Perioperative anxiety is common among patients undergoing surgery, potentially leading to negative outcomes. Immersive virtual reality (VR) has shown promise in reducing anxiety in various clinical settings. This study aimed to evaluate the effectiveness of VR in reducing perioperative anxiety in patients undergoing gynecological oncology surgery and was conducted as a single-center, double-arm, single-blinded randomized controlled trial at the Gold Coast University Hospital, Queensland, Australia. Participants were randomized into the VR intervention + care as usual (CAU) group (n = 39) and the CAU group (n = 41). Anxiety scores were assessed using a six-tier visual facial anxiety scale at baseline, after the intervention/CAU on the same day, and, several days up to weeks later, immediately before surgery. There was no significant difference in baseline anxiety scores, type of operation, or suspected cancer between the two groups. The VR intervention significantly reduced anxiety scores from baseline to preoperative assessment (p< 0.001). The median anxiety score in the VR intervention group decreased from 3 (interquartile range 2 to 5) at baseline to 2 (2 to 3) prior to surgery, while the control group’s scores were 4 (2 to 5) and 4 (3 to 5), respectively. Multivariate analysis showed that group assignment was the sole outcome predictor, not age, type of procedure, or the time elapsed until surgery. Thus, VR exposure was effective in reducing perioperative anxiety in patients undergoing gynecological oncology surgery. The use of VR as a preparation tool may improve patient experience and contribute to better surgical outcomes, warranting further research into exploring the potential benefits of VR in other surgical specialties and its long-term impact on patient recovery.
围手术期焦虑在接受手术的患者中较为常见，可能对预后产生不良影响。沉浸式虚拟现实技术在多种临床场景中已显示出缓解焦虑的潜力。本研究旨在评估虚拟现实对妇科肿瘤手术患者围手术期焦虑的缓解效果，采用单中心、双臂、单盲随机对照试验设计，在澳大利亚昆士兰黄金海岸大学医院开展。受试者被随机分配至虚拟现实干预联合常规护理组（n=39）和单纯常规护理组（n=41）。通过六级视觉面部焦虑量表分别在基线期、干预/常规护理实施当日、以及术前数日至数周内进行焦虑评分评估。两组患者在基线焦虑评分、手术类型及疑似癌症诊断方面均无显著差异。虚拟现实干预显著降低了从基线期至术前评估期间的焦虑评分（p<0.001）。虚拟现实干预组焦虑评分中位数从基线期的3分（四分位距2-5）降至术前的2分（2-3），而对照组评分分别为4分（2-5）和4分（3-5）。多变量分析显示，组别分配是焦虑评分的唯一预测因素，年龄、手术类型及术前等待时间均无显著影响。研究表明，虚拟现实干预能有效缓解妇科肿瘤手术患者的围手术期焦虑。将虚拟现实作为术前准备工具可改善患者体验，并有助于提升手术预后，值得进一步探索虚拟现实技术在其他外科专科的潜在效益及其对患者康复的长期影响。
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