Comparison of Virtual Reality-Based and Routine Preoperative Education on Surgical Anxiety and Salivary Cortisol

Starting soon · Not applicable

Conditions studied: Lumbar Disc Herniation, Preoperative Anxiety

In brief

This randomized controlled pilot study aims to compare the effects of virtual reality-based preoperative education and routine preoperative education on surgical anxiety in patients undergoing lumbar disc surgery. In addition to evaluating psychological outcomes, the study will also compare psychometric anxiety assessments with a biological stress marker, salivary cortisol, to examine the relationship between subjective and physiological stress responses. Preoperative anxiety is common among surgical patients and may negatively influence both emotional well-being and physiological stress regulation. Virtual reality-based education may provide a more immersive and engaging learning experience compared to routine education, potentially reducing anxiety levels. Participants will be randomly assigned to either a virtual reality-based education group or a routine preoperative education group. Surgical anxiety will be assessed using validated psychometric measurement tools, and physiological stress response will be evaluated through salivary cortisol analysis. The study will further explore the concordance between psychometric findings and biological stress indicators. The results may contribute to the development of innovative, evidence-based nursing interventions and provide insight into the relationship between psychological and biological indicators of preoperative anxiety.

Key facts

Study ID

NCT07443111

Run by

Bezmialem Vakif University

People needed

56

Starts

2026-02-27

Expected to finish

2026-05-27

Last updated by the study team

2026-03-02

Who can join

Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age between 18 and 65 years
• Hospitalized patients scheduled for elective lumbar disc herniation surgery in the preoperative period
• American Society of Anesthesiologists (ASA) physical status I-III
• Able to read and understand Turkish and be literate
• Sufficient cognitive capacity to understand the informed consent form (no advanced dementia, severe aphasia, impaired consciousness, or neurological/psychiatric condition interfering with communication)
• Willing to complete the State Anxiety Inventory - State form (STAI-S) for surgical anxiety assessment and to provide a saliva sample using a non-invasive method
• No severe visual impairment that would prevent the use of a virtual reality headset (visual impairments correctable with glasses or contact lenses are acceptable)
• Provision of written and verbal informed consent

You may not qualify if…

• Presence of an emergency or urgent neurosurgical indication (e.g., traumatic acute subdural hematoma, acute intracranial hemorrhage with herniation signs)
• History of diagnosed epilepsy, particularly photosensitive epilepsy
• Severe cognitive impairment, severe aphasia, lack of cooperation, or altered level of consciousness
• History of psychiatric hospitalization within the last 6 months due to severe psychiatric disorders such as psychotic disorder, bipolar disorder, or severe major depressive disorder
• Chronic systemic steroid use or endocrine disorders significantly affecting adrenal cortex function (e.g., Cushing syndrome, Addison's disease)
• Untreated severe thyroid disease that may affect cortisol metabolism
• History of severe vertigo or vestibular disorders with prior intolerance to VR-like visual stimuli
• Severe visual impairment not correctable with glasses or contact lenses that would prevent adequate perception of VR content
• Inability to complete the VR session due to nausea, dizziness, or similar symptoms during headset use (in such cases, the intervention will be discontinued and the participant will be withdrawn from the study)
• Severe oral lesions, active serious oral infection, or significant salivary gland pathology interfering with saliva sampling
• Known pregnancy or suspected pregnancy
• Participation in another randomized controlled trial or VR-based intervention within the last 3 months
• Withdrawal of consent during the study or cancellation/postponement of the scheduled surgical procedure

Full record on ClinicalTrials.gov

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