# Effectiveness of psychological intervention based on implicit theory combined with virtual reality in patients with unruptured intracranial aneurysm receiving their first cerebral angiography after flow-diverter stent implantation

## TL;DR

A psychological intervention using virtual reality and implicit theory helps reduce stress and improve cooperation in patients undergoing cerebral angiography after a stent implant.

## Contribution

Combines implicit theory with VR for psychological intervention in UIA patients post-stent implantation.

## Key findings

- The experimental group showed significantly lower anxiety and higher treatment confidence and implicit cognition scores.
- The intervention improved physiological regulation and procedural compliance during angiography.
- The experimental group's implicit cognition scores exceeded the threshold for positive cognition.

## Abstract

To investigate the efficacy of psychological intervention using implicit theory combined with virtual reality (VR) in patients with unruptured intracranial aneurysm (UIA) undergoing their first cerebral angiography (CA) after implantation of a flow-diverter stent.

One hundred and four patients with UIA who underwent their first CA six months after flow-diverter stent implantation in our hospital between October 2022 and October 2024 were enrolled by convenience sampling. The participants were then randomly divided into a control group (n=52) and an experimental group (n=52). The control group received routine nursing intervention, while the experimental group was given both routine nursing and psychological intervention based on implicit theory combined with VR. The levels of anxiety, physiological stress indicators, and treatment compliance were compared between the two groups.

Repeated-measures ANOVA revealed significant group × time interactions for anxiety (SAS: F(2, 204) = 267.89, P < 0.001, ηp² = 0.724), treatment confidence (VAS-TC: F(2, 204) = 101.36, P < 0.001, ηp² = 0.498), and implicit cognition (IAT: F(2, 204) = 598.74, P < 0.001, ηp² = 0.854). Post-intervention (T1) and pre-procedure (T2), the experimental group showed significantly lower SAS scores and higher VAS-TC and IAT scores than the control group (all P < 0.001). Notably, the experimental group’s mean IAT score at T2 (80.1 ± 4.5) exceeded the pre-specified threshold for positive implicit cognition (65 points). During the angiography, the experimental group also demonstrated superior physiological regulation (higher baroreflex sensitivity and heart rate variability indices, all P < 0.001), better examination tolerance (fewer body movements, lower pain scores, P < 0.001), and higher procedural compliance (accuracy of instruction execution: 92.3% vs. 67.5%, P = 0.001) compared to the control group.

Implicit theory combined with VR can significantly reduce intraprocedural stress responses and increase cooperation during diagnostic and therapeutic procedures, enhancing long-term compliance through the reconstruction of cognitive structures, optimizing autonomic nerve regulation, and improving pain tolerance. The findings provide a multi-dimensional evidence-based reference for the use of psychological intervention in UIA patients following flow-diverter stent implantation.