Artroscopic Surgery, Orthopedic Surgery
Conditions
Keywords
Orthopedic surgery, Virtual reality, Surgical anxiety, Surgical fear, Preoperative education, Patient satisfaction, Pain management, Physiological parameters, Surgical preparation, VR intervention, Pain assessment, Electrodermal activity, Patient education tools, Preoperative anxiety reduction, VR-based operating room introduction, patient education.
Brief summary
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.
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.
Interventions
BEHAVIORALVirtual 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.
Sponsors
Acibadem University
Acibadem Altunizade Hospital, Istanbul
Acibadem Atasehir Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Preoperative anxiety level: State Anxiety - State-Trait Anxiety Inventory (STAI-I) | 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. |
| Patient satisfaction with perioperative care | 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. |
| Surgical fear level: Surgical Fear Questionnaire (SFQ) | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain level: Numeric Rating Scale (NRS) | 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. |
| Physiological parameters: Heart rate | 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. |
| Electrodermal activity (EDA) | 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. |
| Physiological parameters: Systolic blood pressure | 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. |
| Physiological parameters: Diastolic blood pressure | 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. |
| Physiological parameters: Respiratory rate | 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. |
| Physiological parameters: Peripheral oxygen saturation (SpO₂) | 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. |
| Physiological parameters: Body temperature | 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. |
Countries
Turkey (Türkiye)
Outcome results
None listed