Alimonaki Elina Christiana, Bothou Anastasia, Diamanti Athina, Deltsidou Anna, Paliatsiou Styliani, Karampas Grigorios, Kyrkou Giannoula
Department of Midwifery, University of West Attica, 12243 Athens, Greece.
Second Department of Obstetrics and Gynaecology, Aretaieio University Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Nurs Rep. 2025 Jul 25;15(8):268. doi: 10.3390/nursrep15080268.
Perioperative care is an integral part of the procedure of a surgical operation, with strictly defined rules. The need to upgrade and improve some individual long-term processes aims at optimal patient care and the provision of high-level health services. Therefore, preoperative care is drawn up with new data resulting from the evolution of technology to upgrade the procedures that need improvement. According to the international literature, a factor considered to be of major importance is high preoperative anxiety and its effects on the patient's postoperative course. High preoperative anxiety is postoperatively responsible for prolonged hospital stays, increased postoperative pain, decreased effect of anesthetic agents, increased amounts of analgesics, delayed healing of surgical wounds, and increased risk of infections. The use of Virtual Reality technology appears as a new method of managing preoperative anxiety. This study investigates the effect and effectiveness of Virtual Reality (VR) technology in managing preoperative anxiety in adult patients. A literature review was performed on 193 articles, published between 2017 and 2024, sourced from the scientific databases PubMed and Cochrane, as well as the trial registry ClinicalTrials, with a screening and exclusion process to meet the criterion of investigating VR technology's effectiveness in managing preoperative anxiety in adult patients. This systematic review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Out of the 193 articles, 29 were selected. All articles examined the efficacy of VR in adult patients (≥18) undergoing various types of surgery. The studies represent a total of 2.354 participants from 15 countries. There are two types of VR applications: distraction therapy and patient education. From the studies, 14 (48%) used the distraction VR intervention, 14 (48%) used the training VR intervention, and 1 (4%) used both VR interventions, using a range of validated anxiety scales such as the STAI, VAS-A, APAIS, and HADS. Among the 29 studies reviewed, 25 (86%) demonstrated statistically significant reductions in preoperative anxiety levels following the implementation of VR interventions. VR technology appears to manage preoperative anxiety effectively. It is a non-invasive and non-pharmacological intervention with minimal side effects. Based on the review, the management of preoperative anxiety with VR technology shows good levels of effectiveness. Further investigation of the efficacy by more studies and randomized controlled trials, with a larger patient population, is recommended to establish and universally apply VR technology in the preoperative care process as an effective method of managing preoperative anxiety.
围手术期护理是外科手术过程中不可或缺的一部分，有着严格规定的规则。升级和改进一些个体长期流程的需求旨在实现最佳的患者护理并提供高水平的医疗服务。因此，术前护理是根据技术发展产生的新数据制定的，以升级需要改进的流程。根据国际文献，一个被认为至关重要的因素是术前高度焦虑及其对患者术后病程的影响。术前高度焦虑在术后会导致住院时间延长、术后疼痛加剧、麻醉剂效果降低、镇痛药用量增加、手术伤口愈合延迟以及感染风险增加。虚拟现实技术的应用似乎是一种管理术前焦虑的新方法。本研究调查了虚拟现实（VR）技术在管理成年患者术前焦虑方面的效果和有效性。对2017年至2024年间发表在科学数据库PubMed、Cochrane以及试验注册库ClinicalTrials上的193篇文章进行了文献综述，并经过筛选和排除过程，以符合研究VR技术在管理成年患者术前焦虑有效性的标准。本系统综述是按照系统评价和Meta分析的首选报告项目（PRISMA 2020）指南进行的。在这193篇文章中，选出了29篇。所有文章都检验了VR对接受各类手术的成年患者（≥18岁）的疗效。这些研究共有来自15个国家的2354名参与者。VR应用有两种类型：分散注意力疗法和患者教育。在这些研究中，14项（48%）使用了分散注意力的VR干预，14项（48%）使用了培训VR干预，1项（4%）同时使用了两种VR干预，使用了一系列经过验证的焦虑量表，如状态特质焦虑量表（STAI）、视觉模拟焦虑量表（VAS - A）、成人术前焦虑量表（APAIS）和医院焦虑抑郁量表（HADS）。在 reviewed 的29项研究中，25项（86%）表明在实施VR干预后术前焦虑水平有统计学意义的降低。VR技术似乎能有效管理术前焦虑。它是一种非侵入性、非药物干预，副作用极小。基于该综述，用VR技术管理术前焦虑显示出良好的有效性水平。建议通过更多研究和随机对照试验，纳入更大的患者群体，进一步研究其疗效，以便在术前护理过程中确立并普遍应用VR技术作为管理术前焦虑的有效方法。
