3.3 Palliative medicine, Umeå
Palliative Medicine at Norrland University Hospital in Umeå
Palliative Medicine at Norrland University Hospital in Umeå consists of a multidisciplinary team providing specialized palliative care in patients’ homes. Palliative care is a form of care for people with illnesses where curative treatment is no longer possible. One of the primary goals of palliative care is to relieve suffering: physical suffering through effective symptom management, and psychological, social, and spiritual/existential suffering through conversations and support based on each person’s needs and wishes.
The project at Palliative Medicine in Umeå offered patients receiving specialized palliative home care in Umeå, together with their relatives when applicable, the opportunity to try virtual nature environments as a complementary method to enhance well-being.
Aim
The aim was to investigate the value and usefulness of virtual nature environments within palliative care and to increase the experience of well-being among patients, relatives, and healthcare staff.
Participants
- Patients with serious illness enrolled in specialized palliative home care
- Relatives of the patients
- Staff working in palliative medicine who meet patients and relatives in their daily work
Intervention and Follow-up
VR- headsets were used, and participants could choose from ten different nature environments recorded in northern Sweden and Finland.
Participants received information about the study and were introduced to the VR equipment by a research nurse working within the service who was also responsible for the patient’s care. During the first session, they were able to try the VR headset and explore the different environments based on their own preferences.
After this, two sessions were conducted with the patient and, when applicable, a relative. During these sessions they could experience a self-selected nature environment for approximately 15 minutes. Measurements of symptoms (for patients) and mood (for relatives) were taken before and after the nature experience.
The two measurement sessions were carried out on different days, usually in connection with a home visit by the responsible nurse. Afterwards, patients and relatives had the opportunity to borrow the equipment for an additional two weeks to use the method independently.
Following the intervention, patients and relatives were offered the opportunity to participate in an individual qualitative interview lasting approximately 30 minutes. The interviews were conducted by researchers from the Department of Nursing.
Results
Patients were recruited from April 2024 to March 2025. In total, seven patients and four relatives participated in the project and completed the full intervention. Five patients and four relatives also took part in the interviews.
Quantitative data indicated a tendency toward slightly reduced symptoms among patients after experiencing virtual nature environments. Relatives showed a tendency toward a more positive mood.
Patients often chose environments that included animals or birds, as well as winter landscapes. They expressed a preference for environments containing events or elements that could capture their attention and provide distraction.
Three main themes were identified in the qualitative analysis of interviews with patients and relatives:
- Being in a place where calm and peace become possible
- Connecting with nature through previous experiences
- Barriers to fully engaging with nature
The first theme described experiences of moving into another world, finding peace and tranquility, and becoming free from emotional distress and physical suffering.
The second theme concerned reconnecting with past experiences, feeling at home in nature, but also experiencing sadness over lost opportunities.
The third theme related to discomfort when nothing happened in the environment and the perception of virtual nature as a complement rather than a replacement for real nature. Adequate sound with sufficient volume was also identified as important for the experience.
No participants reported any direct side effects or discomfort associated with the intervention.
Implementation
After completion of the study, the researchers have been in contact with various representatives of palliative care services in the Västerbotten region to support the implementation of virtual nature environments in routine care.
Publication
Catharina Norberg1, Lisbeth Slunga Järvholm2, Kristina Lämås1
Experiences and effects of using immersive virtual nature environments among patients and relatives in palliative home care – a mixed method study. Manuscript in preparation for scientific publication.
- Department of Nursing, Umeå University
- Department of Epidemiology and Global Health, Umeå University
Summary presentation (from Vaasa conference, dec. 2025)
Virtual nature interventions at Palliative Medicine in Umeå, Sweden
- Lisbeth Slunga Järvholm et.al.