Background: Fear of dyspnea (FD) refers to the unpleasant emotional response and anticipatory anxiety experienced by individuals following an episode of breathlessness. Nearly half of COPD patients (≈47%) develop FD, which not only undermines the initiation and efficacy of pulmonary rehabilitation but also drives a vicious cycle of “breathlessness - fear of dyspnea - activity avoidance - exacerbated breathlessness”, ultimately degrading quality of life and increasing rehospitalization and mortality. While cognitive behavioral therapy (CBT) can ameliorate fear responses in chronic disease populations, its lack of immersive, context-rich scenarios often limits patient engagement and long-term adherence. Virtual reality (VR) technology, by delivering interactive, immersive rehabilitation environments, has shown promise in enhancing patient motivation, adherence, and self-efficacy in COPD. In this study, we developed a VR-based dyspnea fear adaptation system to create a safe, controllable, and engaging platform aimed at alleviating FD and securing lasting rehabilitative benefits for COPD patients. Objective: To develop a virtual reality adaptation platform for COPD patients experiencing fear of dyspnea and to evaluate its usability in this target population. Method: A research team was established, and through a comprehensive literature review and Delphi expert consultations, a fear of dyspnea adaptation protocol was developed and the VR platform was designed. The platform comprises two components: a patient-facing side and an administrative side. The patient-facing side includes a login module, an adaptation module, and a symptom self-assessment module. The administrative side consists of a login module, a real-time monitoring and adaptation module, a safety surveillance module, and a user management module.) Between June to September 2023, 25 patients with COPD were enrolled from three medical centers in Suzhou to evaluate the usability of the virtual reality-based dyspnea-related fear adaptation platform. Result: Fifteen of the enrolled COPD patients completed the usability evaluation. The platform achieved a mean System Usability Scale (SUS) score of 79.50±3.12, a Igroup Presence Questionnaire (IPQ) score of 21.6±2.10, and a Simulator Sickness Questionnaire (SSQ) score of 10.18±2.29, all indicating good usability, strong immersion, and minimal cybersickness. Conclusion: The virtual reality-based fear of dyspnea adaptation platform for COPD patients demonstrated a sound design and high usability, and holds promise for alleviating dyspnea-related fear in this population.

Chronic Obstructive Pulmonary Disease, Virtual Reality, Fear of Dyspnea, Nursing