The Effect of Virtual Reality Distraction on Preoperative Anxiety in Abdominal Surgery Patients

January 20, 2026 updated by: Sevim Akbal, Trakya University

The Effectiveness of Virtual Reality Distraction on Preoperative Anxiety in Abdominal Surgery Patients: A Double-Blinded Randomised Controlled Trial

Hospitalization, medical interventions to be performed, and uncertainties specific to surgical intervention create a certain level of anxiety in the patient. It is known that being in the hospital negatively affects the coping mechanisms of the patient. In the pre-surgical period, the nurse's practices that will facilitate the patient's coping with the situation and managing his anxiety have a positive effect on anxiety during and after surgery and on anxiety-related symptoms. For these reasons, it is aimed to determine the effect of virtual reality on pre-surgical anxiety in this study.The hypothesis of the study is that watching videos with virtual glasses will reduce preoperative anxiety.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Hypothesis H1: The anxiety level of patients who watch relaxing video through VR is lower than that of those who do not.

H2: The stress level of patients who watch relaxing video through VR is lower than that of those who do not.

H3: The heart rate level of patients who watch relaxing video through VR is lower than that of those who do not.

This study was carried out between January 30, 2023 and December 20th 2024 at the General Surgery Service of a university hospital, which has a 48-bed capacity and accommodates 1-2 patients per room. The hospital is situated in the Trakya region of the Edirne province in Türkiye and serves as a major healthcare provider, offering a comprehensive range of medical services to the surrounding provinces and contributes to medical and health sciences education and research. At this service, nurses ensure that patients are prepared for surgery in accordance with the daily determined operating room schedule by instructing them to remove their clothing, except for their underwear, and put on their green surgical gowns and caps. Following this preparation, patients remain in their beds while awaiting the arrival of healthcare support personnel for their transfer to the operating room. This waiting period typically lasts between 20 to 25 minutes.

The sample size was calculated based on the study by Mosso et al. (2009) that evaluated the effect of virtual reality intervention on patients' anxiety levels in the preoperative period. An effect size of d=0.920 was obtained by comparing the pre- and post-interventional VAS-A score changes of the intervention group (2.2±2.94) and the control group (5.27±3.69). The G-Power software (G-Power 3.1.9.7, Kiel, Germany) was used for the sample size calculation, applying an effect size of d=0.920, an alpha error probability of 0.05, and a statistical power of (1-β err prob) = 0.95. As a result, a total of 96 patients were enrolled in the study, with 32 patients allocated to each group.

Patients aged ≥ 18 years, scheduled for elective abdominal surgery (including appendectomy, ileal/bowel surgery, hernia repair surgery, gallbladder/pancreas surgery) waiting at the service to be transferred to the operating room in the morning of surgery, and able to communicate and provide informed consent. Patients scheduled to undergo abdominal cancer surgery, those requiring unplanned surgery such as emergency cases, those in isolation, those with visual and/or auditory disabilities, and those with neurological problems such as vertigo were excluded.

In this study, data were collected using "Patient Information Form", "Visual Analog Scale-Anxiety (VAS-A)", and "Smart Bracelet".

Study Type

Interventional

Enrollment (Actual)

96

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria Patients aged ≥ 18 years

Scheduled for elective abdominal surgery (e.g., appendectomy, ileal/bowel surgery, hernia repair, gallbladder/pancreas surgery)

