Nature Through Virtual Reality as a Stress-Reduction Tool: A Systematic Review

The current systematic review aims to assess the acute stress-reduction effects of virtual reality (VR) natural environments. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, while the inclusion criteria were established through population, intervention, comparison, outcome, and study design (PICOS). The studies were included if (a) based on a nonclinical population; (b) compared the exposure to virtual nature through 360° images, biophilic elements, VR prerecorded videos, or immersive environments, excluding augmented reality; (c) objective (physiological parameters) or subjective (e.g., self-report questionnaires) measures were reported; (d) the reported measures contained quantitative outcomes; and (e) the records were published between 2010 and 2023. Four hundred nine studies were initially retrieved, 19 of which were finally included for synthesis. The eligible studies comprised a total of 1,168 participants. The quality assessment of the studies revealed a score of 10.1/15, indicating that studies were of overall “moderate quality.” Heterogeneity among the type of natural environment, type of stress induction, and type of comparator (nonnatural environment) was retrieved. Differences were also present regarding either the physiological or psychological variables analyzed. The exposure to natural environments through VR seemingly reduces objective and subjective stress levels. The presence of (a) natural sounds, (b) natural lighting, and (c) water elements seem to be key elements that help VR users reducing stress.