Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Musculoskeletal Diseases

Behaviors and Mental Disorders

Rare Diseases

Prostatic Neoplasms

Urinary Bladder Neoplasms

Scoliosis

Carcinoma, Renal Cell

Stress, Psychological

Kidney Neoplasms

Urogenital Neoplasms

Urogenital Diseases

Male Urogenital Diseases

Urologic Neoplasms

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Urologic Diseases

Spinal Curvatures

Spinal Diseases

Bone Diseases

Kidney Diseases

Behavioral Symptoms

Renal Cell Carcinoma

Patients will follow the usual care procedures and after each procedure they answer questionnaires related to pain and stress levels (VAS), Anxiety and depression levels (HADS), health-related quality of life (HRQoL), mental wellbeing (SWEMWBS), self-efficacy (GSE) and Patient Activation status (PAM-13).

Intervention group will be exposed to the use of SaMD CARINAE for 2 months approximately, a patientcentred digital health support program. The intervention trial will include a total of 4 visits: 1. Baseline (2-4 weeks before surgery); 2. Hospital admission (1-3 days before surgery); 3. Hospital discharge (1 week after the surgery approx.); 4. Post-operative day 14 (2 weeks after the surgery approx). After each visit and intervention trial with SaMD CARINAE the experimental group answer the same questionnaires of the control group, above mentioned Participants allocated to the intervention group will also be asked to complete questionnaires about usability, satisfaction and subjective experience.

SaMD CARINAE delivers the following digital therapeutic intervention to the patients: 1) Personalised patient-centred health education program to improve patient's disease and recovery self-management skills. 2) AI-based behaviour change program to promote healthier lifestyle habits. 3) Personalised mental well-being coaching program to improve patient's ability to cope with emotional disturbances such as stress and anxiety. 4) A collaborative digital support platform to enable information exchange between patients, caregivers, and healthcare professionals.

SaMD CARINAE

Clara Hernández Cera

Ignacio Muñoz Carvajal

Juan José Lázaro Alcay

Andrea Vallejo Tarrat

JG Maessen, Prof. dr.

Marco Dellabella

Preventing pre-surgical stress can help patients achieve positive outcomes on health and well-being. However, very few patients receive adequate stress relief support prior to a surgical procedure. Provision of education and information about the surgery can be a crucial component of the preoperative experience and is inversely related to levels of preoperative anxiety. However, resource constraints make face-to-face education sessions untenable, given cost considerations and time investment by trained health personnel. Interventions based on mobile health (mHealth) technologies, geared towards increasing familiarity with surgical procedures and hospital environments have been shown to help patients feel informed about possible benefits and risks of available treatment options. mHealth apps and Virtual Reality (VR) can offer patients experience in the perioperative environment that can be helpful in empowering patients and enhancing a more positive experience, while reducing stress. However, available applications focus only on providing informative content, neglecting the importance of patient empowerment with a more robust educational curriculum.

According to this, the Software as a Medical Device (SaMD) CARINAE, aims to support patients and caregivers during the whole perioperative process. SaMD CARINAE consists of an mHealth mobile application for patients and caregivers, a Virtual Reality headset for patients, and a web application for healthcare professionals.

Patients will be randomly assigned to intervention group or the control group. Intervention group will be exposed to the use of SaMD CARINAE for 2 months approximately. The intervention trial will include a total of 4 visits: 1. Recruitment; 2. Hospital admission; 3. Hospital discharge; 4. Post-operative follow-up in 14 days.

SaMD CARINAE delivers the following interventions to the patients:

* Personalised patient-centred health education program to improve patient's condition and recovery self-management skills.
* Artificial Intelligence-based behaviour change program to promote healthier lifestyle habits.
* Personalised mental well-being coaching program to improve patient's ability to cope with emotional disturbances such as stress and anxiety.
* A collaborative digital support platform to enable information exchange between patients, caregivers, and healthcare professionals.

The program is delivered to patients and caregivers as a SaMD mHealth application (smartphone app) and an immersive environment with a VR device. Healthcare professionals will be able to access the collaborative digital support platform through a web application.

