Limitations
anxiety
Our study has some limitations. First, this study was performed at a single institution with a single surgeon, and it was custom built to depict the exact process our patients experience. Generalizability is thus limited, since patients at other centers or with other surgeons may not experience a benefit. Additionally, we did not control for the presence of previous surgical procedures between the groups: a patient who has undergone surgery previously might not experience as much anxiety as someone who has never undergone surgery and is not as engaged in the experience. Furthermore, since participation was voluntary, our results may have been influenced by self-selection bias. Once enrolled, some patients no longer wished to complete the surveys, and this accounted for a small but noticeable attrition rate between patients who completed the preoperative surveys and those who did not complete either the entire or portions of the postoperative survey. Additionally, the study was underpowered in both groups, which increases the risk of type II error and reduces our confidence in the findings that were not statistically significant.