Design principles for PTG-oriented VR mindfulness in cancer survivorship: a qualitative-to-prototype translation framework

Introduction: Cancer survivorship is a prolonged phase shaped by late effects and ongoing recovery work, yet scalable, survivor-centred psychosocial supports remain limited, and VR-guided mindfulness design is often under-specified for repeatable use in real-world recovery contexts.

Methods: Using an interpretive phenomenological approach, we conducted two linked qualitative phases: focus groups with adult cancer survivors (n = 14; ≥1 year post-treatment; recruited via an Irish cancer care centre) to generate survivorship-derived requirements, followed by rapid iterative development of a comfort-first, ∼15-min bespoke VR PTG mindfulness prototype (Meta Quest 3s) and semi-structured post-use interviews (n = 10) to refine and validate design decisions; data across phases were analysed using inductive reflexive thematic analysis.

Results: Presented is a survivor-derived, theory-aligned design principles framework for PTG-oriented VR mindfulness supported by explicit traceability from qualitative requirements to prototype design decisions, emphasising attention-by-design (one focal anchor per scene, explicit signalling, staged sensory complexity), comfort as a precondition for psychological accessibility (seated use, stable horizon, conservative audio, screening and stop rules), onboarding-as-intervention (plain-language guidance, progressive disclosure, minimal in-session decisions), accessibility and inclusion (controller-free interaction, low literacy support, remembered presets), and engagement features that sustain return use without competing with therapeutic flow; brief guidance is also provided for mechanism-aligned measurement, co-design/patient-centred communication, and strategic positioning.

Conclusion: By translating lived survivorship experience into scene- and interaction-level VR design rules operationalised in a comfort-first prototype, this work advances medically relevant guidance for building repeatable VR mindfulness tools intended to support growth-oriented coping in survivorship and provides a reproducible foundation for future refinement and evaluation.