occurrence of mental health illnesses and facilitate coping with mental health illnesses. This demand has been exacerbated post the advent of the COVID-19 pandemic and the subsequent increase in incidence of mental health disorders. To address these demands, a growing body of research is exploring alternative solutions to traditional mental health treatment methods. Commercial video games have been shown to impart cognitive benefits to those playing regularly (ie, attention control, cognitive flexibility, and information processing). In this paper, we specifically focus on the mental health benefits associated with playing commercial video games to address symptoms of depression and anxiety. In light of the current research, we conclude that commercial video games show great promise as inexpensive, readily accessible, internationally available, effective, and stigma-free resources for the mitigation of some mental health issues in the absence of, or in addition to, traditional therapeutic treatments.

Administering Virtual Reality Therapy to Manage Behavioral and Psychological Symptoms in Patients With Dementia Admitted to an Acute Care Hospital: Results of a Pilot Study

BACKGROUND

As virtual reality (VR) technologies become increasingly accessible and affordable, clinicians are eager to try VR therapy as a novel means to manage behavioral and psychological symptoms of dementia, which are exacerbated during acute care hospitalization, with the goal of reducing the use of antipsychotics, sedatives, and physical restraints associated with negative adverse effects, increased length of stay, and caregiver burden. To date, no evaluations of immersive VR therapy have been reported for patients with dementia in acute care hospitals.

OBJECTIVE

This study aimed to determine the feasibility (acceptance, comfort, and safety) of using immersive VR therapy for people living with dementia (mild, moderate, and advanced) during acute care hospitalization and explore its potential to manage behavioral and psychological symptoms of dementia.

METHODS

A prospective, longitudinal pilot study was conducted at a community teaching hospital in Toronto. The study was nonrandomized and unblinded. A total of 10 patients aged >65 years (mean 86.5, SD 5.7) diagnosed with dementia participated in one or more research coordinator-facilitated sessions of viewing immersive 360° VR footage of nature scenes displayed on a Samsung Gear VR head-mounted display. This mixed-methods study included review of patient charts, standardized observations during the intervention, and pre- and postintervention semistructured interviews about the VR experience.

RESULTS

All recruited participants (N=10) completed the study. Of the 10 participants, 7 (70%) displayed enjoyment or relaxation during the VR session, which averaged 6 minutes per view, and 1 (10%) experienced dizziness. No interference between the VR equipment and hearing aids or medical devices was reported.

CONCLUSIONS

It is feasible to expose older people with dementia of various degrees admitted to an acute care hospital to immersive VR therapy. VR therapy was found to be acceptable to and comfortable by most participants. This pilot study provides the basis for conducting the first randomized controlled trial to evaluate the impact of VR therapy on managing behavioral and psychological symptoms of dementia in acute care hospitals.