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• Prenatal testing induces elevated anxiety levels among high-risk pregnant women. • The utilization of virtual reality and music during non-stress tests alleviates anxiety and enhances satisfaction among high-risk pregnant women undergoing the procedure. • Virtual reality intervention resulted in a reduction in the duration of reactive non-stress tests. Prenatal tests cause high-risk pregnant women to experience high anxiety levels. This paper investigated the effect of Virtual Reality (VR) and music on anxiety, non-stress test parameters, and satisfaction of high-risk pregnant women undergoing non-stress tests (NSTs). This was a randomized controlled trial. The sample consisted of 102 participants randomized into three groups (VR = 34, music = 34, and control = 34). Maternal anxiety was assessed using the Spielberger State-Trait Anxiety Inventory-S (STAI-S) before and after NSTs. Satisfaction was evaluated using the Visual Analogue Scale (VAS) after NSTs. NST parameters were evaluated after NSTs. The findings were reported based on the Consolidated Standards of Reporting Trials (CONSORT). The VR and music groups had significantly lower mean posttest STAI-S scores than the control group (p <.05). There was no significant difference in NST findings (reactive/nonreactive) between the groups (p >.05). The VR group had a significantly shorter reactive NST duration than the control group (p <.05). The VR and music groups had significantly higher mean VAS-satisfaction scores than the control group (p <.05) Virtual reality and music during NSTs help high-risk pregnant women experience less anxiety and satisfy them more with the procedure. We recommend that obstetric midwives and nurses use these low-cost, simple, and noninvasive methods to reduce anxiety in high-risk pregnant women during prenatal testing. [ABSTRACT FROM AUTHOR]

• Anesthesia or surgical-related fears may cause perioperative anxiety. • Cesarean section is a surgical procedure and is associated with fear and anxiety. • Preoperative anxiety may lead to higher postoperative pain. • Guided imagery can reduce anxiety, keep fear under control before cesarean section. Guided imagery (GI) helps patients feel happy, relaxed, calm, and safe while ensuring positive thinking. This study was conducted to investigate the impact of GI applied before cesarean section (CS) on preoperative anxiety, surgical fear, and physiological parameters. Participants were randomized into the GI (n = 29) or control (n = 28) groups in this randomized controlled trial. Participants in the GI group were given a 15-minute GI audio recording three days before their CS and were allowed to listen to it every night for 3 days until the CS. Finally, they listened on the day of the CS, immediately after preparing for the CS. Anxiety levels were evaluated using the State Anxiety Inventory-S (STAI-S) 3 days before the CS (STAI-S1) and 15 min after the preparations on the CS morning (STAI-S2); while surgical fear was evaluated using the Surgical Fear Questionnaire (SFQ) 3 days before the CS (SFQ1-Total) and 15 min after the preparations on the CS morning (SFQ2-Total). Blood pressure, temperature, heart rate, respiratory rate, and fetal heart rate were also evaluated. A significant difference in the mean STAI-S scores was observed 15 min after the preparations for the CS between the GI and control groups (mean difference (MD) -4.51, 95 % confidence intervals (CIs) [-7.71, -1.31]). However, no significant difference was found in the mean SFQ scores between the groups (MD -5.53, 95 %CIs [-16.69, 5.63]). In the within group comparison of GI and the control group, no statistically significant difference was observed in the score means of the GI group (STAI-S1 with STAI-S2 and SFQ1-Total with SFQ2-Total). However, the score means of the control groups STAI-S2 was higher than STAI-S1 (MD -5.82, 95 %CIs [-8.16, -3.48]), and SFQ2-Total was higher than SFQ1-Total (MD -6.71, 95 %CIs [-10.97, -2.46]). No significant difference was found in physiological parameters between the groups. This study revealed the effectiveness of GI during the period before CS in reducing preoperative anxiety and keeping surgical fear under control. Nurses and other healthcare professionals involved in preoperative care can utilize GI to reduce preoperative anxiety and manage surgical fear before a CS. NCT05790954 [ABSTRACT FROM AUTHOR]