Exploring the Effects of Augmented Reality Educational Videos on Anxiety in Patients Undergoing Cardiac Catheterization

This study investigates the effectiveness of augmented reality educational videos in improving anxiety among patients undergoing cardiac catheterization.

The study participants were patients undergoing cardiac catheterization. The control group received routine care, which included standard paper-based educational materials for cardiac catheterization. The experimental group received routine care in addition to viewing cardiac catheterization educational videos through an augmented reality (AR) application.

The Visual Analog Scale for Anxiety (VAS-A), the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), and physiological indicators were used to assess participants' subjective and objective levels of anxiety. Assessments and measurements were conducted at three time points: before the intervention, immediately after the intervention, and within 6 hours after completion of cardiac catheterization. Due to the characteristics of the HADS-A subscale, it was administered only at two time points: before the intervention and within 6 hours after completion of cardiac catheterization.

The main research questions addressed in this study are:

• What are the differences in anxiety levels among cardiac catheterization patients based on their basic characteristics?
• How effective is the AR intervention in reducing anxiety among patients undergoing cardiac catheterization?
• What are the effects of AR intervention on patients' anxiety levels (VAS-A, HADS-A) and physiological indicators before the intervention, after the intervention, and after the completion of the cardiac catheterization procedure?

Study Overview

• Status: Completed
• Conditions: Anxiety; Cardiac Catheterization; Augmented Reality
• Intervention / Treatment: Other: Augmented Reality; Other: Paper-based education

• Study Type: Interventional
• Enrollment (Actual): 107
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • South Dist
    • Taichung, South Dist, Taiwan, 402306
      • Chung Shan Medical University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Diagnosis requiring conventional cardiac catheterization, such as ischemic heart disease (ICD-10 code: I20-I25.0).
• Individuals aged 20-75 years with full capacity for civil conduction.
• Individuals eligible for AR (Ambient Neurological) experience and without a history of neurological disorders, such as visual or auditory impairments, or epilepsy.

Exclusion Criteria:

• Emergency cardiac catheterization
• History of anxiety disorder, depression, or arrhythmia (e.g., atrial fibrillation)
• Regular use of heart rate suppressants, anti-anxiety medications, and sedatives
• Patients who have only undergone peripheral arteriovenous angiography

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group	Other: Augmented Reality; The experimental group received routine care (paper-based education) before cardiac catheterization and additionally viewed a cardiac catheterization educational video through an augmented reality (AR) application. The AR intervention consisted of an interactive educational video played on a tablet computer for participants to watch. The video content was developed based on findings from the literature review, hospital educational leaflets, and manuals. A professional company was commissioned to create the graphics and programming and develop the AR application. The video presented information related to cardiac catheterization through real-life images, illustrations, and voice narration, with a total duration of approximately 8 minutes. To ensure the quality and rigor of the intervention tool, three cardiology experts were invited to evaluate the content. The Content Validity Index (CVI) of the intervention was 0.85.; Other: Paper-based education; Routine care consisted of verbal education using an educational leaflet. The leaflet was based on the standard educational materials routinely used in the cardiology department of the hospital and was developed by the hospital nursing department according to clinical practice and relevant care guidelines. The content of the educational leaflet included the causes and symptoms of myocardial infarction, pre-procedure preparation for cardiac catheterization, post-procedure puncture wound care, and key points for self-care after discharge. During the intervention process, participants received verbal education from the researcher before cardiac catheterization, accompanied by explanations using the educational leaflet. The educational session lasted approximately 10 minutes, and participants were encouraged to ask questions to enhance their understanding of the educational content.
Active Comparator: Control Group	Other: Paper-based education; Routine care consisted of verbal education using an educational leaflet. The leaflet was based on the standard educational materials routinely used in the cardiology department of the hospital and was developed by the hospital nursing department according to clinical practice and relevant care guidelines. The content of the educational leaflet included the causes and symptoms of myocardial infarction, pre-procedure preparation for cardiac catheterization, post-procedure puncture wound care, and key points for self-care after discharge. During the intervention process, participants received verbal education from the researcher before cardiac catheterization, accompanied by explanations using the educational leaflet. The educational session lasted approximately 10 minutes, and participants were encouraged to ask questions to enhance their understanding of the educational content.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in anxiety scores measured by the Visual Analog Scale for Anxiety (VAS-A)	The Visual Analog Scale for Anxiety (VAS-A) is used to assess the subjective level of anxiety. It consists of a continuous 100-mm horizontal line ranging from 0 to 100 mm, with 0 mm representing no anxiety and 100 mm representing extreme anxiety. Higher scores indicate greater levels of anxiety. A VAS-A score of ≥50 mm is considered to represent clinically significant anxie.	pre-intervention, immediately after the intervention, and within 6 hours after completion of after procedure
Change in anxiety scores measured by the Hospital Anxiety and Depression Scale-Anxiety Subscale (HADS-A)	The Hospital Anxiety and Depression Scale (HADS) consists of 14 items, including 7 anxiety items and 7 depression items. In this study, only the Hospital Anxiety and Depression Scale-Anxiety Subscale (HADS-A), which contains 7 items, was used. The HADS-A is scored using a Likert-type scale, with total scores ranging from 0 to 21. Higher scores indicate greater levels of anxiety. Scores of 0-7 indicate normal anxiety levels, scores of 8-10 indicate mild anxiety, and scores of 11 or higher indicate severe anxiety.	pre-intervention, and within 6 hours after completion of after procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in heart rate	Assess the level of physiological anxiety through changes in heart rate.	pre-intervention, immediately after the intervention, and within 6 hours after completion of after procedure
Change in systolic blood pressure	Assess the level of physiological anxiety through change in systolic blood pressure	pre-intervention, immediately after the intervention, and within 6 hours after completion of after procedure
Change in diastolic blood pressure	Assess the level of physiological anxiety through change in diastolic blood pressure	pre-intervention, immediately after the intervention, and within 6 hours after completion of after procedure
Change in respiratory rate	Assess the level of physiological anxiety through change in respiratory rate	pre-intervention, immediately after the intervention, and within 6 hours after completion of after procedure

Collaborators and Investigators

• Sponsor: Chung Shan Medical University

Study record dates

Study Major Dates

• Study Start (Actual): May 7, 2025
• Primary Completion (Actual): November 28, 2025
• Study Completion (Actual): November 28, 2025

Study Registration Dates

• First Submitted: May 31, 2026
• First Submitted That Met QC Criteria: June 30, 2026
• First Posted (Actual): July 1, 2026

Study Record Updates

• Last Update Posted (Actual): July 1, 2026
• Last Update Submitted That Met QC Criteria: June 30, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: CSH-2025-A-033

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