Alleviating Pre-operative Anxiety With Innovative 3D Immersive Virtual Reality
Condition: Virtual Reality; Anxiety; Preoperative Anxiety
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      To construct and evaluate an immersive 3D simulation to familiarize patients with the
      pre-operative experience, and investigate whether A) immersive 3D virtual reality video can
      reduce pre-operative anxiety, and B) how this approach compares to current practice of
      viewing traditional educational videos.
    

Detailed description: 
      The prevalence of pre-operative anxiety is estimated as being as high as 80% in surgical
      populations. Physiologically, this may result in higher cortisol levels, which may slow down
      the healing and recovery process. A multitude of perioperative clinical trials have revealed
      that pre-operative anxiety is associated with reduced short-term postoperative recovery,
      increased pain scores, nause & vomiting, sleep disturbances, surgical wound infections,
      increased length of stay, and cardiac complications. It has also been linked with worse
      functional outcomes and quality of life up to one-year after surgery.

      Literature looking at factors associated with preoperative anxiety outline a general theme of
      the fear of the unknown that is distressing. Specifically, the most distressing events seem
      to be waiting to be collected for surgery, waiting outside the operating room (OR), being
      transferred to the OR bed and having monitors and oxygen mask applied. These moments prior to
      surgery are when patients are most likely to continuously ruminate over 'what comes next' and
      the fact of not knowing - leading to anxiety. One survey of 161 patients presenting for
      elective surgery inquired about factors that led to being calm prior to their procedure and
      found that being well informed of the pre-operative process was a critical aspect of anxiety
      relief. Approaches such as implementation of the pre-anesthetic clinic (PAC) and the use of
      videos of what to expect leading up to surgery have been implemented to address this issue
      but have been costly or have had mixed effects.

      Virtual reality (VR) technology presents a new educational opportunity for patients in an
      effort to reduce pre-operative anxiety. Through immersive 3D simulation, patients can
      experience the journey of being prepped for surgery and transferred to the OR. A patient can
      learn about their pre-operative experience in a more engaging manner as opposed to passively
      reading, watching video or being verbally taught about it by the healthcare provider. A
      patient is educated by having the perception of being physically present in the pre-operative
      experience days or weeks prior to their OR date.
    

Intervention name(s): IPAD; VR Goggles
Intervention type(s): Other; Other
Intervention description(s): Patients undergoing surgery will watch the video using an PAD; Patients undergoing surgery will watch the video using goggles
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention