Between reality and meaning: a qualitative study on virtual reality as a compassionate technology in end-of-life care.

Résumé

BACKGROUND: Virtual reality (VR) is increasingly recognized as a supportive tool in palliative care due to its potential to promote relaxation, emotional comfort, and spiritual reflection. In Thailand, where end-of-life care is shaped by family relationships, Buddhist beliefs, and the value of a peaceful death, little is known about how VR is perceived in this context.AIM: To explore perceptions, emotional and spiritual needs, and anticipated acceptability of VR in end-of-life care among terminally ill patients, family caregivers, and palliative care professionals in Thailand.METHOD: A qualitative descriptive study was conducted using semi-structured interviews with 15 purposively selected participants, including five terminally ill patients, five family caregivers, and five healthcare professionals. The study focused on anticipated rather than directly experienced use of VR. Interviews were conducted in Thai, audio-recorded, transcribed verbatim, and analyzed using inductive content analysis. Rigor was enhanced through investigator triangulation, reflexive memo writing, peer debriefing, and an audit trail.RESULTS: Four interrelated themes were developed: (1) emotional and existential needs, including longing for home, peace, and unresolved concerns; (2) spirituality and meaning, where VR was perceived as a medium for reflection and religious connection; (3) facilitators and barriers, including perceived benefits alongside concerns about usability, emotional impact, and staff workload; and (4) compassionate innovation, reflecting the potential of VR to support dignity, comfort, and meaning at the end of life. Participants viewed VR not merely as a distraction tool, but as a means of symbolic connection and emotional support.CONCLUSION: In this Thai palliative care context, VR was perceived as a potentially compassionate and culturally meaningful technology that may support emotional, existential, and spiritual well-being when tailored to patient readiness, cultural values, and clinical feasibility. As findings reflect anticipated perceptions, further research is needed to evaluate its practical, emotional, and ethical impacts in clinical settings.