Finally, the control group will not be exposed to SaMD CARINAE solution, following the traditional routine visits, and after each traditional visit patients will answer to questionnaires specified in the secondary outcome measures section.

The SaMD CARINAE embeds the I-Change Model, which claims that behavioral changes depend on the inner motivation to perform a specific behavior and the self-perception of personal abilities, or self-efficacy perception, to carry out the behavioral change.

CARINAE for Stress Relief in Perioperative Care

CARINAE: A Digital Health Intervention for Stress Relief in Perioperative Care: Clinical Study

Patient and caregiver-reported visual analog scale question to assess subjective stress.

Along a 100 mm horizontal line, patient and caregiver indicate their perceived stress intensity. Rating varies from 0 (minimum values) to 100 (maximum value). Ratings of 0 to 4 mm can be considered no stress; 5 to 44 mm, mild stress; 45 to 74 mm, moderate stress; and 75 to 100 mm, severe stress.

Patient-reported visual analog scale question to assess subjective pain. Along a 100 mm horizontal line, patient and caregiver indicate their perceived pain intensity. Rating varies from 0 (minimum values) to 100 (maximum value). Ratings of 0 to 4 mm can be considered no pain; 5 to 44 mm, mild pain; 45 to 74 mm, moderate pain; and 75 to 100 mm, severe pain.

Patient-reported questionnaire on anxiety and depression levels during the hospital stay. Hospital Anxiety and Depression Scale is a fourteen-item scale with seven items each for anxiety and depression subscales evaluated on a 0-3 Likert Scale. Rating varies from 0 to 21 and a subscale score \>8 denotes anxiety or depression.

Patient-reported questionnaire on quality of life. The questionnaire consists of five items related each to one dimension: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems (1), some problems (2), and extreme problems (3). The maximum score of 1 indicates the best health state, by contrast with the scores of individual questions, where higher scores indicate more severe or frequent problems. In addition, there is a visual analogue scale (VAS) to indicate the general health status with 100 indicating the best health status.

Patient-reported questionnaire on emotional status. It consists of 20 items that describe n emotions of a positive or negative nature, 10 of them positive and 10 negative. Each item is answered using an Likert-tscale with 5 response options (not at all, very little, somewhat, quite a lot, very much).

Scores can range from 10 - 50, with higher scores representing higher levels of positive or negative affect.

Patient- and caregiver-reported questionnaire on mental well-being. It consists of 7 items and each item is answered using a 1-5 Likert scale. Scores range from 7 to 35 and higher scores indicate higher positive mental wellbeing.

Patient- and caregiver-reported questionnaire on self-efficacy perception. It consists of 10 items evaluated on a 1-4 Likert scale. Scores range from 10 to 40 amd higher scores indicate higher self-efficacy.

Patient-reported questionnaire on the level of activation. It consists of 13 items that have four possible response options ranging from (1) strongly disagree to (4) strongly agree, and an additional "not applicable" option. To calculate the total score, the raw score is divided by the number of items answered (excepting non-applicable items) and multiplied by 13. Then, this score is transformed to a scale with a theoretical range 0-100, based on calibration tables, with higher scores indicating higher patient activation. The raw scores can be converted into four activation levels: 1 (≤47.0) not believing activation important, 2 (47.1-55.1) a lack of knowledge and confidence to take action, 3 (55.2-67.0) beginning to take action and 4 (≥67.1) taking action.

Questionnaire on SaMD CARINAE usability by patients, caregivers and healthcare professionals

Ad-hoc questionnaire for patients and healthcare professional on the digital solution usability

Net Promoter Score (NPS) is a questionnaire that measures patient and healthcare professionals experience and provides the core measurement for customer experience management programs.

Ad-Hoc questionnaire for the healthcare professional on the digital solution

Maastricht University Medical Center

Hospital Sant Joan de Deu

Parc Taulí Hospital Universitari

Hospital Universitario Reina Sofia de Cordoba

Istituto Nazionale di Ricovero e Cura per Anziani

Adhera Health, Inc.

