<![CDATA[Introduction: Preoperative anxiety is commonly experienced by patients undergoing surgery and may be related to concerns about anesthesia, surgical outcomes, postoperative pain, and possible complications. Non-pharmacological nursing interventions such as the Butterfly Hug technique and music therapy may provide relaxation and emotional support before surgery. Objective: This case study aimed to describe the application of a combination of the Butterfly Hug technique and music therapy and the observed changes in preoperative anxiety among patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection of the prostate (TURP). Method: A descriptive case study was conducted in the Central Operating Theater of Surakarta Central General Hospital. Three male patients with BPH who were scheduled for TURP under spinal anesthesia and experienced preoperative anxiety were selected purposively. Anxiety was assessed before and after a single 10–15-minute session using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Changes in blood pressure, pulse rate, and observable behavioral responses were also documented. Result: APAIS scores decreased in all three cases. Mr. J's score decreased from 24 to 14, Mr. S's from 23 to 15, and Mr. H's from 22 to 12. Before the intervention, all three patients were categorized as having severe anxiety. After the intervention, two patients were categorized as having moderate anxiety and one as having mild anxiety. The patients also appeared calmer, showed less facial tension, maintained better eye contact, and asked fewer repeated questions about the procedure. Conclusion: The combination of the Butterfly Hug technique and music therapy was associated with an observed reduction in preoperative anxiety across the three cases. These preliminary findings suggest that the combination may be a feasible non-pharmacological nursing approach for supporting patients with preoperative anxiety; however, the findings cannot establish a causal effect and are not generalizable beyond the cases presented]]>
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