Doctor-Led VR and Medical Games for Perioperative Fear in Pediatric Urology: A Retrospective Cohort Study

Objective: To evaluate whether a doctor-led interdisciplinary intervention integrating immersive virtual reality (VR) panoramic preview and interactive medical games is associated with reduced perioperative fear and anxiety, improved medical compliance, and enhanced parental satisfaction in children aged 5– 12 years undergoing elective pediatric urological surgery. Methods: A retrospective cohort study was conducted on 120 eligible children treated between January and December 2024. Participants were divided into a control group receiving conventional preoperative education and nursing care (n=60) and a research group receiving additional VR and medical game intervention (n=60). Propensity score matching (PSM) was applied to balance potential baseline confounding factors. Fear was assessed with the Children’s Medical Fear Scale (CMFS) (0– 4 points per item, 5-level scoring, Cronbach’s α=0.852). Anxiety was measured with the Spence Children’s Anxiety Scale–Short Version (SCAS-S) (1– 4 points per item, 4-level scoring, Cronbach’s α=0.83). Medical compliance and parental satisfaction were also evaluated as secondary outcomes. Results: After intervention, the research group demonstrated significantly lower CMFS (18.5± 3.2 vs. 25.8± 4.5) and SCAS-S (22.3± 4.1 vs. 30.7± 5.3) scores, higher medical compliance rate (93.3% vs. 75.0%), and greater parental satisfaction compared with the control group (all P< 0.05). Conclusion: The doctor-led combined VR and medical game intervention is associated with reduced perioperative fear and anxiety, improved medical compliance, and enhanced family satisfaction, showing promising clinical value for perioperative psychological management in pediatric urological surgery.