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- Title
Augmented Reality for Perioperative Anxiety in Patients Undergoing Surgery: A Randomized Clinical Trial.
- Authors
Rizzo Jr, Michael G.; Costello II, Joseph P.; Luxenburg, Dylan; Cohen, Jacob L.; Alberti, Nicolas; Kaplan, Lee D.
- Abstract
Key Points: Question: Does a preoperative walkthrough of a patient's day of surgery using augmented reality (AR) effect the patient's anxiety levels? Findings: In this randomized clinical trial that included 95 patients, patients who received the preoperative AR experienced a significant decrease in preoperative State-Trait Anxiety Inventory (STAI) score compared with the control group that received standard education materials. There was no significant difference in STAI scores after operations. Meaning: These findings suggest that a preoperative AR walkthrough may be a useful tool for reducing preoperative anxiety, but its impact on postoperative anxiety is less clear. This randomized clinical trial assesses whether the use of an augmented reality walkthrough of the day of surgery reduces patient perioperative anxiety compared with a standard educational control. Importance: Both augmented reality (AR) and virtual reality (VR) have had increasing applications in medicine, including medical training, psychology, physical medicine, rehabilitation, and surgical specialties, such as neurosurgery and orthopedic surgery. There are little data on AR's effect on patients' anxiety and experiences. Objective: To determine whether the use of an AR walkthrough effects patient perioperative anxiety. Design, Setting, and Participants: This randomized clinical trial was conducted at an outpatient surgery center in 2021 to 2022. All patients undergoing elective orthopedic surgery with the senior author were randomized to the treatment or control group. Analyses were conducted per protocol. Data analysis was performed in November 2022. Intervention: AR experience explaining to patients what to expect on their day of surgery and walking them through the surgery space. The control group received the standard educational packet. Main Outcomes and Measures: The main outcome was change in State-Trait Anxiety Inventory (STAI) from the screening survey to the preoperative survey. Results: A total of 140 patients were eligible, and 45 patients either declined or were excluded. Therefore, 95 patients (63 [66.3%] male; mean [SD] age, 38 [16] years) were recruited for the study and included in the final analysis; 46 patients received the AR intervention, and 49 patients received standard instructions. The AR group experienced a decrease in anxiety from the screening to preoperative survey (mean score change, −2.4 [95% CI, −4.6 to −0.3]), while the standard care group experienced an increase (mean score change, 2.6 [95% CI, 0.2 to 4.9]; P =.01). All patients postoperatively experienced a mean decrease in anxiety score compared with both the screening survey (mean change: AR, −5.4 [95% CI, −7.9 to −2.9]; standard care, −6.9 [95% CI, −11.5 to −2.2]; P =.32) and preoperative survey (mean change: AR, −8.0 [95% CI, −10.3 to −5.7]; standard care, −4.2 [95% CI, −8.6 to 0.2]; P =.19). Of 42 patients in the AR group who completed the postoperative follow-up survey, 30 (71.4%) agreed or strongly agreed that they enjoyed the experience, 29 (69.0%) agreed or strongly agreed that they would recommend the experience, and 28 (66.7%) agreed or strongly agreed that they would use the experience again. No differences were observed in postoperative pain levels or narcotic use. Conclusions and Relevance: In this randomized clinical trial, the use of AR decreased preoperative anxiety compared with traditional perioperative education and handouts, but there was no significant effect on postoperative anxiety, pain levels, or narcotic use. These findings suggest that AR may serve as an effective means of decreasing preoperative patient anxiety. Trial Registration: ClinicalTrials.gov Identifier: NCT04727697
- Subjects
ANXIETY prevention; PERIOPERATIVE care; ELECTIVE surgery; STATE-Trait Anxiety Inventory; AUGMENTED reality; CONFIDENCE intervals; ORTHOPEDIC surgery; SURGERY; PATIENTS; PATIENTS' attitudes; RANDOMIZED controlled trials; PSYCHOLOGICAL tests; PRE-tests &; post-tests; COMPARATIVE studies; DESCRIPTIVE statistics; STATISTICAL sampling; DATA analysis software; OUTPATIENT services in hospitals
- Publication
JAMA Network Open, 2023, Vol 6, Issue 8, pe2329310
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.29310