Prolonged hospitalization can reduce opportunities for independent activity, choice, and control and may contribute to passivity, low mood, anxiety, and distress in some older adults. Zenctuary VR+ is a seated, nature-based virtual reality program that combines calming environments with simple, low-demand activities. The active program allows participants to make choices, move between predefined locations, and influence elements of the virtual environment. Trained staff supervise every session and provide support when needed.
The trial evaluates whether the interactive version of Zenctuary VR+ reduces psychological distress more than passive exposure to the same virtual environments. A total of 100 hospitalized adults aged 60 years or older will be randomly assigned to the interactive VR condition or the passive VR condition. Eligible participants are expected to remain hospitalized for at least four weeks following enrolment. Both groups will receive six sessions over three weeks. Psychological distress and related psychological factors will be assessed before the first session, immediately after the three-week intervention period, and four weeks after the final session.
Aged 60 years or older
Diagnosed with at least one chronic medical condition
Currently receiving inpatient hospital care
Expected to remain hospitalized for at least four weeks following enrolment
Cognitive impairment, defined as a score below 18 on the Montreal Cognitive Assessment (MoCA)
Impaired consciousness or reduced alertness that would prevent meaningful participation
Current or previous diagnosis of a psychotic disorder
Current substance use disorder that would interfere with participation in the study procedures