{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:14:52Z","timestamp":1788347692362,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preoperative anxiety affects a substantial proportion of surgical patients and may adversely influence perioperative outcomes. Virtual reality (VR) technology offers an innovative approach for anxiety management, yet evidence regarding its efficacy in surgical settings remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the effectiveness of an immersive VR\u2010based intervention for reducing preoperative anxiety among adult patients undergoing elective abdominal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective, single\u2010center, randomized controlled trial was conducted from March 2023 to December 2024. Three hundred eight patients scheduled for elective abdominal surgery were randomly allocated to either the VR intervention group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009155) or the standard care control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009153). The VR group received a 10\u201315\u2009min immersive relaxation experience prior to anesthesia induction. The primary outcome was pre\u2010induction anxiety measured using the State\u2013Trait Anxiety Inventory, State subscale (STAI\u2010S). Secondary outcomes included intraoperative cooperation scores, physiological stress markers, and patient satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients in the VR group demonstrated significantly lower pre\u2010induction STAI\u2010S scores compared to controls (36.5\u2009\u00b1\u200910.5 vs. 48.0\u2009\u00b1\u200910.9, mean difference \u221211.5, 95% CI \u221213.9 to \u22129.2, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20091.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The VR group also exhibited higher intraoperative cooperation scores (82.8\u2009\u00b1\u20099.3 vs. 74.8\u2009\u00b1\u200911.8, mean difference 8.0, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and attenuated physiological stress responses including heart rate (82.5\u2009\u00b1\u200912.8 vs. 89.5\u2009\u00b1\u200912.4\u2009bpm, mean difference \u22127.0, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), systolic blood pressure (133.3\u2009\u00b1\u200915.0 vs. 142.0\u2009\u00b1\u200914.5\u2009mmHg, mean difference \u22128.7, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and serum cortisol (14.9\u2009\u00b1\u20094.3 vs. 20.1\u2009\u00b1\u20094.8\u2009\u03bcg\/dL, mean difference \u22125.2, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20091.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The VR group reported higher satisfaction scores (8.1\u2009\u00b1\u20091.1 vs. 7.4\u2009\u00b1\u20091.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Subgroup analyses revealed consistent benefits across surgery types, anesthesia modalities, and demographic characteristics. Adverse events were minimal, with only 4.5% of VR participants reporting mild transient symptoms including dizziness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093, 1.9%), headache (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093, 1.9%), and eye strain (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091, 0.6%), all of which resolved spontaneously within minutes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immersive VR\u2010based intervention effectively reduces preoperative anxiety and improves patient cooperation in adults undergoing elective abdominal surgery. This non\u2010pharmacological approach represents a promising adjunct to standard perioperative care protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70775","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:43:47Z","timestamp":1780307027000},"page":"2114-2124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Virtual Reality\u2010Based Intervention for Reducing Preoperative Anxiety in Adult Surgical Patients: A Randomized Controlled Trial"],"prefix":"10.1111","volume":"96","author":[{"given":"Lei","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Xianning Central Hospital (The First Affiliated Hospital of Hubei University of Science and Technology)  Xianning Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Xianning Central Hospital (The First Affiliated Hospital of Hubei University of Science and Technology)  Xianning Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9441-0045","authenticated-orcid":false,"given":"Tongling","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Xianning Central Hospital (The First Affiliated Hospital of Hubei University of Science and Technology)  Xianning Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0375-9393.18.12520-X"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1492-5"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-14-67"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181aae87a"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(00)00189-6"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200607000-00002"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.53.11.1209"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1108"},{"issue":"5","key":"e_1_2_11_10_1","first-page":"1314","article-title":"Lorazepam Premedication in Older Patients and Its Effect on Postoperative Delirium and Cognitive Dysfunction","volume":"123","author":"Louter K. 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