Karsten Lomholt Lassen

Background/Objectives: Older patients are more susceptible to the process of understanding and retrieving information. To provide adequate preoperative information, reduce their vulnerability and anxiety, and thereby facilitate pre-, intra-, and postoperative care, the adoption of new information technologies is essential. This study aimed to explore elderly patients’ experiences and perceptions of a Virtual Reality (VR)-based preoperative informational tool designed for individuals scheduled to undergo TKA. Method: A qualitative content analysis was conducted from February to June 2025 based on 14 semi-structured post-discharge interviews. Participants were recruited as part of a randomized controlled trial. Results: One main theme and two categories describe patients’ experiences of using VR information, which is perceived as a valuable supplement to standard preoperative information. The category “Using VR as an information tool” includes how patients experienced the immersive environment, how it affected them, and their views on using the VR glasses. The category “Apply the information provided” described how patients evaluated and applied the VR content in relation to their expectations and the actual surgical experience. Conclusions: Immersive virtual reality (VR) shows promise as a preoperative information tool, improving patients’ understanding of the perioperative process and supporting engagement in their own care. Its effectiveness depends on reliable technical performance and adaptation to individual needs. VR should complement, not replace, communication with healthcare professionals. Further research is needed to identify optimal timing for VR delivery and its impact on preoperative anxiety and patient experience.

Background and Objective: Virtual reality (VR) is a rapidly evolving technology that is currently utilized in hospital settings for various types of surgical procedures. The extent to which VR is evident in improving patient outcomes is unknown. This systematic review assesses the impact of VR on adult patients undergoing elective surgical procedures. Databases and Data Treatment: The following databases were sought: CENTRAL, MEDLINE, EMBASE, and CINAHL. All studies published after 2017 were included. The risk of bias was assessed using the ROB2 and ROBINS‐I. Meta‐analyses and Trial Sequential Analyses were performed, and the quality of evidence was evaluated using the GRADE approach for the randomised controlled trials. Results: A total of 37 full‐text studies ( n = 3152) were included. VR significantly reduced anxiety measured by the Numeric Rating Scale ( p < 0.0001) and the State–Trait Anxiety Inventory ( p = 0.008). Furthermore, Numeric Rating Scale pain was significantly reduced ( p < 0.00005), with a significantly shorter recovery time and a non‐significant improvement in patient satisfaction. Adverse events were infrequent and mild, with no serious adverse events reported. The risk of bias was primarily “some concerns”, and the certainty of evidence ranged from moderate to low. Conclusions: VR appears effective in reducing pain and anxiety in adult patients in an in‐hospital setting. It offers a relatively safe adjunct to standard care with minimal side effects. However, heterogeneity in outcomes and the risk of bias suggest a need for more standardised, high‐quality trials. Significance Statement: This systematic review with meta‐analysis and trial sequential analysis provides updated evidence that virtual reality can significantly reduce anxiety and pain in patients undergoing surgical procedures. Through combining recent RCTs and cohort studies with robust methodological approaches, this review strengthens the evidence for VR as an effective non‐pharmacological intervention. With minimal adverse events and significant improvements in recovery time, VR represents a scalable tool that can strengthen multimodal strategies and promote safer and more comfortable patient experiences.

Background. Preoperative anxiety is common among patients scheduled for surgery and can have affect clinical outcomes. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a scale used to assess preoperative anxiety and the need for information among surgical patients. The aim of this study was to translate the original version of APAIS into Danish. Furthermore, to evaluate the Danish version of the APAIS by following the guidelines provided by the International Society for Pharmacoeconomics and Outcome Research (ISPOR). Methods The translation process followed the ISPOR guidelines and involved forward and back trans-lations, reconciliation, cognitive debriefing, and proofreading. The results were evaluated through statistical analysis. Results A total of 14 total knee arthroplasty patients participated in the cognitive debriefing process and provided feedback on the comprehensibility and feasibility of the Danish version of APAIS. Based on the feedback from the cognitive debriefing, the Danish version of APAIS demonstrated comprehensibility and feasibility. The difference in comprehensibility and feasibility between middle-aged and elderly individuals was statistically non-significant. Conclusion The Danish version of APAIS is comprehensible and feasible for assessing preoperative anxiety and the need for information among Danish-speaking patients who were scheduled for total knee arthroplasty surgery. Clinical Relevance The Danish APAIS provides a time-efficient, culturally appropriate alternative to existing scales, supporting early identification of anxiety and enhancing patient-centered care. By addressing preoperative concerns, the scale has the potential to improve surgical outcomes, streamline recovery processes, and foster better communication between patients and clinical teams. Keywords: Amsterdam Preoperative Anxiety and Information Scale, APAIS, translation, anxiety, information, preoperative