Feasibility and acceptability of a metaverse-based hybrid counseling program among young adults living alone: A mixed-methods study

초록

Aim: This mixed-methods study examined the feasibility and acceptability of a metaverse-based hybrid counseling program for young adults living alone and explored preliminary psychological outcomes and participants' experiences. Methods: A non-equivalent control group pre-test-post-test design was used for the quantitative component. The intervention comprised two metaverse-based individual counseling sessions and two face-to-face sessions. Depression, interpersonal problems, social adaptability, and self-esteem were assessed at baseline and post-intervention. Exploratory between-group comparisons used independent t-tests and adjusted ANCOVA models. Focus group interviews were analyzed thematically. Results: The program was feasible and acceptable. No significant adjusted between-group differences were found for depression, interpersonal problems, or social adaptability. For self-esteem, baseline and post-intervention scores were related differently by group, indicating variation by baseline self-esteem level. Depression decreased within both groups, and interpersonal problems decreased within the experimental group, but these changes did not translate into significant between-group differences. Qualitative analysis identified two themes: authentic self-expression in a psychologically safe virtual environment and a desire for continued participation. Participants described anonymity and accessibility as supporting emotional disclosure and engagement. Conclusion: The intervention was feasible and acceptable, but the quantitative findings did not provide consistent evidence of between-group improvement. Self-esteem findings varied by baseline level and do not establish efficacy. Qualitative findings suggest that metaverse-based hybrid counseling may offer a low-threshold, accessible approach to mental health support. Larger, adequately powered controlled studies are needed. Relevance to mental health nursing: This study is relevant to mental health nursing because it examines an innovative hybrid counseling intervention for young adults living alone, a population at increased risk of emotional distress and social isolation. The findings suggest that integrating metaverse-based and face-to-face approaches may offer a feasible and acceptable way to support access to mental health services and engagement with counseling, while informing the development of flexible, technology-enhanced mental health nursing interventions in community settings. Accessible summary: What is known on the subject? Young adults living alone are at an increased risk of loneliness, depression, and social isolation. Many young adults experience barriers to accessing traditional, face-to-face mental health support. Digital and online counseling approaches may improve accessibility and reduce the stigma associated with seeking help. What this paper adds to existing knowledge. This study examined a metaverse-based hybrid counseling program that combined virtual and face-to-face sessions. The quantitative findings did not show consistent between-group improvements across psychological outcomes. Participants described the program as accessible and psychologically safe, and reported that the virtual environment supported emotional disclosure and continued engagement. What are the implications for practice?

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