HospiceNCT06186960

Tandem VR: Synchronized Nature-Based Experiences in Virtual Reality for Hospice Patients and Their Caregivers

A study testing Tandem Virtual Reality in people with Hospice and End of Life, run by Prisma Health-Upstate at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

Who is it for?: Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for: Hospice, End of Life, Palliative Care
What is being tested?: Tandem Virtual Reality
Type of treatment: Medical device
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 26 participants
Where: 1 siteUnited States
Study dates: 1 Mar 2024to 30 Apr 2025
Phase: Interventional
Are there results?: Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 18 years and older
All sexes
Healthy volunteers accepted
Adult, Older adult

Who may be able to join

English speaking
Projected life expectancy of <6 months (established by hospice experts)
Cognitively intact (has sufficient judgment, planning, organization, and self-control)

Who cannot join

Having a cognitive impairment that affects protocol participation. This will be done with the assistance of Research Recruiters to assess eligibility.
Have a condition that interferes with VR usage, including but not limited to seizures, facial injury precluding safe placement of headset
Have a prognosis of hours or actively dying at the time enrollment
Patients with motion sickness
Patients with claustrophobia
Patients with visual and hearing impairment
Patients with inability to speak English

Trial locations and contacts

1 site in 1 country.

United States1 site

Cottingham Hospice House
Seneca, South Carolina, 29672

Other trials in United States

About this study

Background: Nature-based virtual reality (VR) and other outdoor experiences in head-mounted displays (HMDs) offer powerful, non-pharmacological tools for hospice teams to help patients undergoing end-of-life (EOL) transitions. However, the psychological distress of the patient-caregiver dyad is interconnected and highlights the interdependence and responsiveness to distress as a unit. Hospice care services and healthcare need strategies to help patients and informal caregivers with EOL transitions.

Read the detailed description

Methods: This study uses a synchronized Tandem VR approach where patient- caregiver dyads experience immersive nature-based and other outdoor VR content. This mixed methods study will recruit 20 patient-caregiver dyads (N = 40) enrolled in home hospice services nearing the end-of-life. Dyads will experience a personalized nature-based or other outdoor VR experience lasting 5-15 minutes. Self-reported questionnaires and semi-structured interviews will be collected before and after the VR intervention to identify the impacts of personalized nature-based and other outdoor Tandem VR experiences on the QOL, pain, and fear of death in patient-caregiver dyads enrolled with hospice services. Additionally, this protocol will determine the acceptance of personalized nature-based and other outdoor Tandem VR experiences by dyads as a non-pharmacological modality for addressing patient and caregiver needs. Acceptance was quantified by the number of dyads accepting or declining the VR experience during recruitment.

Discussion: Using personalized, nature-based and other outdoor VR experiences, the patient-caregiver dyads can simultaneously engage in an immersive encounter to help alleviate symptoms associated with declining health and EOL phases for the patient and the often overburdened caregiver. This protocol focuses on meeting the need for person- and caregiver-centered, non-pharmacological interventions to reduce physical, psychological, and spiritual distress.

Conditions: Hospice, End of Life, Palliative Care, Pain, Anxiety, Fear of Death
Being tested: Tandem Virtual Reality
Keywords: hospice, palliative care, virtual reality, VR, quality of life, personalized, nature, tandem
Medical subject headings: Death, Pain, Anxiety Disorders, Necrophobia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Tandem Virtual RealityDevice
Hospice patients and their primary caregiver will each wear virtual reality headsets and will experience a customized and synchronized 5-15min virtual reality experience.

Study groups in NCT06186960
Study group	Role	What they receive
Tandem Virtual Reality Experience	Experimental	Tandem VR Intervention After the surveys are completed, the researchers will share a personalized library of immersive, nature-based, 360-degree VR experiences for the participant-caregiver dyads to choose from based on their VR Intake Form. Once the dyad has determined their desired Tandem VR experience from the library, the researchers will assist the dyads in donning the VR head mounted display (HMD). The researchers will ensure the safety of both dyads while using the HMDs. The researchers will then initiate the Tandem VR experience. The duration of the Tandem VR experience will be 5-15 minutes. Receives: Device: Tandem Virtual Reality

What is being measured

The primary outcome is the main question the study is designed to answer.

