Participants in this group underwent a routine gynecological examination while wearing virtual reality glasses that displayed immersive nature-themed videos with visual and auditory stimuli to reduce anxiety and pain.

Participants in this group received standard gynecological examination without any virtual reality intervention. No visual or auditory stimulus was provided during the procedure.

Participants in the intervention group wore virtual reality (VR) glasses during the gynecological examination. The VR content included immersive nature-themed scenes accompanied by calming background music. The intervention aimed to provide a multisensory distraction to reduce perceived anxiety and pain levels during the procedure.

The State Anxiety Inventory (STAI-I) consists of 20 self-report items that measure how the individual feels at a specific moment. Each item is rated on a 4-point Likert scale: 1 (Not at all) to 4 (Very much so). The scale includes both direct and reverse-scored items. Reverse-scored items include items 1, 2, 5, 8, 10, 11, 16, 19, and 20. The total score is calculated by subtracting the sum of reverse-scored items from the sum of direct items and then adding 50. Total scores range from 20 to 80, with higher scores indicating greater anxiety. The questionnaire will be administered immediately before and 15 minutes after the gynecological examination. The change in scores will be analyzed to evaluate the intervention's effectiveness.

The Visual Analog Scale for Pain (VAS) is a widely used unidimensional tool designed to assess subjective pain intensity. It consists of a 10-centimeter horizontal line anchored by two descriptors: "no pain" on the left end and "worst imaginable pain" on the right. Participants will be asked to place a mark along the line that best reflects the intensity of their current pain. The distance (in centimeters) from the left end to the mark will be measured, yielding a score between 0 and 10, with higher scores indicating greater pain intensity. The VAS will be administered once, within 10 minutes following the gynecological examination.

The Pain Beliefs Questionnaire (PBQ) will be administered immediately before the gynecological examination to evaluate participants' beliefs about pain.

The PBQ contains 12 items divided into two subscales:

Organic Beliefs Subscale (8 items): Items 1, 2, 3, 5, 7, 8, 10, 11

Psychological Beliefs Subscale (4 items): Items 4, 6, 9, 12

Each item is rated using a 6-point Likert scale (1 = always, 2 = almost always, 3 = often, 4 = sometimes, 5 = rarely, 6 = never).

Scores for each subscale will be calculated by averaging the responses of the corresponding items. There is no cutoff point. Higher scores reflect stronger beliefs related to the respective dimension.

The total score range for each subscale is 1 to 6. Higher scores indicate stronger organic or psychological beliefs about pain.