Table 3.
Facilitators to implementation and the number of publications they were mentioned in (n)
| Category | Facilitator | Definition | n | References |
|---|---|---|---|---|
| Category 1: Condition ( n = 1 facilitator) | ||||
| Socio-demographics | Young age | Younger people may be more open to new technology and feel comfortable to use VR during treatment | 2 | [34, 38] |
| Category 2: Technology ( n = 5 facilitators) | ||||
| Technical functionality | Client safety | Client is physically safe in treatment room while using VR hardware | 6 | [13, 34, 44, 53–55] |
| Reliability | VR hardware is reliable and stable while in use | 1 | [55] | |
| Usability | Patient comfort | The patient is comfortable while using VR hardware and software | 4 | [34, 44, 52, 56] |
| Easy to use | The VR hardware and software is easy to use by end-users | 3 | [34, 53, 55] | |
| Effect of VR on treatment | Realism and immersion | VR is able to induce feelings of realism and immersion | 4 | [13, 40, 41, 57] |
| Category 3: Value proposition ( n = 8 facilitators) | ||||
| Influencing treatment | Safe and controlled environment | Having a virtual environment that is controlled by the healthcare provider and therefore offers a safe space to practice behavior | 5 | [39–41, 45, 51] |
| Different reality | Practice behavior in a virtual environment of choice, while physically in the treatment room | 4 | [41, 44, 48, 51] | |
| Personalizing treatment | VR can be adapted to fit patient needs and treatment goals | 3 | [51, 54, 55] | |
| Facilitate human interaction | VR could facilitate human contact by practicing virtual roleplays, which other technologies can not | 3 | [39, 45, 47] | |
| Control and self-efficacy | VR could increase behavioral control and self-efficacy in patients | 2 | [41, 51] | |
| Insight into behavior and experiences | VR could increase insight of healthcare provider into behavior of patients and their experiences | 1 | [34] | |
| Practical resources | Financial viability | VR demonstrates financial viability and has a strong business case | 1 | [34] |
| Time and resource efficient | VR is time and resource efficient to use compared to other treatment forms | 1 | [40] | |
| Category 4: Adopter system ( n = 18 facilitators) | ||||
| Factors that influence opinion towards VR—healthcare providers | Evidence of VR value | Availability of validated evidence on the value of VR for treatment | 10 | [13, 34, 37–39, 41, 43, 44, 46, 58] |
| Experience with technology | Having experience with technology in general and/or with VR | 7 | [35, 40, 43–46, 49] | |
| Added value of VR | Being aware of the benefits of VR for patients and treatment | 4 | [34, 36, 46, 48] | |
| Improvement in patients | Perception of improvement in patients’ health and treatment goals | 2 | [37, 50] | |
| Satisfaction with VR | Being satisfied with the usability of VR hardware and software | 2 | [38, 49] | |
| Support from management | Perceived support from management to use VR | 2 | [43, 58] | |
| Innovativeness | Being intrigued by the innovativeness of VR in existing treatment | 1 | [45] | |
| Attitude towards VR—patients | Patient motivation | VR could enhance patient motivation and engagement in treatment | 11 | [13, 34, 35, 40, 43, 48, 50, 51, 53, 57–59] |
| Positive | VR is perceived as positive, fun and engaging by patients | 1 | [50] | |
| Less stressful | Exposure in VR is less stressful than in-vivo exposure | 1 | [51] | |
| Encouraged by healthcare provider | Patient feels encouraged and supported by healthcare provider to use VR | 1 | [50] | |
| Attitude towards VR—colleagues | Positive social influence | Positive opinion of VR of colleagues causes a “domino effect” | 1 | [37] |
| Integrating VR in routines | Combine and integrate VR | The capacity to combine and integrate VR in existing treatment | 2 | [36, 48] |
| Knowledge and skills needed to use VR | Training | Offering training on how to use VR hardware and software | 8 | [34, 35, 37, 39, 45, 46, 48, 50] |
| Knowledge and skills | Developing sufficient knowledge and skills to feel confident and comfortable using VR | 5 | [34, 44, 46, 52, 53] | |
| Intervision | The possibility of frequent contact with colleagues on VR for support, troubleshooting and reviewing VR use | 2 | [13, 45] | |
| Protocols | Having protocols or guides available on how to use VR | 2 | [46, 60] | |
| Technological capabilities | The use of VR may increase technological capabilities and vice versa | 1 | [45] | |
| Category 5: Organization ( n = 18 facilitators) | ||||
| Readiness to innovate | Innovative culture | Having an innovative culture within the organization | 2 | [34, 44] |
| Champions | Strategic recruitment of champions to promote VR uptake and credibility | 2 | [34, 44] | |
| Willingness to invest | Organization is willing to invest time and money in VR | 1 | [58] | |
| Introducing VR to healthcare providers | Try out VR | Giving the opportunity and time to healthcare providers to try out VR for themselves | 8 | [13, 34, 37, 38, 47, 48, 50, 54] |
| Educational materials | Creating access for healthcare providers to educational materials on VR | 5 | [43, 46, 54, 58, 60] | |
| E-mail updates | Sending e-mail updates on VR use and added value of VR to keep healthcare providers informed on VR progress in the organization | 2 | [13, 60] | |
| Staff meetings | Introduce VR and opportunities of VR during staff meetings | 1 | [34] | |
| Providing support for healthcare providers | Time to learn VR | Offering enough time for healthcare providers to learn how to use VR | 13 | [13, 34, 38, 42–46, 50, 53, 58, 60] |
| Technical system support | Offering technical system support to healthcare providers who work with VR | 12 | [13, 34, 38, 42–46, 50, 53, 58, 60] | |
| Rooms availability | Having enough rooms available for VR use | 8 | [13, 35, 37, 38, 44, 48, 50, 58] | |
| Support staff | Having support staff available that helps set up the VR system | 6 | [35–37, 43, 45, 58] | |
| VR systems | Sufficient VR systems to use in treatment | 5 | [13, 35, 38, 43, 56] | |
| Staff who operate VR | Having selected healthcare providers available who operate VR for multiple patients, instead of training all staff on VR | 4 | [35–37, 58] | |
| Staff who supervise VR | Having technical support staff available who supervise VR sessions and help healthcare providers | 4 | [37, 38, 45, 53] | |
| Training on patient suitability | Organizing training in determining patient suitability for VR | 4 | [34, 35, 39, 59] | |
| Train-the-trainer | A learning model in which colleagues who have experience with VR train colleagues that are new to VR | 1 | [59] | |
| Integrating VR in organizational structure and workflow | Fit current protocols | VR should fit with current treatment protocols | 2 | [42, 44] |
| Reinforcement from management | Reinforcement from management to refer clients to VR treatment | 2 | [35, 37] | |
| Category 6: Wider system ( n = 2 facilitators) | ||||
| Societal development | Innovation minded | Opinion leaders being innovation-minded and open towards VR | 2 | [44, 46] |
| Opinion of society | General positive opinion of society on VR | 1 | [41, 46] | |
| Category 7: Embedding and adoption over time ( n = 1 facilitator) | ||||
| Challenge to scale up | Commonplace and affordable | VR becomes more commonplace and affordable, making it easier to scale up VR use | 1 | [41] |