Co-design of a Virtual Reality Cognitive Remediation Program for Depression (bWell-D) With Patient End Users and Clinicians: Qualitative Interview Study Among Patients and Clinicians

Maria Elena Hernandez Hernandez; Erin Michalak; Nusrat Choudhury; Mark Hewko; Ivan Torres; Mahesh Menon; Raymond W Lam; Trisha Chakrabarty

doi:10.2196/43904

Co-design of a Virtual Reality Cognitive Remediation Program for Depression (bWell-D) With Patient End Users and Clinicians: Qualitative Interview Study Among Patients and Clinicians

JMIR Serious Games. 2023 Apr 7:11:e43904. doi: 10.2196/43904.

Authors

Maria Elena Hernandez Hernandez¹, Erin Michalak¹, Nusrat Choudhury², Mark Hewko³, Ivan Torres¹, Mahesh Menon¹, Raymond W Lam¹, Trisha Chakrabarty¹

Affiliations

¹ University of British Columbia, Faculty of Medicine, Department of Psychiatry, Vancouver, BC, Canada.
² National Research Council Canada, Medical Devices, Simulation and Digital Health, Montreal, QC, Canada.
³ National Research Council Canada, Medical Devices, Simulation and Digital Health, Winnipeg, MB, Canada.

PMID: 37027183
PMCID: PMC10131700
DOI: 10.2196/43904

Abstract

Background: Major depressive disorder (MDD) is the leading cause of global disability; however, the existing treatments do not always address cognitive dysfunction-a core feature of MDD. Immersive virtual reality (VR) has emerged as a promising modality to enhance the real-world effectiveness of cognitive remediation.

Objective: This study aimed to develop the first prototype VR cognitive remediation program for MDD ("bWell-D"). This study gathered qualitative data from end users early in the design process to enhance its efficacy and feasibility in clinical settings.

Methods: Semistructured end-user interviews were conducted remotely (n=15 patients and n=12 clinicians), assessing the participants' perceptions and goals for a VR cognitive remediation program. Video samples of bWell-D were also shared to obtain feedback regarding the program. The interviews were transcribed, coded, and analyzed via thematic analysis.

Results: End users showed an optimistic outlook toward VR as a treatment modality, and perceived it as a novel approach with the potential of having multiple applications. The participants expressed a need for an engaging VR treatment that included realistic and multisensorial settings and activities, as well as customizable features. Some skepticism regarding its effectiveness was also reported, especially when the real-world applications of the practiced skills were not made explicit, as well as some concerns regarding equipment accessibility. A home-based or hybrid (ie, home and clinic) treatment modality was preferred.

Conclusions: Patients and clinicians considered bWell-D interesting, acceptable, and potentially feasible, and provided suggestions to enhance its real-world applicability. The inclusion of end-user feedback is encouraged when developing future VR programs for clinical purposes.

Keywords: VR; co-design; cognitive dysfunction; cognitive remediation; depression; depressive; immersive; mental health; mental illness; qualitative study; thematic analysis; user-centered design; virtual reality.

©Maria Elena Hernandez Hernandez, Erin Michalak, Nusrat Choudhury, Mark Hewko, Ivan Torres, Mahesh Menon, Raymond W Lam, Trisha Chakrabarty. Originally published in JMIR Serious Games (https://games.jmir.org), 07.04.2023.