Skin and Connective Tissue Diseases

Breast Neoplasms

Breast Diseases

Skin Diseases

Group A) an intervention group (n=80) who will receive the standard care and information (oral and written) + the digital information tool.

Group B) a control group (n=80) who will receive standard care and information (oral and written).

The patients randomized to group A will receive verbal and written information regarding the digital information tool and how to use it, as well as verbal and written information about the study. They will also receive information about the different instruments and surveys they will be asked to answer at different occasions during the RT treatment period. The applied instruments for data collection will be administrated in person or by post at the baseline collection and by post (including pre-paid return envelope) on consecutive collections. Approximately 30 patients (in group A) will be asked to make regular notes in a notebook during the waiting period prior start of RT as well as during RT treatment period. Following completion of the RT treatment period individual in-depth and telephone interviews will take place with 10-12 patients that accept participation.

Digital information tool

maria brovall

This project uses participatory design combined with qualitative and quantitative methods to develop, explore and evaluate the usefulness of a digital information tool to prepare and support patients before, during and after RT as treatment for breast cancer.

The study is a prospective and longitudinal Randomised Control Trial (RCT) study with an Action Research (AR) participatory design approach, including mixed-method data collection, i.e., standardised instruments, interviews (face-to-face and telephone), diaries, observation, and time measurements. The timeline for the study is scheduled between autumn 2020 to spring 2022. The study will consist of two arms: A) an intervention group (n=80), who will receive standard care and information and the digital information tool; and B) a control group (n=80) who will receive standard care and information (verbal and written). Recruitment and randomisation will be completed at two hospitals in the South western part of Sweden.

As a pre-phase, a pilot study was performed for the development and testing of the digital information tool (Digi-Do), approved by the Regional Ethics Committee (Dnr 917-17) with 30 patients in total (15 women with breast cancer and 15 men with prostate cancer). According to the study's co-design, iterative methodology \[26-27 in manuscript\], changes have since been made to the digital information tool and a second version has now been developed for the full RCT. The present study has been approved by the Swedish Ethical Review Authority (Dnr 2020-00170). An ongoing systematic literature review will also guide the present study, and the project is registered in PROSPERO (PROSPERO;168073).

The digital information tool applied in this project is divided into two separate but coherent applications (apps) for mobile devices: one (VR-app) with a guided tour of the RT-department with a voice-over to describe 360 images to create a sense of actually having visited the department prior to start of RT, and one (information app) containing information obtained through the pre-treatment phase. If a VR-effect is not desirable, the patient can complete the simulated study-visit on their mobile phone or tablet as well as present the images in the browser of an integrated media player. Three areas of information are available in the information app: 1) Q\&As from the existing written information, presented both in writing and a recorded voice; 2) practical information, such as maps, public transportation options with relevant links to public transport, telephone numbers, and information about possibilities for staying at the patient hotel; and 3) three short animated films about cancer and physical activity during RT.

Digi-Do - a Digital Information Tool to Help Patients Diagnosed With Breast Cancer

Digi-Do - a Digital Information Tool to Help Patients Diagnosed With Breast Cancer to be Involved and Prepared Before, During, and After Start of Radiotherapy Treatment

The individual in-depth and/or telephone interviews will take place on two occasions (1-4 weeks and 6 months post-RT completion) and with at least ten of the patients who have accepted participation and have made regular notes. Questions will include topics such as their experiences of receiving the information through the digital information tool during the waiting time and treatment period, of using the digital information tool, to what extent the digital information has affected their involvement and preparedness for the radiation treatment, as well as their experiences during the time since the end of RT

The National Comprehensive Cancer Network Distress Thermometer is a brief screening tool for cancer patients to assess psychosocial distress

The Swedish version of the General Self-efficacy (GSE) Scale. The GSE scale consists of 10 items rated on a fourpoint Likert scale (''not at all true'' to ''exactly true'').

The communicative and critical health literacy scale - Swedish version. The first three items include statements focusing on the capacity for collecting, extracting, and understanding relevant health information. Each item is rated on a 4-point scale, ranging from 1 (never=better) to 4 (often=worse).