Awaiting transfer to the operating room on the morning of surgery

Able to communicate effectively

Able to provide informed consent

Exclusion Criteria Patients scheduled for abdominal cancer surgery

Patients undergoing unplanned or emergency surgery

Patients in isolation

Patients with visual and/or auditory impairments

Patients with neurological conditions such as vertigo

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Virtual Reality Glasses Group
The intervention group will watch a virtual reality video with mobile virtual glasses by the researcher (SŞ) and the stress level on the smart wristband will be recorded. In addition, necessary variables will be recorded with the data collection form.
Behavioral: Watching video with virtual glasses
Using Mobile Virtual Glasses; In the preoperative period, after the patient is taken to the surgical service, a virtual reality video will be watched with mobile virtual glasses at the specified time (before going to the operating room on the day of surgery). Measurements will be made before and after the application. Necessary hygiene will be provided before the use of glasses, and the researcher will ensure hand cleaning before entering the patient's room.
Placebo Comparator: Non-Virtual Reality Glasses Group
The plain version of the video, which was shown to the intervention group by the researcher (SŞ) to the placebo group, will be watched over the phone with the naked eye and the stress level on the smart bracelet will be recorded. In addition, necessary variables will be recorded with the data collection form.
Behavioral: watching video without virtual glasses
The plain version of the video, which was shown to the intervention group by the researcher (SŞ) to the placebo group, will be watched over the phone with the naked eye and the stress level on the smart bracelet will be recorded.
No Intervention: Control Group
Anxiety control will be done by the researcher (SU) for the control group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Preoperative Anxiety Level-1
Time Frame: 2 minutes before the intervention. Preoperative.
Visual Analogue Scale-Anxiety (VAS-A):This scale was used to evaluate patients' preoperative anxiety levels on the morning. It consists of a horizontal line on the paper with scored from "0" for "experiencing no anxiety" on the left side to "10" for " experiencing too much anxiety" on the right side.It is also reported to be valid in evaluating preoperative anxiety of surgery patients. The anxiety levels of a total of 96 patients were evaluated subjectively using the VAS-A scale. Patients marked the level of anxiety they felt on a scale
2 minutes before the intervention. Preoperative.
Preoperative Stress Level-1
Time Frame: 2 minutes before the intervention. Preoperative.
This wearable device (smart bracelet) was used to evaluate the stress levels and heart rates of patients. It utilizes a built-in sensor to estimate users' stress levels, providing a score ranging from 1 to 100, where 1 indicates minimal stress and 100 represents very high stress. This estimation is derived from Heart Rate Variability (HRV) data. The device applies a proprietary algorithm-referred to as a stress model-to interpret HRV fluctuations and classify the user's stress level accordingly. The stress levels of a total of 96 patients were measured objectively with a smart bracelet.
2 minutes before the intervention. Preoperative.
Preoperative Heart Rate
Time Frame: 2 minutes before the intervention. Preoperative.
This wearable device was used to evaluate the stress levels and heart rates of patients. It utilizes a built-in sensor to estimate users' stress levels, providing a score ranging from 1 to 100, where 1 indicates minimal stress and 100 represents very high stress. This estimation is derived from Heart Rate Variability (HRV) data. The device applies a proprietary algorithm-referred to as a stress model-to interpret HRV fluctuations and classify the user's stress level accordingly. The heart rate levels of a total of 96 patients were measured objectively with a smart bracelet.
2 minutes before the intervention. Preoperative.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Preoperative Anxiety Level-2
Time Frame: Preoperative. immediately after intervention.
Visual Analogue Scale-Anxiety (VAS-A):This scale was used to evaluate patients' preoperative anxiety levels on the morning. It consists of a horizontal line on the paper with scored from "0" for "experiencing no anxiety" on the left side to "10" for " experiencing too much anxiety" on the right side.It is also reported to be valid in evaluating preoperative anxiety of surgery patients. The anxiety levels of a total of 96 patients were evaluated subjectively using the VAS-A scale. Patients marked the level of anxiety they felt on a scale. The patient was evaluated after watching the video. The average video duration was 20 minutes.
Preoperative. immediately after intervention.
Preoperative Stress Level
Time Frame: Preoperative. immediately after intervention.
This wearable device was used to evaluate the stress levels and heart rates of patients. It utilizes a built-in sensor to estimate users' stress levels, providing a score ranging from 1 to 100, where 1 indicates minimal stress and 100 represents very high stress. This estimation is derived from Heart Rate Variability (HRV) data. The device applies a proprietary algorithm-referred to as a stress model-to interpret HRV fluctuations and classify the user's stress level accordingly. The patient was evaluated after watching the video. The average video duration was 20 minutes. The stress levels of a total of 96 patients were measured objectively with a smart bracelet.
Preoperative. immediately after intervention.
Preoperative Heart Rate
Time Frame: Preoperative. immediately after intervention.
This wearable device was used to evaluate the stress levels and heart rates of patients. It utilizes a built-in sensor to estimate users' stress levels, providing a score ranging from 1 to 100, where 1 indicates minimal stress and 100 represents very high stress. This estimation is derived from Heart Rate Variability (HRV) data. The device applies a proprietary algorithm-referred to as a stress model-to interpret HRV fluctuations and classify the user's stress level accordingly. The patient was evaluated after watching the video. The average video duration was 20 minutes. The heart rate levels of a total of 96 patients were measured objectively with a smart bracelet.
Preoperative. immediately after intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Trakya University

Investigators

  • Principal Investigator: Dogan Albayrak, Dr, Trakya University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 30, 2023

Primary Completion (Actual)

December 20, 2024

Study Completion (Actual)

December 20, 2024

Study Registration Dates

First Submitted

January 30, 2023

First Submitted That Met QC Criteria

February 7, 2023

First Posted (Actual)

February 8, 2023

Study Record Updates

Last Update Posted (Actual)

January 23, 2026

Last Update Submitted That Met QC Criteria

January 20, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TUTF-GOBAEK 2022/240

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Data will be shared when requested from the authors.

IPD Sharing Time Frame

6 months after publication

IPD Sharing Access Criteria

The primary author is reached via e-mail and if requested, data will be shared with the consent of all authors.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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