Older Adults’ Experiences and Perceptions of Immersive Virtual Reality: A Systematic Review and Thematic Synthesis (Preprint)

Abstract

BACKGROUND Immersive virtual reality (IVR) can be defined as fully computer-generated environments that are displayed through a head-mounted display. Existing research suggests that key features of IVR can assist older adults in their everyday lives–providing opportunities in health promotion and tackling social isolation and loneliness. There has been a surge in the number of qualitative studies exploring older adults’ experiences and perceptions of IVR. However, there has been no systematic synthesis of these studies to inform the design of new, more accessible IVR technologies. OBJECTIVE The objective of this study was to systematically review and synthesize qualitative studies exploring older adults’ experiences and perceptions of IVR. METHODS A systematic review and thematic synthesis was conducted following the ENTREQ guidelines. Two reviewers completed title and abstract screening, full-text screening, data extraction and quality appraisal. Thematic synthesis is derived from the qualitative method, thematic analysis. It involves three key steps: initial coding and grouping of these codes, the formation of descriptive themes from these codes and finally, going beyond the data to form novel insights and theories known as analytical themes. Confidence in the evidence was assessed using the GRADE-CERQual approach. RESULTS Thirteen studies were included in the final synthesis, consisting of 224 participants ranging across nine countries and five continents. Confidence in the evidence ranged from high to moderate. Four descriptive themes were generated: (1) facilitating IVR interactions, (2) experiencing unique features of IVR, (3) perceptions of IVR and (4) accounts of agency in IVR. The findings from the descriptive themes suggested that there are several improvements that need to be made to existing IVR devices to greater facilitate older adults’ use of this technology. However, despite this, older adults’ responses to IVR were generally positive. Three analytical themes were then generated: (1) tolerating the bad to experience the good, (2) buying in to IVR: don’t judge a book by its cover and (3) “it proves to me I can do it”. The analytical themes illustrated that older adults were willing to tolerate discomforts that accompany existing IVR technologies to experience features such as immersive social networking experiences, there was a discrepancy between older adults’ perceptions of IVR prior to use–which were generally negative–and after use–which were generally positive–and, IVR provided a platform for older adults to access certain activities and environments more easily than in the real world due to limitations caused by ageing. CONCLUSIONS This review highlights the need to overcome initial negative views of IVR and perceived barriers to use by emphasizing the unique ability of IVR to increase older adults’ agency through features such as presence, immersion, and embodiment, which in turn offer new opportunities to take part in meaningful activities tailored to their needs and preferences. INTERNATIONAL REGISTERED REPORT RR2-10.1177%2F16094069211009682