Smartphone addiction, emotional coping strategies, and mental health symptoms in Chinese university students: a gender-based analysis.

Preoperative anxiety affects 11%–89% of surgical patients, depending on health care setting, patient characteristics, and measurement methods. It is primarily driven by fears of surgical complications, anesthesia-related risks, postoperative pain, and a lack of adequate preoperative information. This anxiety triggers psychological distress and physiological responses, including activation of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. This triggers the release of catecholamines and glucocorticoids, increasing the risk of infection and delaying wound healing, thereby delaying recovery. Additionally, it is associated with prolonged hospital stays and increased readmissions, elevating health care costs. Benzodiazepines are commonly used for preoperative anxiety but have significant drawbacks, including sedation-related side effects, prolonged recovery, and dependency risks, underscoring the need for safer, holistic alternatives. Nonpharmacological strategies, such as cognitive-behavioral therapy, guided relaxation, and mindfulness-based interventions, effectively reduce preoperative anxiety but require significant time, resources, and trained personnel, limiting their scalability in routine perioperative care. Virtual Reality (VR) is a computer-generated technology that immerses users in a simulated environment through VR headsets. Unlike other nonpharmacological approaches that require multiple tools or trained personnel, VR headsets can be preloaded with customized content, offering education, guided relaxation, and immersive distraction into a single device, making it highly adaptable and scalable for clinical use.