Design and Development of an Immersive Virtual Reality Application for Psychological Support of Dialyzed Patients

Abstract

Depression and anxiety affect up to 52% of hemodialysis patients, yet most cases remain undiagnosed and untreated. This paper presents the design and preliminary evaluation of an immersive virtual reality mindfulness application specifically designed for use during hemodialysis sessions, when patients remain physically immobilized for 3-4 hours, three to four times weekly, to transform this idle treatment time into therapeutic psychological intervention without imposing additional time burdens. The application integrates naturalistic Alpine environments, alpha-frequency binaural beats, guided meditation, and positive affirmations within a 30-minute experience accessible through head-tracking-only interaction to accommodate patients’ restricted movement during dialysis. Preliminary evaluation with eight healthy volunteers in a laptop setting demonstrated excellent usability (System Usability Scale: 91.88/100) and high immersion (EGameFlow: 5.75/7), with particularly strong performance on cognitive immersion dimensions therapeutically relevant for anxiety and depression management, including temporal distortion, sustained attention, and worry reduction. Qualitative feedback identified refinement priorities including narration pacing optimization and environmental visual enhancement. While this study establishes foundational usability and immersion benchmarks using laptop-based testing with nonclinical participants, clinical validation with actual hemodialysis patients using head-mounted displays remains necessary to assess therapeutic efficacy and implementation feasibility in dialysis care contexts.