JMIR Publications

ABSTRACT

Background:

Against the backdrop of global population aging, the development of low-burden and widely acceptable interventions to support emotional health in older adults has become a critical research priority. Virtual reality (VR) has been increasingly applied in medical rehabilitation and psychological interventions due to its immersive and interactive features. However, its potential as a form of digital therapy that integrates cultural content and artistic design remains underexplored, particularly with respect to the mechanisms through which such experiences facilitate emotional regulation in older populations. Empirical studies combining subjective emotional outcomes with objective physiological indicators are especially scarce.

Objective:

This study aimed to examine the emotional regulation effects of an artistic cultural heritage–based VR experience among older adults and to explore its underlying mechanisms by integrating subjective psychological assessments with objective physiological responses.

Methods:

A mixed-methods experimental design was adopted using the Historic Centre of Macao (including the Ruins of St. Paul’s and surrounding areas) as the study context. Two VR conditions were developed for comparison: (1) an artistic cultural heritage VR environment and (2) a conventional photorealistic replica VR environment. A total of 49 participants aged 60 years and older were recruited. During the VR experience, electrodermal activity (EDA) was continuously recorded to capture emotional arousal. Physiological data were triangulated with pre- and post-intervention psychological questionnaires assessing emotional states, as well as semi-structured interviews.

Results:

Compared with the photorealistic replica VR condition, the cultural heritage VR experience was significantly more effective in enhancing positive emotions and reducing negative emotions. Participants in the cultural heritage VR condition also exhibited higher levels of emotional arousal, as evidenced by greater frequency and amplitude of EDA responses. These physiological patterns were consistent with changes observed in subjective emotional reports, indicating convergence between objective and self-reported measures of emotional experience. Be sure to include relevant statistics here, such as sample sizes, response rates, P values or Confidence Intervals. Be specific (by stating the value) rather than general (eg, “there were differences between the groups”).

Conclusions:

By integrating subjective psychological assessments with objective physiological indicators, this study provides empirical evidence supporting the effectiveness of artistic cultural heritage–based VR experiences in promoting emotional health among older adults. The findings further propose a digital therapy pathway of “experience–emotional arousal–emotional health.” This study extends the theoretical framework of VR applications in geriatric mental health and offers a replicable, evidence-based approach for emotion-supportive design in digital heritage initiatives and community-based elderly care settings.