This prospective randomized controlled trial aims to evaluate the effects of verbal and video-based preoperative education on anxiety levels and serum cortisol response in women scheduled for elective cesarean delivery under spinal anesthesia.

Eligible participants will be randomly assigned to receive either standard verbal education or a standardized video-based educational intervention before surgery. Anxiety levels will be assessed using the State-Trait Anxiety Inventory (STAI-S), and serum cortisol levels will be measured before and after the educational intervention.

The primary objective is to compare the effectiveness of the two educational methods in reducing preoperative anxiety and physiological stress response.

Preoperative anxiety is common among women undergoing elective cesarean delivery and may contribute to increased physiological stress responses, including elevated serum cortisol levels. Effective preoperative education may improve patient understanding of the surgical and anesthetic process and reduce anxiety.

This single-center prospective randomized controlled trial will be conducted at Elazig Fethi Sekin City Hospital. Women aged 18 years or older who are scheduled for elective cesarean delivery under spinal anesthesia and provide written informed consent will be eligible for participation.

Participants will be randomly allocated to one of two groups:

1. Verbal Education Group:

   Participants will receive routine face-to-face verbal information regarding the surgical procedure and spinal anesthesia from an anesthesiologist.

2. Video-Based Education Group:

Participants will watch a standardized educational video covering the same information provided in the verbal education group.

Educational interventions will be delivered at least one hour before surgery.

Anxiety levels will be assessed using the State-Trait Anxiety Inventory-State (STAI-S) before and after the educational intervention. Serum cortisol concentrations will be measured from venous blood samples obtained during routine clinical blood collection before and after education.

The primary outcomes are changes in STAI-S scores and serum cortisol levels following the educational intervention. Secondary analyses will evaluate the relationship between educational modality and physiological stress response.

A total of 140 participants are planned for enrollment, with 70 participants in each study group.

Inclusion Criteria:

• Female participants aged 18 years or older
• Scheduled for elective cesarean delivery
• Planned to undergo spinal anesthesia
• American Society of Anesthesiologists (ASA) physical status I or II
• Able to understand the study procedures and provide written informed consent

Exclusion Criteria:

• Emergency cesarean delivery
• History of psychiatric disease
• Current use of anxiolytic or antidepressant medications
• Endocrine disorders, including adrenal or thyroid disease
• Current corticosteroid therapy
• Previous surgery performed under spinal anesthesia
• Cognitive impairment or communication difficulties that may interfere with completion of anxiety assessments
• ASA physical status III, IV, or V

Individual participant data will not be made publicly available. Data contain potentially identifiable clinical information and were collected under local ethics committee approval and informed consent procedures that do not include public data sharing.