Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2022

Open Access 01-12-2022 | Anxiety | Study protocol

The effectiveness of using virtual reality technology for perioperative anxiety among adults undergoing elective surgery: a randomised controlled trial protocol

Published in: Trials | Issue 1/2022

Login to get access

Abstract

Background

More than 2.5 million people are admitted for surgery in Australia each year, and between 40 to 80% will experience moderate to high preoperative anxiety. Elevated levels of preoperative anxiety can increase the risk of postoperative complications such as pain, delayed wound healing, infection, prolonged recovery, and longer hospitalisation. Limited previous research on Virtual Reality (VR) indicates a positive impact on surgery-related anxiety and suggests that the intervention potentially leads to reduce postoperative complications.

Objective

To evaluate the effectiveness of using VR technology for perioperative anxiety among adults undergoing elective surgery.

Method

A two-group parallel randomised controlled trial (RCT) will be conducted, including 150 adult patients (aged 18 years and over) undergoing elective surgery and requiring an overnight stay at a major metropolitan hospital. Eligible participants will be screened for anxiety via the Amsterdam Preoperative Anxiety and Information score (APAIS). Those with moderate to severe anxiety will be randomly allocated to receive the VR session or usual care, in the preoperative holding area. Intervention participants will use a head-mounted VR device to watch and listen to a nature scene for 10 minutes.

Study outcomes

The primary outcome is perioperative anxiety measured using the visual analogue scale for anxiety (VAS-A). Secondary outcomes include stress levels (measured by saliva cortisol level and heart rate), postoperative pain, patient satisfaction with perioperative care, hospital length of stay, and VR-associated adverse events.

Conclusion

This study will help evaluate if a brief preoperative VR session can reduce perioperative anxiety for adult elective surgical patients.

