Virtual Nature Versus Guided Imagery for Anxiety and Well-Being in Hospitalized Older Adults

Inclusion Criteria: * Aged 65 years or older * Receiving inpatient hospital care, with at least two weeks of hospitalisation at the time of enrolment * Montreal Cognitive Assessment (Hungarian version) score of 18 or above, with education correction * Physically able to safely wear a head-mounted virtual reality display * Adequate corrected or uncorrected vision and hearing * Able to communicate in Hungarian * Stable psychiatric and cardiovascular condition, as determined from medical history and in consultation with the treating physician * Able to provide independent written informed consent Exclusion Criteria: * Epilepsy with recurrent seizures, or photosensitivity * Neurological condition associated with increased risk during virtual reality use, including Meniere's disease and significant carotid stenosis * Active psychosis, hallucinations, or severe depression with psychotic features * Open wound or skin lesion on the face, chronic neck pain, or spinal condition preventing safe use of the head-mounted display * Severe uncorrectable sensory impairment * Unstable psychotropic medication during the preceding eight weeks * Regular use of analgesic or psychotropic medication that may substantially affect perception of the experience * Active alcohol or substance use disorder within the past year * Refusal or inability to provide informed consent Enrolment is deferred, rather than excluded, in the presence of active delirium or infectious illness, until the condition resolves.