Effects of Virtual Reality on Anxiety, Stress, Pain, and Patient Satisfaction Among Palestinian Patients Undergoing Colonoscopy: Randomized Controlled Trial

Background and Aims: Colonoscopy frequently causes significant pre-procedural anxiety and intra-procedural pain. This randomized controlled trial evaluated immersive, culturally adapted virtual reality (VR) therapy on anxiety, perceived stress, pain, patient satisfaction, and hemodynamic stability in Palestinian adults undergoing colonoscopy. Methods: = 75). All received standard pharmacological sedation; the VR group additionally received culturally adapted passive VR distraction. Primary outcomes: State-Trait Anxiety Inventory (STAI) and Perceived Stress Scale-10 (PSS-10). Secondary outcomes: pain (VAS/NRS), satisfaction, and hemodynamic parameters. Intention-to-treat analysis was applied. Results: = 0.002). VR-related side effects were minimal (4.0% mild transient dizziness). Conclusion: Immersive, culturally adapted VR is a highly effective, safe adjunct that significantly reduces anxiety, stress, and pain while improving satisfaction and hemodynamic stability during colonoscopy. Healthcare institutions should consider integrating VR into routine endoscopic care. Relevance to Clinical Practice: ClinicalTrials.gov identifier: NCT07145203 (registered 21 August 2025).