{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:31:57Z","timestamp":1777944717069,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"1-2","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100010055","name":"University of Salford Manchester","doi-asserted-by":"publisher","award":["Funder reference ID: NUFA86."],"award-info":[{"award-number":["Funder reference ID: NUFA86."]}],"id":[{"id":"10.13039\/100010055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Perioperative Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Cardiac surgery patients may experience stress and anxiety, negatively impacting recovery. Pharmacological treatments are frequently used but may result in side effects. We aimed to assess the effectiveness of immersive virtual reality mindfulness and music therapy in reducing preoperative and postoperative anxiety. Between March and July 2024, 36 participants were randomised to 15\u2009min of either virtual reality (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200919) or music therapy (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200917) preoperatively and on postoperative day 3. Primary endpoints were anxiety levels and salivary cortisol, assessed before and after intervention using the paired Wilcoxon test. Median age was 66 (interquartile range = 58\u201373); 64% were male. Both music therapy and virtual reality groups showed significant preoperative Spielberger State-Trait Anxiety Inventory score reductions after intervention: music therapy from 40 (30\u201348) to 23 (21\u201324) and virtual reality from 40 (31\u201354) to 23 (20\u201335) (both\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001); there was no significant difference between groups (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.7). Median virtual reality immersion and absorption scores were 90\/100 (interquartile range = 80\u201390; 80\u201394). Cortisol levels did not significantly change. Postoperatively, 21 patients participated (virtual reality\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200911, music therapy\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20098), showing reduced anxiety: music therapy from 31 (26\u201332) to 23 (20\u201327), virtual reality from 33 (23\u201341) to 24 (22\u201330). Results show feasibility, tolerability, and preliminary evidence of anxiety reduction, supporting further research into music therapy and virtual reality for cardiac surgery patients. The trial was registered with the International Standard Randomised Controlled Trial Number Registry (ISRCTN51014051) (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1186\/ISRCTN51014051\">https:\/\/doi.org\/10.1186\/ISRCTN51014051<\/jats:ext-link>\n                    ).\n                  <\/jats:p>","DOI":"10.1177\/17504589251370291","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T11:45:16Z","timestamp":1759578316000},"page":"59-67","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A randomised pilot study evaluating music therapy and virtual reality mindfulness sessions for reducing anxiety and stress in patients undergoing first-time elective cardiac surgery"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5250-1104","authenticated-orcid":false,"given":"Bhuvaneswari","family":"Krishnamoorthy","sequence":"first","affiliation":[{"name":"Directorate of Nursing and Midwifery and School of Health and Society, University of Salford, Salford, UK"},{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"},{"name":"Faculty of Health, Department of Cardiovascular Sciences, Biology and Medicine, University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moslem","family":"Abdelghafar","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rick","family":"Air","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Halyckyj-Smith","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Citarella","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Iles-Smith","sequence":"additional","affiliation":[{"name":"Directorate of Nursing and Midwifery and School of Health and Society, University of Salford, Salford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Elliott","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Division of Psychology and Mental Health, Medicine and Health, University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Barnard","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azita","family":"Rajai","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK"},{"name":"Centre for Biostatistics, Division of Population Health, University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajamiyer","family":"Venkateswaran","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006908.pub2"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.40588"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsv094"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000004165"},{"issue":"2","key":"e_1_3_2_6_1","first-page":"90","article-title":"Preoperative anxiety in candidates for heart surgery","volume":"8","author":"Fathi M","year":"2014","unstructured":"Fathi M, Alavi SM, Joudi M, et al 2014 Preoperative anxiety in 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