The Swedish Functional Health Literacy scale scale comprises five items about persons' skills in reading and understanding health information. Each item is rated on a 4-point scale, ranging from 1 (never=better) to 4 (often=worse).

The The eHealth Literacy Questionnaire (eHLQ) is a psychometrically robust multidimensional tool designed to be used to understand and evaluate people's interaction with digital health services

Ten patients respectively from groups A and B will be consequently asked to participate in the time measurement and observational part of the study (n=20). All planned treatments for the first week of RT (n=5), and, additionally, one session in the last week of treatment, will be measured based on seven timepoints; patient enters door of RT room, patient lies on table, first image, first field beam on, last field beam on, patient leaves table, and patient leaves RT room. This will result in approximately 120 points of measurement. During each RT session, observations of questions asked by patients and staff will be documented in a protocol, including what subjects are addressed, who initiates the question, and whether, how, and to where the staff refers the patient for further information.

Jonkoping University

Associate Professor

Participants will be asked to use virtual reality during their infusion for a duration of at least 10 minutes.

The DESTEK V4 is a smartphone VR headset made by DESTEK, a manufacturer based in the US. This mobile virtual reality headset is compatible with most iOS and Android smartphones, as long as their screen size is between 4.5 and 6.

Destek V4 Virtual Reality Headset

June Y. Hou, MD

The purpose of this feasibility prospective study is to explore if the use of virtual reality as a distraction intervention for women with gynecologic cancer during chemotherapy administration reduces adverse symptoms. In this study, the treatment participants serve as their own control. The study will be performed over a 3 month period limit in order to assess implementation capability and symptom management of gynecologic cancer patients receiving chemotherapy treatment at Columbia University Irving Medical Center (CUIMC).

Gynecologic cancer encompasses various conditions such as uterine, ovarian, cervical, peritoneal, fallopian tube, vaginal and vulvar cancers. Of these, uterine cancer is the top 4th cancer diagnosed and ovarian cancer the 5th deadliest in women.

Many of these patients require some form of chemotherapy administration during their treatment course. Chemotherapy is given at different stages of the treatment course with some patients receiving it prior to surgical intervention (neo-adjuvant), post-surgical intervention (adjuvant), and in the recurrent disease setting. Chemotherapy infusions can cause distressing side effects to the patients in the form of physical and also emotional/psychological effects, which may disrupt compliance to treatment protocols. Physical symptoms often begin during the administration of chemotherapy, such as nausea, vomiting, fatigue, pain, and anorexia. As a result, patients frequently experience psychological distress, including feelings of depression, helplessness, anxiety, and cognitive decline. These directly interfere with the patient's ability to perform activities of daily living and daily quality of life. The purpose of this study is to assess the effect of virtual reality (VR) sessions as a distraction intervention at time of chemotherapy infusion on symptom control.

VR creates an alternative, 'less stressful' environment, and is easy to use. Users of VR wear a head-mounted display with a close proximity screen that creates a sense of being transported into a 3-dimensional world. The technology can be individualized to be interactive, and allows for an immersion experience by engaging several senses simultaneously. Importantly, VR has become increasingly portable, immersive and inexpensive to adopt. VR does not require a subject's experience or competency prior to use in the clinical setting. VR has been used to assess and treat a wide variety of medical, surgical, psychiatric, and neurocognitive conditions including pain, addiction, anxiety disorders, schizophrenia, eating disorders, and stroke rehabilitation.

There have also been functional MRI studies demonstrating the effect of VR on the brain during receipt of painful stimuli. Multiple studies have demonstrated the benefit of VR as a distraction intervention for decreasing symptom distress, particularly in regards to anxiety, distress and fatigue, and have demonstrated that it is feasible to integrate in the chemotherapy setting for patients receiving treatments for various cancers, as well as when enduring medical procedures.

In summary, VR has been shown to be safe and effective in reducing emotional distress of patients undergoing chemotherapy. These studies are generally limited in small sample size, but all have shown to be safe and feasible. To date, the benefit of VR during chemotherapy infusion has not been evaluated in patients with gynecologic cancer.