Quality of Life Domains
Quality of life will be measured with the McGill Quality of Life Questionnaire (MQOL-E). This assesses eight important life domains: cognition, healthcare, environment, feeling like a burden, and their relationships with physical, psychological, social, and existential/spiritual domains. The 16-item questionnaire uses a 0-10 response scale with a higher score indicating a higher quality of life.
Measured: 15 minutes
Fear of Death
The Collett-Lester Fear of Death Scale (CL-FODS), measures changes in perception of fear of death and 28 items. The CL-FODS uses a 5-Likert scale ranging from 1= not to 5=very for how disturbed or made anxious a person is by different aspects of death and dying. A higher score indicates a higher fear of death. Some example items include rating how disturbed or made anxious you are about the shortness of life, the lack of control over dying, and feeling lonely without your person. The CL-FODS has four subsections: Death of Self, Death of Others, Dying of Self, and Dying of Others. The means of each subsection and then the total scale scores illustrate the degree of anxiety about death and dying, with a higher value indicating the severity of anxiety about death and dying.
Measured: 15 minutes
Perception of Pain
Wisconsin Brief Pain Scale Questionnaire will assess perception of pain. Patients will rate their pain from 0=no pain to 10=worst pain imaginable in response to items such as "average pain," "worst pain," "least pain" over the last seven days, and "pain right now." An average of the responses to these items is used to create a single pain severity score. A higher score indicates more perceptions of pain.
Measured: 15 minutes
Acceptance of Tandem VR
Determine the acceptance of personalized nature-based Tandem VR experiences by dyads as a non-pharmacological modality for addressing the needs of dyads. Acceptance is quantified by the number of dyads accepting or declining the VR experience during recruitment.
Measured: 1 minute
Perceived Benefits and Value of Tandem VR
Semi-structured interview data will be gathered and examined using a thematic analysis to capture the perceived benefits and value of Tandem VR.
Measured: 20 minutes

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

1 Mar 202430 Apr 2025

First posted2 Jan 2024
Study start1 Mar 2024
Primary completion20 Nov 2024
Study completion30 Apr 2025

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
Publications (1)Papers the sponsor has linked to this study.
Other trials for HospiceStudies of the same condition, open and under way.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Interventional
Phase: Phase N/A
Primary purpose: Treatment
Allocation: Not applicable
Intervention model: Single group
Model description: Multiple Method Design
Masking: None (open label)
Enrolment: 26 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT06186960
Sponsor's protocol ID: 2079177-3
Status last verified: Feb 2026
First submitted: 30 Nov 2023
Last updated: 6 Apr 2026
Results posted: Yes, on ClinicalTrials.gov
Data monitoring committee: Yes
FDA-regulated drug: No
FDA-regulated device: Yes
Individual data sharing: No

Publications

McAnirlin O, Thrift J, Li F, Pope JK, Browning MHEM, Moutogiannis PP, Thomas G, Farrell E, Evatt MM, Fasolino T. The Tandem VR protocol: Synchronized nature-based and other outdoor experiences in virtual reality for hospice patients and their caregivers. Contemp Clin Trials Commun. 2024 Jun 22;40:101318. doi: 10.1016/j.conctc.2024.101318. eCollection 2024 Aug.
PubMed 39045392

Want to know more?

The sponsor has not listed a contact. The official record may have more details.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

See locations

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Prehospital Care of End-of-Life Patients by the Strasbourg Mobile Emergency and Resuscitation Service: A Qualitative Study of Healthcare Professionals' Experiences and Use of a Comfort Care Booklet
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All Hospice trials

Study at a glance

From the registry record, last updated by the sponsor on 6 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Tandem VR: Synchronized Nature-Based Experiences in Virtual Reality for Hospice Patients and Their Caregivers
ClinicalTrials.gov ID: NCT06186960
Acronym / sponsor ID: 2079177-3
Conditions: Hospice, End of Life, Palliative Care, Pain, Anxiety, Fear of Death
Keywords: hospice, palliative care, virtual reality, VR, quality of life, personalized, nature, tandem
Study type: Interventional
Recruitment status: Completed
Enrolment: 26 participants (actual)
Lead sponsor: Prisma Health-UpstateUniversity, hospital or other
Collaborators: Clemson University
Study start: 1 Mar 2024 (actual)
Primary completion: 20 Nov 2024 (actual)
Study completion: 30 Apr 2025 (actual)
First posted: 2 Jan 2024 (actual)
Results: Posted 13 Mar 2026

