Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Parks, Recreation and Tourism Management

Committee Chair/Advisor

Dr. Matthew Browning


This dissertation focused on studying the lived experience of working with and for people living with severe chronic obstructive pulmonary disease (COPD) to co-create a personalized nature-based virtual reality (VR) experience. People with severe COPD have issues with being able to breathe clearly and deeply, which then influences their ability to visit outdoor places. Outdoor places have been shown to have many positive effects on multi-dimensional health outcomes. Severe COPD can also make traveling to faraway destinations and even visiting nearby outdoor spaces difficult. Therefore, the purpose of this dissertation was to develop personalized nature-based VR experiences as an alternative to physically visiting outdoor spaces for four upstate South Carolina residents with severe COPD. This transdisciplinary research was exploratory and utilized literature and methods from nature, virtual reality, nursing, health narratives and storytelling, and co-creation. Mixed methods were utilized including physiological measures, surveys, semi-structured interviews, and researcher’s voice recordings for data collection with four participants. Based on the research design, Chapter 1 introduced the bodies of literature, background information, and the goal of the dissertation. Chapter 2 measured the effects of co-creating a personalized nature-based VR experience for people with severe COPD, particularly the effects on psychological well-being. Chapter 3 examined the narratives people with severe COPD convey. Chapter 4 explored how cocreating a VR experience with a participant during his end-of-life process and death influenced the researcher (me). Results showed co-creating personalized nature-based VR experiences appeared to increase psychological well-being. Additionally, participants iii offered three counternarratives to society’s assumptions of severe COPD or the “wounded body” narrative: the “teaching body”, the “comedic body”, and the “empowered body”. Chapter 4 reflected on how a participant’s death changed how I viewed the relationship between researcher and participant and the language that was used when discussing research. Chapter 5 discussed research takeaways, limitations, and future directions, such as the value of transdisciplinary teams to yield impactful applied research, the importance of using language in research that is inclusive, and how cocreation can facilitate positive researcher/participant relationships. This dissertation helped people experience outdoor spaces again and share counternarratives to society’s assumptions of severe COPD.

Author ORCID Identifier



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.