Trial registration

Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001350910.
Appendix
Available only for authorised users
Literature
1.
Matthias AT, Samarasekera DN. Preoperative anxiety in surgical patients-experience of a single unit. Acta Anaesthesiol Taiwan. 2012;50(1):3–6.CrossRefPubMed
2.
Perks A, Chakravarti S, Manninen P. Preoperative anxiety in neurosurgical patients. J Neurosurg Anesthesiol. 2009;21(2):127–30.CrossRefPubMed
3.
Wetsch WA, Pircher I, Lederer W, Kinzl J, Traweger C, Heinz-Erian P, et al. Preoperative stress and anxiety in day-care patients and inpatients undergoing fast-track surgery. Bri J Anaesthesia. 2009;103(2):199–205.CrossRef
4.
Bedaso A, Ayalew M. Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia. Patient Safety Surg. 2019;13(1):1–8.CrossRef
5.
Jiwanmall M, Jiwanmall SA, Williams A, Kamakshi S, Sugirtharaj L, Poornima K, et al. Preoperative anxiety in adult patients undergoing day care surgery: prevalence and associated factors. Indian J Psychol Med. 2020;42(1):87–92.CrossRefPubMedPubMedCentral
6.
Jlala H, French J, Foxall G, Hardman J, Bedforth N. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. Bri J Anaesth. 2010;104(3):369–74.CrossRef
7.
Bailey L. Strategies for decreasing patient anxiety in the perioperative setting. AORN J. 2010;92(4):445–60.CrossRefPubMed
8.
9.
Nigussie S, Belachew T, Wolancho W. Predictors of preoperative anxiety among surgical patients in Jimma University specialized teaching hospital, South Western Ethiopia. BMC Surg. 2014;14(1):1–10.CrossRef
10.
Almalki MS, Hakami OAO, Al-Amri AM. Assessment of preoperative anxiety among patients undergoing elective surgery. Egypt J Hosp Med. 2017;69(4):2329–33.CrossRef
11.
Kavakci Ö, Altuntas EE, Müderris S, Kugu N. Effects of the preoperative anxiety and depression on the postoperative pain in ear, nose and throat surgery. Indian J Otol. 2012;18(2):82.CrossRef
12.
Logan DE, Rose JB. Is postoperative pain a self-fulfilling prophecy? Expectancy effects on postoperative pain and patient-controlled analgesia use among adolescent surgical patients. J Pediatr Psychol. 2005;30(2):187–96.CrossRefPubMed
13.
14.
Christian LM, Graham JE, Padgett DA, Glaser R, Kiecolt-Glaser JK. Stress and wound healing. Neuroimmunomodulation. 2006;13(5-6):337–46.CrossRefPubMed
15.
Scott A. Managing anxiety in ICU patients: the role of pre-operative information provision. Nurs Crit Care. 2004;9(2):72–9.CrossRefPubMed
16.
Ebrecht M, Hextall J, Kirtley L-G, Taylor A, Dyson M, Weinman J. Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology. 2004;29(6):798–809.CrossRefPubMed
17.
Schroeder D, Korsakov F, Jolton J, Keefe FJ, Haley A, Keefe DF. Creating widely accessible spatial interfaces: Mobile VR for managing persistent pain. IEEE Comp Graph Appl. 2013;33(3):82–8.CrossRef
18.
19.
Aghamohammadi Kalkhoran M, Karimollahi M. Religiousness and preoperative anxiety: a correlational study. Ann Gen Psychiatry. 2007;6(1):1–5.CrossRef
20.
Grieve RJ. Day surgery preoperative anxiety reduction and coping strategies. Bri J Nurs. 2002;11(10):670–8.CrossRef
21.
Stirling L, Raab G, Alder EM, Robertson F. Randomized trial of essential oils to reduce perioperative patient anxiety: feasibility study. J Advanced Nurs. 2007;60(5):494–501.CrossRef
22.
Hillis K. Possible worlds: The social dynamic of virtual reality technology-Schroeder, R, vol. 60637. CHICAGO: UNIV CHICAGO PRESS 5720 S WOODLAWN AVE; 1997.
23.
Yang J-H, Ryu JJ, Nam E, Lee H-S, Lee JK. Effects of preoperative virtual reality magnetic resonance imaging on preoperative anxiety in patients undergoing arthroscopic knee surgery: a randomized controlled study. Arthroscopy. 2019;35(8):2394–9.CrossRefPubMed
24.
25.
Hendricks TM, Gutierrez CN, Stulak JM, Dearani JA, Miller JD. The use of virtual reality to reduce preoperative anxiety in first-time sternotomy patients: a randomized controlled pilot trial. Mayo Clinic Proc. 2020; Elsevier.
26.
Ganry L, Hersant B, Sidahmed-Mezi M, Dhonneur G, Meningaud J. Using virtual reality to control preoperative anxiety in ambulatory surgery patients: a pilot study in maxillofacial and plastic surgery. J Stomatol Oral Maxillofac Surg. 2018;119(4):257–61.CrossRefPubMed
27.
Schulz KF, Altman DG, Moher D. Group* C. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Int Med. 2010;152(11):726–32.CrossRefPubMed
28.
Laufenberg-Feldmann R, Kappis B. Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study. Eur J Anaesthesiol. 2013;30(12):758–63.CrossRefPubMed