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

Detailed description

Study design

Primary purpose: Treatment
Allocation: Not applicable
Intervention model: Single group
Masking: None (open label)
Number of arms: 1
Model description: Multiple Method Design

Arm	Type	Receives
Tandem Virtual Reality Experience	Experimental	Device: Tandem Virtual RealityTandem VR Intervention After the surveys are completed, the researchers will share a personalized library of immersive, nature-based, 360-degree VR experiences for the participant-caregiver dyads to choose from based on their VR Intake Form. Once the dyad has determined their desired Tandem VR experience from the library, the researchers will assist the dyads in donning the VR head mounted display (HMD). The researchers will ensure the safety of both dyads while using the HMDs. The researchers will then initiate the Tandem VR experience. The duration of the Tandem VR experience will be 5-15 minutes.

Who may qualify

Ages: 18 years and older
Sex: All
Healthy volunteers: Accepted
Age groups: Adult, Older adult

Key inclusion criteria (3 listed)

English speaking
Projected life expectancy of <6 months (established by hospice experts)
Cognitively intact (has sufficient judgment, planning, organization, and self-control)

Key exclusion criteria (7 listed)

Having a cognitive impairment that affects protocol participation. This will be done with the assistance of Research Recruiters to assess eligibility.
Have a condition that interferes with VR usage, including but not limited to seizures, facial injury precluding safe placement of headset
Have a prognosis of hours or actively dying at the time enrollment
Patients with motion sickness
Patients with claustrophobia

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Intervention	Type	Arms
Tandem Virtual RealityHospice patients and their primary caregiver will each wear virtual reality headsets and will experience a customized and synchronized 5-15min virtual reality experience.	Device	Tandem Virtual Reality Experience

Primary outcome

Quality of Life Domains
Time frame: 15 minutes
Quality of life will be measured with the McGill Quality of Life Questionnaire (MQOL-E). This assesses eight important life domains: cognition, healthcare, environment, feeling like a burden, and their relationships with physical, psychological, social, and existential/spiritual domains. The 16-item questionnaire uses a 0-10 response scale with a higher score indicating a higher quality of life.
Fear of Death
Time frame: 15 minutes
The Collett-Lester Fear of Death Scale (CL-FODS), measures changes in perception of fear of death and 28 items. The CL-FODS uses a 5-Likert scale ranging from 1= not to 5=very for how disturbed or made anxious a person is by different aspects of death and dying. A higher score indicates a higher fear of death. Some example items include rating how disturbed or made anxious you are about the shortness of life, the lack of control over dying, and feeling lonely without your person. The CL-FODS has four subsections: Death of Self, Death of Others, Dying of Self, and Dying of Others. The means of each subsection and then the total scale scores illustrate the degree of anxiety about death and dying, with a higher value indicating the severity of anxiety about death and dying.
Perception of Pain
Time frame: 15 minutes
Wisconsin Brief Pain Scale Questionnaire will assess perception of pain. Patients will rate their pain from 0=no pain to 10=worst pain imaginable in response to items such as "average pain," "worst pain," "least pain" over the last seven days, and "pain right now." An average of the responses to these items is used to create a single pain severity score. A higher score indicates more perceptions of pain.
Acceptance of Tandem VR
Time frame: 1 minute
Determine the acceptance of personalized nature-based Tandem VR experiences by dyads as a non-pharmacological modality for addressing the needs of dyads. Acceptance is quantified by the number of dyads accepting or declining the VR experience during recruitment.
Perceived Benefits and Value of Tandem VR
Time frame: 20 minutes
Semi-structured interview data will be gathered and examined using a thematic analysis to capture the perceived benefits and value of Tandem VR.

Results and safety

Results posted to the registry on 13 Mar 2026, as reported by the sponsor. Figures are copied from the record, not re-analysed. Full results on ClinicalTrials.gov.

