Comparison of salivary cortisol levels and obstetric quality of recovery score (ObsQor-10) in caesarean section patients with and without the immersive virtual reality: a study protocol

Background: Immersive virtual reality (IVR) produces a virtual experience that envelops patients in a soothing setting and diverts their attention from the anxiety that precedes surgery. Cortisol levels are the indicator measure of adaptive stress and are frequently used when evaluating anxiety. This study protocol aims to understand how patients undergoing caesarean sections with and without IVR comparison in terms of salivary cortisol levels and obstetric quality of recovery score (ObsQor-10) values. Methods: This study protocol used a prospective analytical experimental research design with a randomized posttest-only parallel group design at Universitas Airlangga Hospital, Surabaya, Indonesia. The ObsQor-10 components will be assessed were physical comfort, emotional status, physical independence, pain, and correlation between postoperative salivary cortisol and ObsQor-10 in patients who underwent C-section delivery with and without IVR. Discussion: Immersive virtual reality (IVR) offers a comprehensive visual and auditory stimulus because, during operation, the stimulation from IVR creates a pleasant and comfortable feeling; this enhances the quality of the healing process after surgery. The ObsQoR-10 instrument, which consists of 10 question items, would evaluate the quality level of postpartum recovery outcomes. Four primary variables were evaluated in this questionnaire: pain following a caesarean delivery, emotional state, physical independence and newborn care, and physical comfort. Nonetheless, a number of non-physical elements, including history, sociocultural context, personality, beliefs, and history of chronic pain, might affect the recovery of patients with caesarean delivery. Conclusion: The difference value between ObsQor-10 and salivary cortisol levels in patients undergoing caesarean section delivery with and without immersive virtual reality is still unknown therefore, needs to be assessed.