The Impact of Patient and Professional Users’ Involvement in Implementation for Virtual Reality in Hospitalised Palliative Cancer Patients in a German Cancer Centre—A Qualitative Analysis
Christina Gerlach, Laura Haas, Melanie Guenther, Kate Binnie, Jonah Lantelme, Julia Thiesbonenkamp-Maag, Bernd Alt-Epping, Cornelia WrzusBackground: Virtual reality (VR) is a promising technology for the relief of physical and psychosocial burdens. We found that individualised VR videos were well tolerated and accepted and seemed to have a stronger effect on well-being and emotional connection than standardised VR in cancer inpatients under palliative care. For implementation, it is important to actively involve patients, as their input helps to ensure that the VR intervention meets their needs, thus making it more likely to be accepted and effective in practice, while balancing the needs of healthcare professionals. Aim: Exploration of patients’ and healthcare professionals’ perspectives on best practice VR intervention implementation. Design: Workshop-based 360° focus group using a strengths–weaknesses–opportunities–threats (SWOT) model and deductive/inductive qualitative analysis with a ‘framework’ approach. Setting/participants: The focus group took place at the National Centre for Tumour Therapy of a German university hospital. Participants were a local doctor (1) and nurses (3) with VR experience, the cooperating patient advisory board of the study (2), and members of a regional self-help group (3). Results: Eighteen subthemes were identified in the SWOT model. While there was agreement on the ‘strength of distraction’ and ‘opportunities of individualised VR’, concerns remained regarding data protection when using private VR content. There was an argument about gatekeeping by relatives worried about mental distress in patients immersing in home or family VR scenes. In contrast, many ideas were discussed regarding how to overcome rejectionist staff attitudes. However, the high organisational time and staff deployment were addressed as major weaknesses. Conclusions: Involving patient stakeholders and healthcare professionals in the planning of the implementation strategy revealed several issues that require attention. In particular, information needs to be provided not only to patients but also to relatives and hospital staff, alongside ensuring data protection and adequate staffing. Trial registration: Registered at German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS); registration number: DRKS00032172; registration date: 11 July 2023.