Participant flow

Group	Started	Completed
Tandem Virtual Reality Experience for Patients	13	11
Tandem Virtual Reality Experience for Informal Caregivers	13	11

Primary outcome: Quality of Life Domains

Time frame: 15 minutes. Mean (Standard Deviation). Unit: units on a scale

Measure	Quality of Life-Patients n = 11	Quality of Life-Informal Caregivers n = 11
Value	1.68 (3.66)	1.27 (1.90)

Population analysed: The quality of life questionnaire assessed the impact of the Tandem VR experience on the patient-caregiver dyad's perception of benefit over the past 2 days. Positive values would have indicated a benefit (ie, greater well-being); Post-pre

Primary outcome: Fear of Death

Time frame: 15 minutes. Mean (Standard Deviation). Unit: units on a scale

Measure	Fear of Their Own Death-Patient n = 11	Fear of Dying Process-Patients n = 11	Fear of Another Person's Death-Patients n = 11	Fear of Another Person's Dying Process-Patients n = 11	Fear of Their Own Death-Informal Caregivers n = 11	Fear of Dying Process-Informal Caregivers n = 11	Fear of Another Person's Death-Informal Cargivers n = 11	Fear of Another Person's Dying Process-Informal Caregivers n = 11
Value	-0.04 (0.24)	0.50 (0.96)	-0.31 (1.18)	-0.11 (1.75)	0.00 (0.33)	0.50 (0.40)	-0.51 (0.64)	-0.23 (0.61)

Population analysed: Fear of Death Questionnaire assessed the patient and informal caregivers on the following parameters: Fear of their own death Fear of they dying process Fear of another person's death Fear of another person's dying process These were assessed Pre and Post experience in Tandem VR. Negative values indicate a benefit (ie, reduced fear); Post-pre

Primary outcome: Perception of Pain

Time frame: 15 minutes. Mean (Standard Deviation). Unit: units on a scale

Measure	Perception of Pain-Patient n = 11	Perception of Pain-Informal Caregivers n = 11
Value	-0.64 (1.43)	-0.18 (1.66)

Population analysed: Means of the effects of the Tandem VR experience on the patient-caregiver dyad perceptions of pain, with negative values indicating a benefit (ie less pain); Post-pre

Primary outcome: Acceptance of Tandem VR

Time frame: 1 minute. Count of participants. Unit: Participants

Measure	Acceptance of Tandem VR Intervention n = 22
Value	22

Adverse events

Time frame: From the initiation of the intervention until the intervention was stopped before completion, 10 minutes. Other adverse events reported at 5% frequency or more

Group	Serious adverse events	Other adverse events	Deaths
Adverse Events During Tandem VR Intervention Reported by Patient	0 of 13 (0%)	1 of 13 (7.7%)	0 of 13
Adverse Events During Tandem VR Intervention Reported by Informal Caregiver	0 of 13 (0%)	0 of 13 (0%)	0 of 13

Limitations and caveats (from the sponsor): Limitations of the study: * small sample size * differences in how pre/post questionnaires were administered * decision made to reduce the burden on patients, could have led to different responses * the questionnaire used to measure wellbeing asked respondents to consider their burdens over last 2 days * unable to determine highest influence questions from wellbeing questionnaire * multiple experiences not performed, was not repeated

Loading the posted results from ClinicalTrials.gov…

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 6 Apr 2026.
Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
Derived from this study: PubMed 39045392McAnirlin O, Thrift J, Li F, Pope JK, Browning MHEM, Moutogiannis PP, Thomas G, Farrell E, Evatt MM, Fasolino T. The Tandem VR protocol: Synchronized nature-based and other outdoor experiences in virtual reality for hospice patients and their caregivers. Contemp Clin Trials Commun. 2024 Jun 22;40:101318. doi: 10.1016/j.conctc.2024.101318. eCollection 2024 Aug.
Individual participant dataSharing planned: No

Related trials for Hospice

RecruitingObservational study
Prehospital Care of End-of-Life Patients by the Strasbourg Mobile Emergency and Resuscitation Service: A Qualitative Study of Healthcare Professionals' Experiences and Use of a Comfort Care Booklet
End-of-life Care, Palliative Care
Not yet recruiting
Inpatient Hospice Transitions Checklist
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Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.

Joshua K Pope principal investigator

Prisma Health Hospice of the Foothills

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

A study testing Tandem Virtual Reality in people with Hospice and End of Life, run by Prisma Health-Upstate at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 13 Mar 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quality of Life Domains (time frame: 15 minutes). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06186960, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Apr 2026.