Background Despite the negative psychological sequelae associated with chronic illness, psychological wellbeing is commonly overlooked in palliative care. Immersive virtual reality (VR) is a novel treatment that may improve psychological outcomes and ameliorate quality of life in adults living with chronic physical illness (ACPI). The aim of the study was to systematically review literature to:

1. Explore the psychotherapeutic applications of immersive VR in ACPI

2. Assess the effect of immersive VR interventions on the psychological welfare of ACPI

Methods A systematic literature review and meta-analysis were conducted. Database searches of Ovid MEDLINE/PubMed, Web of Science, PsycINFO, Embase and Scopus included literature published between July 1993 to March 2023. Given the paucity and heterogeneity of study design and interventions, narrative synthesis was conducted.

Results Out of 12811 texts screened; 31 studies were included. In these studies, 75% of participants were female, and the median age of participants was 50.8 years. Most of the texts included were feasibility or pilot studies. Immersive VR interventions focusing on relaxation and participant engagement demonstrated high acceptability and feasibility when adopted to patient populations dealing with cancer, kidney disease, dementia, cardiovascular disease, and multiple sclerosis. Results indicate that immersive VR can alleviate pain and reduce anticipatory anxiety, particularly in oncological settings.

Conclusions There are notable positive effects associated with immersive VR promoting environment-based and game-based relaxation, amongst people with cancer as well as other restricting chronic physical conditions. Further research on long-term benefits of VR, in wider population groups, is recommended.