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Flow experience and technology acceptance were assessed quantitatively alongside qualitative thematic analysis of weekly semi-structured interviews. Flow experience increased significantly (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; .05,\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    = .82), while technology acceptance remained stable. Perceived usefulness significantly predicted flow (\n                    <jats:italic toggle=\"yes\">R<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = .575); perceived ease of use did not. Five qualitative themes emerged: novelty-driven immersion, just-right challenge, therapist-mediated facilitation, embodied constraints, and occupational inertia limiting real-world leisure generalization. Immersive XR enhanced intrinsically motivated occupational engagement independent of generalized technology attitudes. Effective implementation requires therapist-led bridging strategies to support the transition from virtual immersion toward authentic leisure participation. XR functions as a mediating tool for expanding occupational possibilities in restricted mental health environments, with therapist facilitation constituting an active ingredient of participation.\n                  <\/jats:p>","DOI":"10.1177\/15394492261476591","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T12:04:50Z","timestamp":1786622690000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Flow and Technology Acceptance in Extended Reality Leisure Participation During Mental Health Occupational Therapy"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8339-8565","authenticated-orcid":false,"given":"Chia-Hui","family":"Hung","sequence":"first","affiliation":[{"name":"Department of Occupational Therapy, Chung Shan Medical University, Taichung City, Taiwan"},{"name":"Room of Occupational Therapy, Chung Shan Medical University Hospital, Taichung City , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4132-2239","authenticated-orcid":false,"given":"Shiu-Yuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Chung Shan Medical University Hospital, Taichung City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiang-Ju","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Chung Shan Medical University Hospital, Taichung City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ju","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Chung Shan Medical University, Taichung City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Si","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Chung Shan Medical University, Taichung City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8875-6157","authenticated-orcid":false,"given":"Shih-Chen","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Chung Shan Medical University, Taichung City, Taiwan"},{"name":"Room of Occupational Therapy, Chung Shan Medical University Hospital, Taichung City , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"American Occupational Therapy Association. 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