Effects of Virtual Reality Education on Anxiety and Learning in Patients Undergoing Urolithiasis Surgery (VR-URO)

June 1, 2026 updated by: Wei-Lin, Huang

The Effects of Two-Tier Test-Based Virtual Reality Education on Anxiety, Knowledge, Self-Care Ability, and Cognitive Load in Patients Undergoing Urolithiasis Surgery

This randomized controlled trial aims to evaluate the effects of two-tier virtual reality-based preoperative education on anxiety, learning knowledge, self-care ability, and cognitive load in patients undergoing urolithiasis surgery. Participants will be randomly assigned to routine education, standard virtual reality education, or two-tier virtual reality education groups. Outcomes will be assessed using anxiety scales, knowledge questionnaires, self-care ability measures, and cognitive load assessments before and after the intervention.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Preoperative anxiety is a common concern among patients undergoing urolithiasis surgery and may adversely affect perioperative experiences, treatment adherence, and postoperative recovery. Conventional preoperative education is often limited by time constraints, variability in information delivery, and insufficient patient engagement.

Virtual reality (VR)-based education has emerged as an innovative educational approach that provides immersive and interactive learning experiences. Previous studies have suggested that VR may improve patient understanding of surgical procedures and reduce anxiety by familiarizing patients with the perioperative environment. However, most existing VR education programs provide information passively and may not adequately identify or correct patient misconceptions.

The present study introduces a two-tier virtual reality educational approach that integrates immersive VR scenarios with structured knowledge assessment and feedback mechanisms. By encouraging participants to actively process information and receive immediate clarification of misunderstandings, the intervention is expected to enhance learning effectiveness and support patient self-management.

This randomized controlled trial aims to examine whether a two-tier VR educational strategy can provide additional benefits beyond standard VR education and routine preoperative instruction for patients undergoing urolithiasis surgery. Findings from this study may contribute to the development of more effective patient-centered educational interventions and provide evidence for the integration of advanced VR technologies into perioperative nursing practice.

Study Type

Interventional

Enrollment (Estimated)

90

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 Contact

  • Name: wellin Huang, RN, MSN Student
  • Phone Number: +886 953713535
  • Email: hwl0111@gmail.com

Study Locations

  • Taiwan
      • Keelung, Taiwan, 204
        • Keelung Chang Gung Memorial 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:

  • Patients scheduled to undergo urolithiasis surgery with procedure codes 77026B, 77027B, 77028B, or 76016B.
  • Aged 18 years or older.
  • Conscious and mentally alert.
  • Able to communicate in Mandarin Chinese and read written text.
  • Able to understand and operate virtual reality equipment.

Exclusion Criteria:

  • Patients with current psychiatric disorders or substance abuse.
  • Patients with hearing or visual impairment.
  • Patients with visual dizziness, vertigo, or virtual reality motion sickness symptoms.
  • Patients who are unable to cooperate or unwilling to participate in 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: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Routine Patient Education
Participants receive routine preoperative education provided by clinical nursing staff before urolithiasis surgery.
Experimental: VR Education
Participants receive standard virtual reality-based preoperative education before urolithiasis surgery.
Behavioral: VR Education
Participants receive standard virtual reality-based preoperative education before urolithiasis surgery. The VR program includes immersive 360-degree educational content covering the preoperative process, operating room environment, postoperative care, and self-care instructions.
Experimental: Two-Tier VR Education
Participants receive two-tier virtual reality-based preoperative education with integrated interactive questioning and feedback before urolithiasis surgery.
Behavioral: Two-Tier VR Education
Participants receive two-tier virtual reality-based preoperative education before urolithiasis surgery. The intervention combines immersive 360-degree VR educational content with a two-tier testing mechanism designed to enhance learning comprehension, self-care knowledge, and cognitive engagement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anxiety Score Measured by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Hospital Anxiety and Depression Scale-Anxiety Subscale (HADS-A)
Time Frame: Baseline before intervention, 2 hours after intervention, and postoperative day 1

Anxiety will be assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A).

The APAIS consists of 6 items scored on a 5-point Likert scale. Total scores range from 6 to 30, with higher scores indicating greater preoperative anxiety and information needs.

The HADS-A consists of 7 items scored from 0 to 3. Total scores range from 0 to 21, with higher scores indicating greater anxiety.
Baseline before intervention, 2 hours after intervention, and postoperative day 1

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Urolithiasis Surgery Knowledge Questionnaire Score
Time Frame: Baseline before intervention and 2 hours after intervention

Knowledge regarding perioperative care for urolithiasis surgery will be assessed using a researcher-developed Urolithiasis Surgery Knowledge Questionnaire.

The baseline questionnaire consists of 10 multiple-choice items and the post-intervention questionnaire consists of 20 multiple-choice items covering surgical preparation, operating room orientation, perioperative care, urinary catheter care, Double-J stent management, dietary management, hydration, complication recognition, and prevention of stone recurrence.

Scores range from 0 to 10 at baseline and from 0 to 20 after intervention. Higher scores indicate better understanding of urolithiasis surgery and postoperative self-care
Baseline before intervention and 2 hours after intervention
Postoperative Self-Care Ability Score Measured by the Urolithiasis Self-Care Ability Scale
Time Frame: Postoperative day 1

Postoperative self-care ability will be assessed using the Urolithiasis Postoperative Self-Care Ability Scale developed by Hu et al. (2024).

The scale consists of 30 items across five domains, including disease management, diet and fluid intake, psychosocial management, activity and elimination, and disease-related information.

Each item is rated on a 5-point Likert scale. Total scores range from 30 to 150. Higher scores indicate better postoperative self-care ability.
Postoperative day 1
Cognitive Load Score Measured by the Cognitive Load Questionnaire
Time Frame: 2 hours after intervention

Cognitive load will be assessed using the Cognitive Load Questionnaire developed by Klepsch et al. (2017).

The questionnaire contains 8 items assessing intrinsic cognitive load, extraneous cognitive load, and germane cognitive load.

Each item is rated on a 5-point Likert scale. Total scores range from 8 to 40. Higher scores indicate greater perceived cognitive load during learning.
2 hours after intervention

Collaborators and Investigators

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

Sponsor

Wei-Lin, Huang

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 (Estimated)

July 1, 2026

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

May 1, 2027

Study Registration Dates

First Submitted

May 23, 2026

First Submitted That Met QC Criteria

June 1, 2026

First Posted (Actual)

June 2, 2026

Study Record Updates

Last Update Posted (Actual)

June 2, 2026

Last Update Submitted That Met QC Criteria

June 1, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 202600523B0

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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