The Effect of Operating Room Introduction With Virtual Reality Glasses on Anxiety, Surgical Fear, and Satisfaction Levels in Patients Undergoing Orthopedic Surgery

August 17, 2026 updated by: Rana Güngör, Acibadem University

This study evaluated the effect of an operating room introduction using virtual reality (VR) on anxiety, surgical fear, patient satisfaction, postoperative pain, and physiological parameters in patients undergoing arthroscopic orthopedic surgery.

The intervention consisted of a researcher-developed 360-degree educational video introducing the operating room environment, the surgical team, and the perioperative process. The video was presented using Meta Quest 3 VR goggles. Participants in the intervention group received the VR-based operating room introduction in addition to the institution's standard preoperative education. Participants in the control group received only the institution's standard preoperative education, and no additional intervention was provided.

The study assessed preoperative anxiety, surgical fear, patient satisfaction, postoperative pain, and physiological parameters, including heart rate, blood pressure, respiratory rate, peripheral oxygen saturation, and electrodermal activity. Measurements were obtained at predefined time points before and after the intervention, on the day of surgery, and during the postoperative period.

The study was conducted as a randomized controlled trial with 60 participants, with 30 participants assigned to the intervention group and 30 participants assigned to the control group.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study was conducted as a randomized controlled trial in patients undergoing arthroscopic orthopedic surgery. The intervention group received a researcher-developed operating room introduction video presented through virtual reality (VR) goggles, in addition to the institution's standard preoperative education. The control group received only the institution's standard preoperative education, and no additional intervention was provided.

The operating room introduction video was recorded from the patient's perspective using an Insta360 X4 camera. The final video was 9 minutes and 22 seconds in duration and was presented using Meta Quest 3 VR goggles. The video provided a 360-degree view of the operating room environment and introduced the perioperative process from the patient's perspective.

The video included the patient's transfer from the hospital room to the operating room, encounters with the healthcare team, patient identification procedures, transfer to the operating room area, introduction to the operating room environment, surgical preparation, anesthesia-related procedures, and the perioperative process. The content was designed to familiarize patients with the operating room environment and the sequence of events they would experience during the perioperative period.

The VR intervention was administered to participants in the intervention group before surgery. The VR goggles were appropriately disinfected before use. A researcher remained available during the intervention to assist the participant and ensure the safe use of the VR equipment.

The study included 60 participants who were randomly assigned to either the intervention group or the control group, with 30 participants in each group. Data were collected at predefined time points before and after the intervention, on the day of surgery, and during the postoperative period. The study evaluated anxiety, surgical fear, patient satisfaction, postoperative pain, and physiological parameters, including heart rate, blood pressure, respiratory rate, peripheral oxygen saturation, and electrodermal activity.

Study Type

Interventional

Enrollment (Actual)

60

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

  • Turkey (Türkiye)
    • Ataşehir
      • Istanbul, Ataşehir, Turkey (Türkiye), 34642
        • Acibadem Atasehir Hospitla
    • ataşehir
      • Istanbul, ataşehir, Turkey (Türkiye), 34662
        • Acibadem Altunizade Hospital

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 18-65 years
  • Arthroscopic orthopedic surgery planned
  • General anesthesia planned
  • Conscious and fully oriented to person, place, and time
  • No communication difficulties
  • No neurological or psychiatric disorders
  • No severe visual or hearing impairment
  • No history of vertigo or recurrent dizziness

Exclusion Criteria:

  • Inability to communicate with the patient
  • Administration of premedication before completion of the study measurements
  • Conversion to open surgery during the procedure
  • Development of a life-threatening health problem after surgery
  • Withdrawal from the study

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Virtual Reality-Based Education Group
Behavioral: Virtual Reality-Based Operating Room Education

For the Intervention Group:

The intervention consisted of a researcher-developed 360-degree virtual reality operating room education video. The 9-minute 22-second video was recorded from the patient's perspective using an Insta360 X4 camera and presented with Meta Quest 3 VR headsets. It included transfer from the ward, handover to the surgical team, transfer to the operating table, safety and monitoring, anesthesia induction, emergence from anesthesia, and transfer to the ward. At relevant points, perioperative information was provided through researcher-prepared voice-over narration integrated into the video. Participants watched the video once on an examination bed/stretcher in examination rooms, positioned at approximately 30-45 degrees with a pillow under the head. A disposable hygienic headset strap cover was used. The same device, procedure, and video were used. The VR education was provided in addition to the institution's standard preoperative education.