Virtual Reality for Chemotherapy Patients

Virtual Reality as a Symptom Control Intervention for Women With Gynecologic Cancer Receiving Chemotherapy: A Pilot Proof of Concept Study

Symptom Survey A will be administered prior to first three chemotherapy infusions. Descriptive statistics will be utilized to characterize the survey question response proportions (i.e., distribution of responses to questions on the survey) (frequency, percent). Estimated differences in survey responses between 1) patient's perception pre-intervention vs. 2) patient's perception post-intervention, will be evaluated by the two-sample t-test, Wilcoxon rank-sum test, chi-square test, and Fisher's exact test, as appropriate. All analyses will be performed in SAS version 9.3

Symptom Survey B will be administered after the third chemotherapy infusion. Descriptive statistics will be utilized to characterize the survey question response proportions (i.e., distribution of responses to questions on the survey) (frequency, percent). Estimated differences in survey responses between 1) patient's perception pre-intervention vs. 2) patient's perception post-intervention, will be evaluated by the two-sample t-test, Wilcoxon rank-sum test, chi-square test, and Fisher's exact test, as appropriate. All analyses will be performed in SAS version 9.3

Columbia University

Digestive System Diseases

Anxiety Disorders

Colorectal Neoplasms

Intestinal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Colonic Diseases

Intestinal Diseases

Rectal Diseases

The patients will be exposed to a virtual reality software that simulates the environment of the hospital, from admission to the operating room and the recovery room.

Patients in this group are not exposed preoperatively to the virtual reality software and are given the standard therapy and cares for their disease.

Patients will be exposed to a virtual reality software that simulates the hospital environment, from admission to the operating room and the recovery room.

Virtual Reality Software

A prospective controlled randomized interventional study comparing the effects of the preoperative exposure to a virtual reality software versus not exposure in 126 patients with colorectal cancer. Patients will be divided in two randomized groups, each of them of 63 patients. The hypothesis of the study is that gradual exposure to the hospital environment using a virtual reality software is effective to reduce preoperative anxiety.

The main variable is the level of anxiety in patients undergoing colorectal cancer surgery. It will be measured using State-Trait Anxiety Inventory Scale (STAI-S) and the Hospital Anxiety and Depression Scale (HADS).

Colorectal cancer is the third most frequent neoplasia diagnosed worldwide, and in Spain it is the first in incidence and prevalence, accounting for 15% of all neoplasias according to World Health Organization (WHO).

The incidence of preoperative anxiety in patients undergoing elective surgery is high (60% - 76%). There are many causes for this: anticipation of postoperative pain, loss of independence, separation from the family, fear to the surgical procedure or to severe complications or even death. The incidence of preoperative anxiety varies according to age, sex, educational leve, previous exposure to surgical interventions and the expected impact of the surgical procedure in global quality of life.

Patients with anxiety require higher dosis of induction anesthesia, longer hospital stay, and a higher rate of perioperative complications due to a release of catecholamines, increase on the oxidative demands, causing tachycardia, arrhythmia, high blood pressure, etc.

Gradual exposition is considered an effective way of reducing anxiety. It has been demonstrated that anxiety is decreased in patients with history of surgical interventions, and thus the experience is experimented as an adaptive process. Virtual reality gives the opportunity to experience each of the steps of the hospital stay in a realistic environment.

The hypothesis of this study is that gradual exposure to the hospital environment using virtual reality is an effective tool to reduce preoperative anxiety in patients undergoing colorectal cancer surgery.

Single center prospective randomized two arms study

Exposure to Virtual Reality as Psychosocial Intervention in Colorectal Cancer Surgery

Exposure to Virtual Reality as Psychosocial Intervention in Colorectal Cancer Surgery in Hospital Clinic of Barcelona, Spain

Individual participant data (IPD) data will not be available to other researchers. The study protocol and the global data will be available in the written paper.

Change from Baseline Anxiety STAI scale to STAI scale the day previous to the surgery. Range of scores for each subtest is 20-80, the higher score indicating greater anxiety.

