The effect of 360° virtual reality-based education on preoperative anxiety and hemodynamic parameters in patients undergoing primary brain tumor surgery

Abstract

Background: Preoperative anxiety can adversely affect surgical outcomes, leading to increased discomfort, delayed recovery, poor wound healing, extended hospital stays, and a heightened risk of complications. Virtual reality (VR) technology has emerged as an innovative alternative for mitigating preoperative anxiety. By allowing patients to virtually engage with the surgical environment, VR can enhance familiarity and reduce anxiety.Objectives: This study aimed to evaluate the impact of 360° VR-based education on preoperative anxiety levels and hemodynamic parameters in patients undergoing primary brain tumor surgery.Methods: A interventional study was conducted with consecutive sampling to recruit patients aged 18–65 years, American Society of Anesthesiologists (ASA) 1, 2, and 3, without visual, auditory, reading, psychiatric disorders, or drug dependence. These patients were scheduled for first-time elective primary brain tumor surgery under general anesthesia at the National Brain Centre Hospital, Jakarta, Indonesia, between October and December 2023. A total of 54 patients were randomly assigned to either the intervention group, which received 360° VR-based education, or the control group, which received standard hospital-based preoperative education. Preoperative anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and anxiety-related physiological responses [Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Heart Rate (HR), Respiratory Rate (RR), and Oxygen Saturation (SpO₂)] were assessed before and after the intervention. Descriptive statistics, ANCOVA, and paired and independent samples t-tests were performed for data analysis using SPSS Statistics version 29.Results: The intervention group exhibited a statistically significant reduction in preoperative anxiety scores (APAIS) compared to the control group (F=25.13, P<0.001, partial eta squared=0.348), indicating a strong effect of the intervention. However, no significant differences were observed in SBP, DBP, HR, RR, or SpO₂ between the two groups following the intervention (P>0.05).Conclusion: Compared to traditional hospital-based education, 360° VR-based education effectively reduces preoperative anxiety in patients scheduled for primary brain tumor surgery. Therefore, we recommend implementing similar 360° VR educational strategies for patients prior to such surgical procedures.