29.
Boker A, Brownell L, Donen N. The Amsterdam preoperative anxiety and information scale provides a simple and reliable measure of preoperative anxiety. Can J Anesthesia. 2002;49(8):792–8.CrossRef
30.
Song B, Yang Y, Teng X, Li Y, Bai W, Zhu J. Use of pre-operative anxiety score to determine the precise dose of butorphanol for intra-operative sedation under regional anesthesia: a double-blinded randomized trial. Experiment Therapeut Med. 2019;18(5):3885–92.
31.
Berth H, Petrowski K, Balck F. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) - the first trial of a German version. Psychosoc Med. 2007;4:Doc01. PMID: 19742298; PMCID: PMC2736533.
32.
Chow CH, Van Lieshout RJ, Schmidt LA, Dobson KG, Buckley N. Systematic review: audiovisual interventions for reducing preoperative anxiety in children undergoing elective surgery. J Pediatr Psychol. 2016;41(2):182–203.CrossRefPubMed
33.
Guna J, Geršak G, Humar I, Song J, Drnovšek J, Pogačnik M. Influence of video content type on users’ virtual reality sickness perception and physiological response. Fut Gen Comp Syst. 2019;91:263–76.CrossRef
34.
Pokharel K, Bhattarai B, Tripathi M, Khatiwada S, Subedi A. Nepalese patients' anxiety and concerns before surgery. J Clin Anesth. 2011;23(5):372–8.CrossRefPubMed
35.
Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg. 2000;90(3):706–12.CrossRefPubMed
36.
Caljouw M, Van Beuzekom M, Boer F. Patient’s satisfaction with perioperative care: development, validation, and application of a questionnaire. Bri J Anaesth. 2008;100(5):637–44.CrossRef
37.
Sevinc V, Berkman MI. Psychometric evaluation of Simulator Sickness Questionnaire and its variants as a measure of cybersickness in consumer virtual environments. Appl Ergon. 2020;82:102958.CrossRefPubMed
38.
Ralph N, Norris P. Current opinion about surgery-related fear and anxiety; 2018.CrossRef
39.
Grupe DW, Nitschke JB. Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. Nat Rev Neurosci. 2013;14(7):488–501.CrossRefPubMedPubMedCentral
40.
Gilbert P, Gilbert J. Entrapment and arrested fight and flight in depression: an exploration using focus groups. Psychol Psychother. 2003;76(2):173–88.CrossRefPubMed
41.
Assefa F, Mosse A. Assessment of clients’ satisfaction with health service deliveries at Jimma University specialized hospital. Ethiopian J Health Sci. 2011;21(2):101–10.
42.
Wongkietkachorn A, Wongkietkachorn N, Rhunsiri P. Preoperative needs-based education to reduce anxiety, increase satisfaction, and decrease time spent in day surgery: a randomized controlled trial. World J Surg. 2018;42(3):666–74.CrossRefPubMed
43.
44.
Bondemark L, Ruf S. Randomized controlled trial: the gold standard or an unobtainable fallacy? Eur J Orthod. 2015;37(5):457–61.CrossRefPubMed
Metadata
Title
The effectiveness of using virtual reality technology for perioperative anxiety among adults undergoing elective surgery: a randomised controlled trial protocol
Publication date
01-12-2022
Keyword
Anxiety
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06908-3

Other articles of this Issue 1/2022

Trials 1/2022 Go to the issue

Research

Advancing cluster randomised trials in children’s therapy: a survey of the acceptability of trial behaviours to therapists and parents

Commentary

Conducting a randomised controlled trial of a psychosocial intervention for adolescents with type 1 diabetes during COVID-19: recommendations to overcome the challenges complicated by inconsistent public health guidelines on research

Research

Principles and recommendations for incorporating estimands into clinical study protocol templates

Study protocol

Effectiveness of an app-based intervention to reduce substance use, gambling, and digital media use in vocational school students: study protocol for a randomized controlled trial

Research

Interpreting a Bayesian phase II futility clinical trial

Study protocol

Study protocol for a phase 1/2, single-centre, double-blind, double-dummy, randomized, active-controlled, age de-escalation trial to assess the safety, tolerability and immunogenicity of a measles and rubella vaccine delivered by a microneedle patch in healthy adults (18 to 40 years), measles and rubella vaccine-primed toddlers (15 to 18 months) and measles and rubella vaccine-naïve infants (9 to 10 months) in The Gambia [Measles and Rubella Vaccine Microneedle Patch Phase 1/2 Age De-escalation Trial]