Change from Baseline Anxiety HAD to HAD scale the day previous to the surgery. The total score for the HADS-A can range from 0 to 21. The following guidelines are recommended for the interpretation of scores: 0-7 for normal or no anxiety, 8-10 for mild anxiety, 11-14 for moderate anxiety, and 12-21 for severe anxiety.

Hospital Clinic of Barcelona

Chief of Gastrointestinal Surgery Department

Symptoms and General Pathology

Mouth and Tooth Diseases

Uterine Cervical Neoplasms

Pain

Smear Layer

Dental Deposits

Tooth Diseases

Stomatognathic Diseases

From the preparation stage of the PAP-SMEAR removal procedure to the completion of the PAP-SMEAR removal procedure until the completion of the PAP-SMEAR removal procedure, after providing an internet connection with a smartphone for the image, clicking the youtube.com link and watching Relaxation (https://www.youtube.com/watch?v=H1iboKia3AQ) nature video virtual reality Goggles will be provided.

Virtual reality glasses to be used in the research are not a medical device.

Distraction cards containing five optical illusion figures will be shown to the women by the researcher

From the preparation stage of the PAP-SMEAR ALDIRAN procedure to the completion of the application process that takes PAP-SMEAR, the virtual reality glasses for breathing exercise by clicking the youtube.com link (https://www.youtube.com/watch?v=Pddb09FAs68) after providing an internet connection with a smartphone for the image. will be provided.

The maintenance and applications in the routine PAP-SMEAR application will be done exactly.

Virtual reality glasses to be used in the research are not a medical device. This device is a technological glasses that works with compatible smartphones. During the PAP-SMEAR application to be made with this device, watching a nature video with VR is within the framework of midwifery care applications and is not a treatment option for any treatment method, agent or disease. Although the video watched with VR has no effect on medical treatment and care within the framework of midwifery care, it does not have any harmful effects on women. The participant can withdraw from this study at any time without giving any reason.

Virtual Reality (VR)

It will take about 3-5 minutes to show the cards. The selection of the cards to be used is based on the cards suggested in the literature.

Distraction Cards Practice Group

Virtual Reality (VR) Breathing Exercise Group

mine gökduman keleş, Midwifery

When the literature is examined, it is seen that virtual reality and distraction cards are used during medical procedures, and they have a reducing effect on pain perception and lowering the level of anxiety . On the other hand, no study has been found in the literature on the application of virtual glasses and distraction cards to women in the PAP-SMEAR process. However, in accordance with the results of the study conducted with the application of virtual reality glasses and distraction cards, it is thought that the application of virtual glasses will have a positive effect on reducing the perceived pain of women in the PAP-SMEAR process of distraction cards.

Cervical cancer is the fourth most common cancer worldwide. Cervical cancer is one of the most successfully treatable types of cancer, as long as it is detected early and managed effectively. WHO recommends the use of PAP-SMEAR and HPV DNA primary screening test to prevent cervical cancer in women. . The crude incidence of cervical cancer per 100,000 women in Turkey in 2020 is . WHO has targeted a threshold of 4 per 100,000 women by 2030 for countries to eliminate cervical cancer. To achieve this goal, 90% of girls should be vaccinated with HPV until the age of 15, and 70% of women should be screened with high performance PAP-SMEAR and HPV DNA at the age of 35 and 45 For this reason, it is seen that the PAP-SMEAR test has an important place in the protection of women's health. For the Pap-Smear test procedure, gynecological examination and speculum examination are included . Experiencing pain, anxiety, shyness and fear during gynecological examination are among the barriers to applying for and taking the pap-smear test, which has an important place in protecting women's health In the literature, it is seen that virtual reality glasses and distraction cards, which are cognitive behavioral techniques, are used during medical procedures and have a reducing effect on the perception of pain and reduce the level of anxiety . No study has been found that examines the effect on satisfaction and satisfaction levels. However, in line with the results of the study, it is thought that the PAP-SMEAR procedure will have a positive effect on women's perceived pain and anxiety, and increase their satisfaction levels. It emphasizes the need for cost-effective and feasible non-pharmacological methods by healthcare professionals during PAP-SMEAR application.

