Authors (including presenting author) :
Chu MK(1), Lau WS (1), Chang HE(1), Wong WK(1), Au WK(1), Ng CC(1)
Affiliation :
(1) Department of Neurosurgery, Princess Margaret
Keyword 1: :
Virtual Reality
Keyword 3: :
Preoperative education
Keyword 4: :
Postoperative delirium
Keyword 5: :
Preoperative anxiety
Introduction :
Undergoing surgery often elicits significant stress for patients, frequently manifesting as preoperative anxiety. While postoperative delirium is an acute, fluctuating disturbance in attention, cognition, and consciousness that commonly occurs following surgery, particularly in older adults. It affects 15-50% of surgical patients, with higher prevalence in those undergoing major procedures and patients in intensive care settings. Delirium is associated with significant adverse outcomes, including prolonged hospital stays, increased risk of institutionalization, and higher mortality rates. The relationship between preoperative anxiety and postoperative delirium is well-documented. Reducing preoperative anxiety may therefore mitigate the incidence or severity of postoperative delirium, improving patient outcomes and reducing healthcare burdens. Virtual reality (VR)-based interventions have emerged as a promising tool for managing preoperative anxiety. However, its impact on postoperative delirium remains underexplored despite the established link between preoperative anxiety and increased delirium risk.
Objectives :
The objectives are to investigate the effect of VR-based intervention in preoperative education on postoperative delirium and preoperative anxiety.
Methodology :
Subjects admitted Department of Neurosurgery, Princess Margaret Hospital and scheduled with an elective surgery with general anesthesia will be invited and to be recruited in the study if they meet the inclusion criteria. Subjects will be allocated into intervention group or control group by randomization. Subjects in the intervention group will receive the routine video-based preoperative education information in addition with a 6mins 360° immersive VR-based intervention which provide the information from admission to post-operative care. Subjects in control group will receive routine textual based and video-based preoperative information Postoperative delirium will be measured by Delirium Observation Scale (DOS) to facilitate recognition of delirium by nursing routine clinical care after surgery. Preoperative anxiety will be measured by Amsterdam Preoperative Anxiety and Information Scale (APAIS) before and after the preoperative education.
Result & Outcome :
Total 30 subjects were recruited from June – July 2025 with 1 dropped out as the OT was cancelled due to patient’s physical condition. The incidence of operative delirium (DOS Score >=3) in intervention group was 1 while in control group was 4. For the preoperative anxiety, the APAIS score in intervention group dropped from 17.29 (SD 5.59) to 12.64 (SD 5.88), decreased in 26.89%. While in the control group, the APAIS score dropped from 15.79 (SD 4.07) to 13.64 (SD 4.39), decreased in 13.62%. Both intervention group and control group showed improvement after preoperative education. However, subjects receiving VR-based intervention showed greater reduction in preoperative anxiety and the incidence rate of postoperative delirium was lesser than the control group. This study holds significant implications for nursing practice by evaluating the effectiveness of virtual reality-based preoperative education in reducing preoperative anxiety among neurosurgical patients. The findings inform nurses about the potential of VR to reshape patients’ threat appraisals, enhancing their preparedness and reducing anxiety-related complications, such as postoperative delirium.
