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Effects of Virtual Reality on Anxiety, Stress, Pain, and Patient Satisfaction Among Palestinian Patients Undergoing
Khulud Mansor1, Ibrahim Aqtam1, Mustafa Shouli1
1Ibn Sina College for Health Professions, Department of Nursing Nablus University for Vocational and Technical Education Nablus Palestine.
Background And Aims:
Colonoscopy frequently causes significant pre-procedural anxiety and intra-procedural pain. This randomized controlled trial evaluated immersive, culturally adapted virtual reality (VR) therapy on anxiety, perceived stress, pain, patient satisfaction, and hemodynamic stability in Palestinian adults undergoing colonoscopy.
Methods:
In a single-blinded RCT, 150 patients were randomized to VR (n = 75) or standard care (n = 75). All received standard pharmacological sedation; the VR group additionally received culturally adapted passive VR distraction. Primary outcomes: State-Trait Anxiety Inventory (STAI) and Perceived Stress Scale-10 (PSS-10). Secondary outcomes: pain (VAS/NRS), satisfaction, and hemodynamic parameters. Intention-to-treat analysis was applied.
Results:
The VR group showed significantly greater reductions in post-procedural state-anxiety (29.7 vs. 38.0; p < 0.001; Cohen's d = 1.25) and perceived stress (19.1 vs. 23.9; p < 0.001; d = 0.93). VR patients reported lower pain (VAS 6.4 vs. 8.6; p < 0.001; d = 1.39) and higher satisfaction (84.9 vs. 63.2; p < 0.001; d = 1.70). Heart rates were significantly lower at 30 and 45 min intra-operatively (p < 0.001 and p = 0.002). VR-related side effects were minimal (4.0% mild transient dizziness).
Conclusion:
Immersive, culturally adapted VR is a highly effective, safe adjunct that significantly reduces anxiety, stress, and pain while improving satisfaction and hemodynamic stability during colonoscopy. Healthcare institutions should consider integrating VR into routine endoscopic care.
Relevance To Clinical Practice:
VR is a cost-effective, patient-centered strategy that may reduce sedation needs and enhance colorectal cancer screening adherence. Trial Registration: ClinicalTrials.gov identifier: NCT07145203 (registered 21 August 2025).