IT WILL BE APPLIED BY THE SAME HEALTH PERSONNEL WORKING AT THE KETEM CENTER After the women who meet the sample criteria of the study are determined and they accept to participate in the study, it will be determined which group the women are in from the list determined by randomization (determined from the www.randomizer.org site) according to the acceptance sequence number of the women.

It is seen that the PAP-SMEAR test has an important place in the protection of women's health. For the Pap-Smear test procedure, gynecological examination and speculum examination are included.

The Effect of Virtual Reality and Distraction Cards on Pain

The Effect of Virtual Reality and Distraction Cards on Pain, Anxiety and Satisfaction Levels of Women Who Have Pap-Smears

In the numerical evaluation scale, pain ranges from 0 (absence of pain) to 10 (unbearable pain).

The Verbal Category Scale is also called the Simple Descriptive Scale, and this scale is based on the patient's choice of the most appropriate word to describe the pain condition. Pain severity ranges from mild to unbearable. In this scale, he used the words "mild", "disturbing", "severe", "very severe", "unbearable" to describe the severity of pain (Annex-4). The individual is asked to choose the appropriate category for his situation.

In the State Anxiety Scale; There are ten reversed statements, items 1, 2, 5, 8, 10, 11, 15, 16, 19 and 20. When scoring, the reversed and direct statements are summed. Responses with a value of 4 indicate high anxiety in direct statements. In reversed expressions; Responses with a value of 1 indicate high anxiety, and responses with a value of 4 indicate low anxiety. The State Anxiety Scale score is calculated by adding 50 points to the difference between the total weighted scores of the reverse statements and the direct statements. Scoring in the State Anxiety Scale varies between 20-80 points. A score of less than 36 is considered no anxiety, a score of 37-42 is considered mild anxiety, and a score of 42 and above is considered high anxiety.

The scale is a 5-point Likert-type scale consisting of 19 items including nursing care. All items of the Newcastle Nursing Care Satisfaction Scale are positive. In the scoring used to determine the degree of satisfaction, there are statements such as "Not at all Satisfied=1 point, Slightly Satisfied=2 points, Fairly Satisfied=3 points, Very Satisfied=4 points, Extremely Satisfied=5 points". The scores given to the questions of all items marked on the score evaluation scale are added together. The maximum score obtained from the scale is 95, and the minimum score is 19. Evaluation is made by converting the total score obtained from the scale to 100. The increase in the total score obtained from the scale indicates that the patients' satisfaction with nursing is high.

The pulse rate and saturation values of women will be evaluated physiologically using the sensor compatible planet 50n LT model pulse oximeter (Nellcor COVIDIEN SPO 2) device

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
CARINAE for Stress Relief in Perioperative Care	NCT05184725	Psychological S... Cardiopulmonary... Coronary Artery... Cardiac Valve R... Hip Replacement Orthognathic Su... Scoliosis Knee Replacemen... Prostate Cancer Kidney Cancer Bladder Cancer	SaMD CARINAE	8 Years -	Adhera Health, Inc.
Digi-Do - a Digital Information Tool to Help Patients Diagnosed With Breast Cancer	NCT04394325	Breast Cancer	Digital informa...	18 Years -	Jonkoping University
Digi-Do - a Digital Information Tool to Help Patients Diagnosed With Breast Cancer	NCT04394325	Breast Cancer	Digital informa...	18 Years -	Jonkoping University
Virtual Reality for Chemotherapy Patients	NCT04723108	Oncologic Compl...	Destek V4 Virtu...	18 Years -	Columbia University
Exposure to Virtual Reality as Psychosocial Intervention in Colorectal Cancer Surgery	NCT04058600	Anxiety Colorectal Canc...	Virtual Reality...	18 Years - 99 Years	Hospital Clinic of Barcelona
The Effect of Virtual Reality and Distraction Cards on Pain	NCT05662683	Smear Layer Cervical Cancer	Virtual Reality... Distraction Car... Virtual Reality...	30 Years - 65 Years	Turkish Ministry of Health, Kahramanmaras Provincial Health Directorate

Spots Global Cancer Trial Database for virtual reality (vr)