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A prospective randomized controlled trial was conducted with 140 female patients aged 20\u201365 years, assigned to four groups (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935\/group): (1) written explanation only, (2) VR education with verbal breathing guidance, (3) VR education with neurologic music intervention and live breathing guidance, and (4) written explanation with neurologic music intervention. Psychological states were assessed using the Korean version of the Profile of Mood States. Satisfaction and comprehension were evaluated with a structured questionnaire. ANCOVA revealed a significant overall effect of group assignment on psychological responses (F\u2009=\u20093.693,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.014). Group 3 reported lower mean anxiety and depression compared with Group 2, although targeted comparisons between these groups were not statistically significant. One-way analysis of variance revealed significant differences in satisfaction scores (F\u2009=\u200910.125,\n                    <jats:italic>p<\/jats:italic>\n                    &lt;.001), with Group 3 showing higher satisfaction (M\u2009=\u200945.31, SD\u2009=\u20094.28) than Group 2 (M\u2009=\u200943.26, SD\u2009=\u20095.20). These findings suggest that VR-based preoperative education was associated with improvements in psychological outcomes and patient satisfaction. However, targeted comparisons between key intervention groups did not reveal statistically significant differences in anxiety and depression.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-51676-8","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T10:15:21Z","timestamp":1778494521000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Music therapy integrated virtual reality education for preoperative anxiety in gynecological surgery"],"prefix":"10.1038","volume":"16","author":[{"given":"Yoo Seop","family":"Shin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung Sun","family":"Yeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Won","family":"Na","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Min","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Ji","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"51676_CR1","first-page":"31","volume":"85","author":"CB Jaruzel","year":"2017","unstructured":"Jaruzel, C. 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