Other Names:
  • VR-Based Operating Room Orientation
  • Virtual Reality Surgical Environment Training
No Intervention: Standard Education Group

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Preoperative anxiety level: State Anxiety - State-Trait Anxiety Inventory (STAI-I)
Time Frame: STAI-I was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and within 2 hours after surgery.
State anxiety will be assessed using the State Anxiety subscale of the State-Trait Anxiety Inventory (STAI-I). The STAI-I consists of 20 items rated on a 4-point Likert-type scale, with total scores ranging from 20 to 80. Higher scores indicate higher levels of state anxiety.
STAI-I was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and within 2 hours after surgery.
Patient satisfaction with perioperative care
Time Frame: Satisfaction will be measured within 2 hours after discharge procedures have started.
Patient satisfaction with perioperative care will be assessed using a 10-point satisfaction scale. Scores range from 1 to 10, with higher scores indicating higher satisfaction.
Satisfaction will be measured within 2 hours after discharge procedures have started.
Surgical fear level: Surgical Fear Questionnaire (SFQ)
Time Frame: Surgical fear was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; and on the day of surgery, before surgery.
Surgical fear was assessed using the Surgical Fear Questionnaire (SFQ). The SFQ consists of 8 items rated on an 11-point scale from 0 (not afraid at all) to 10 (very afraid). The total score ranges from 0 to 80, with higher scores indicating greater surgical fear.
Surgical fear was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; and on the day of surgery, before surgery.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain level: Numeric Rating Scale (NRS)
Time Frame: Postoperative pain was assessed within 2 hours after surgery.

This measure compared postoperative pain levels between the virtual reality education and standard education groups. Pain level was assessed using the Numerical Rating Scale (NRS).

Minimum Value: 0 (No Pain) Maximum Value: 10 (Worst Pain) Higher Scores: Indicate worse outcomes, meaning more severe pain.
Postoperative pain was assessed within 2 hours after surgery.
Physiological parameters: Heart rate
Time Frame: Heart rate was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Heart rate was assessed in the intervention and control groups.
Heart rate was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Electrodermal activity (EDA)
Time Frame: Before and after the intervention (3 min each), on the morning of surgery before transfer (3 min), and continuously during ward-to-OR transfer, from transfer start to handover completion.
Electrodermal activity (EDA) was assessed to evaluate physiological arousal in the intervention and control groups. EDA was recorded using a Shimmer3 GSR+ device.
Before and after the intervention (3 min each), on the morning of surgery before transfer (3 min), and continuously during ward-to-OR transfer, from transfer start to handover completion.
Physiological parameters: Systolic blood pressure
Time Frame: Systolic blood pressure was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Systolic blood pressure was assessed in the intervention and control groups.
Systolic blood pressure was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Physiological parameters: Diastolic blood pressure
Time Frame: Diastolic blood pressure was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Diastolic blood pressure was assessed in the intervention and control groups.
Diastolic blood pressure was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Physiological parameters: Respiratory rate
Time Frame: Respiratory rate was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Respiratory rate was assessed in the intervention and control groups.
Respiratory rate was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Physiological parameters: Peripheral oxygen saturation (SpO₂)
Time Frame: Peripheral oxygen saturation (SpO₂) was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Peripheral oxygen saturation (SpO₂) was assessed in the intervention and control groups.
Peripheral oxygen saturation (SpO₂) was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Physiological parameters: Body temperature
Time Frame: Body temperature was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.
Body temperature was assessed in the intervention and control groups.
Body temperature was assessed 24-48 hours before surgery, before the intervention; immediately after the intervention; on the day of surgery, before surgery; and at the first and second hours after admission to the inpatient ward.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Trait anxiety level: State-Trait Anxiety Inventory (STAI-II)
Time Frame: 24-48 hours before surgery, prior to the intervention/education.
Trait anxiety was assessed using the STAI-II subscale of the State-Trait Anxiety Inventory. The STAI-II consists of 20 items scored on a 4-point Likert-type scale, with total scores ranging from 20 to 80. Higher scores indicate higher levels of trait anxiety.
24-48 hours before surgery, prior to the intervention/education.

Collaborators and Investigators

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

Sponsor

Acibadem University

Collaborators

Acibadem Altunizade Hospital, Istanbul
Acibadem Atasehir Hospital

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

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)

July 7, 2025

Primary Completion (Actual)

October 25, 2025

Study Completion (Actual)

October 25, 2025

Study Registration Dates

First Submitted

March 19, 2025

First Submitted That Met QC Criteria

March 25, 2025

First Posted (Actual)

April 2, 2025

Study Record Updates

Last Update Posted (Actual)

August 19, 2026

Last Update Submitted That Met QC Criteria

August 17, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ORTO2025-VR01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified individual participant data underlying the study results will be shared with qualified researchers upon reasonable request, subject to ethical and data protection requirements. No personally identifiable information will be shared.

IPD Sharing Time Frame

Starting 6 months after publication of the primary study results and available for 5 years.

IPD Sharing Access Criteria

De-identified individual participant data and supporting information will be available to qualified researchers upon reasonable request for scientifically valid research purposes. Requests will be reviewed by the principal investigator and will be subject to ethical and data protection requirements. Data will be provided after approval of the request and, where applicable, completion of a data access agreement.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • 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

product manufactured in and exported from the U.S.

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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