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NCT Number: NCT07620873

Effects of Virtual Reality Education on Anxiety and Learning in Patients Undergoing Urolithiasis Surgery

This randomized controlled trial aims to evaluate the effects of two-tier virtual reality-based preoperative education on anxiety, learning knowledge, self-care ability, and cognitive load in patients undergoing urolithiasis surgery. Participants will be randomly assigned to routine education, standard virtual reality education, or two-tier virtual reality education groups. Outcomes will be assessed using anxiety scales, knowledge questionnaires, self-care ability measures, and cognitive load assessments before and after the intervention.

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Key information

Conditions

Urolithiasis Anxiety Disorders Calculi Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Kidney Calculi Kidney Diseases Kidney Stone Male Urogenital Diseases Mental Disorders Nephrolithiasis Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms Ureter Stones Urinary Calculi Urogenital Diseases Urologic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Keelung Chang Gung Memorial Hospital

Keelung, 204, Taiwan

Location status: Recruiting

About this study

Preoperative anxiety is a common concern among patients undergoing urolithiasis surgery and may adversely affect perioperative experiences, treatment adherence, and postoperative recovery. Conventional preoperative education is often limited by time constraints, variability in information delivery, and insufficient patient engagement.

Virtual reality (VR)-based education has emerged as an innovative educational approach that provides immersive and interactive learning experiences. Previous studies have suggested that VR may improve patient understanding of surgical procedures and reduce anxiety by familiarizing patients with the perioperative environment. However, most existing VR education programs provide information passively and may not adequately identify or correct patient misconceptions.

The present study introduces a two-tier virtual reality educational approach that integrates immersive VR scenarios with structured knowledge assessment and feedback mechanisms. By encouraging participants to actively process information and receive immediate clarification of misunderstandings, the intervention is expected to enhance learning effectiveness and support patient self-management.

This randomized controlled trial aims to examine whether a two-tier VR educational strategy can provide additional benefits beyond standard VR education and routine preoperative instruction for patients undergoing urolithiasis surgery. Findings from this study may contribute to the development of more effective patient-centered educational interventions and provide evidence for the integration of advanced VR technologies into perioperative nursing practice.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients scheduled to undergo urolithiasis surgery with procedure codes 77026B, 77027B, 77028B, or 76016B.
  • Aged 18 years or older.
  • Conscious and mentally alert.
  • Able to communicate in Mandarin Chinese and read written text.
  • Able to understand and operate virtual reality equipment.

Exclusion criteria

  • Patients with current psychiatric disorders or substance abuse.
  • Patients with hearing or visual impairment.
  • Patients with visual dizziness, vertigo, or virtual reality motion sickness symptoms.
  • Patients who are unable to cooperate or unwilling to participate in the study.

Treatment and study plan

VR Education

Behavioral

Participants receive standard virtual reality-based preoperative education before urolithiasis surgery. The VR program includes immersive 360-degree educational content covering the preoperative process, operating room environment, postoperative care, and self-care instructions.

Two-Tier VR Education

Behavioral

Participants receive two-tier virtual reality-based preoperative education before urolithiasis surgery. The intervention combines immersive 360-degree VR educational content with a two-tier testing mechanism designed to enhance learning comprehension, self-care knowledge, and cognitive engagement.

Primary outcomes

  1. Anxiety Score Measured by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Hospital Anxiety and Depression Scale-Anxiety Subscale (HADS-A)

    Time frame: Baseline before intervention, 2 hours after intervention, and postoperative day 1

    Anxiety will be assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A).

    The APAIS consists of 6 items scored on a 5-point Likert scale. Total scores range from 6 to 30, with higher scores indicating greater preoperative anxiety and information needs.

    The HADS-A consists of 7 items scored from 0 to 3. Total scores range from 0 to 21, with higher scores indicating greater anxiety.

Secondary outcomes

  1. Urolithiasis Surgery Knowledge Questionnaire Score

    Time frame: Baseline before intervention and 2 hours after intervention

    Knowledge regarding perioperative care for urolithiasis surgery will be assessed using a researcher-developed Urolithiasis Surgery Knowledge Questionnaire.

    The baseline questionnaire consists of 10 multiple-choice items and the post-intervention questionnaire consists of 20 multiple-choice items covering surgical preparation, operating room orientation, perioperative care, urinary catheter care, Double-J stent management, dietary management, hydration, complication recognition, and prevention of stone recurrence.

    Scores range from 0 to 10 at baseline and from 0 to 20 after intervention. Higher scores indicate better understanding of urolithiasis surgery and postoperative self-care

  2. Postoperative Self-Care Ability Score Measured by the Urolithiasis Self-Care Ability Scale

    Time frame: Postoperative day 1

    Postoperative self-care ability will be assessed using the Urolithiasis Postoperative Self-Care Ability Scale developed by Hu et al. (2024).

    The scale consists of 30 items across five domains, including disease management, diet and fluid intake, psychosocial management, activity and elimination, and disease-related information.

    Each item is rated on a 5-point Likert scale. Total scores range from 30 to 150. Higher scores indicate better postoperative self-care ability.

  3. Cognitive Load Score Measured by the Cognitive Load Questionnaire

    Time frame: 2 hours after intervention

    Cognitive load will be assessed using the Cognitive Load Questionnaire developed by Klepsch et al. (2017).

    The questionnaire contains 8 items assessing intrinsic cognitive load, extraneous cognitive load, and germane cognitive load.

    Each item is rated on a 5-point Likert scale. Total scores range from 8 to 40. Higher scores indicate greater perceived cognitive load during learning.

Study contacts

Contact information is provided by the study sponsor or research team.

wellin Huang, RN, MSN Student

CONTACT

[email protected]

+886 953713535

Sponsors and collaborators

Lead sponsor

Wei-Lin, Huang

Other

Registry information

Official study title

The Effects of Two-Tier Test-Based Virtual Reality Education on Anxiety, Knowledge, Self-Care Ability, and Cognitive Load in Patients Undergoing Urolithiasis Surgery

Acronym: VR-URO

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jun 2, 2026
Registry last updated
Jul 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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