Prevalence of pre-operative anxiety among adult patients undergoing elective surgery: A prospective observational single-centre study.

Asiri, Salihah; Duff, Jed; Currie, Jane; Guilhermino, Michelle

Objective: This study aimed to investigate the prevalence of pre-operative anxiety in elective surgical patients at a major metropolitan hospital in Australia. Background: Globally, 310 million people are admitted for surgery every year. It is estimated that up to 80 per cent of these patients experience clinically relevant anxiety in the pre-operative period. Pre-operative anxiety can result in post-operative complications such as pain, delayed wound healing, surgical site infection, prolonged recovery and extended hospital stays. While pre-operative anxiety has many negative consequences, this anxiety has often been overlooked in clinical practice. Methods: A prospective study was conducted between November 2021 and June 2022, involving 308 adult patients scheduled for elective surgery. Pre-operative anxiety levels were measured using the Amsterdam pre-operative anxiety and information scale (APAIS), and age, sex and surgery type were collected. Results: In total, 308 patients were enrolled, more than half (58%, n=279) were women. The mean (± SD) APAIS score out of 20 was 8.69 (± 4.08). Almost one-third (32.4%, n=100) of patients had significant pre-operative anxiety (APAIS score > 11/20). Women were three times more likely to experience anxiety than men (OR=3.39, 95% CI 1.97--5.82). Conversely, older patients were less likely to experience anxiety, with a reduction in anxiety of two per cent for each year above 18 years (OR=0.98, 95%CI 0.97--0.99). Patients reported higher anxiety levels related to the surgery itself compared to the anaesthesia, with mean scores of 5.04 (± 2.48) and 3.65 (± 2.07) out of 10, respectively. More than half the patients (54.9%, n=169) reported needing more information about anaesthesia and surgery. Conclusions: Findings suggest that clinically relevant anxiety is common yet underdiagnosed. A higher prevalence is observed among females and those under the age of 30. The surgical procedure more than the anaesthesia was reported to cause higher anxiety. Relevance to clinical practice: Identifying the prevalence of high pre- operative anxiety highlights the importance of routine screening and the use of a standardised assessment tool for accurate evaluation in clinical practice. Prioritising interventions for at-risk groups, such as women and younger patients, is imperative to mitigate the risks of post-operative pain, delayed wound healing, surgical site infection, prolonged recovery and extended hospital stays.

QUEENSLAND; PREOPERATIVE period; PUBLIC hospitals; SCALE analysis (Psychology); PATIENT education; SURGERY; PATIENTS; RESEARCH funding; SCIENTIFIC observation; QUESTIONNAIRES; LOGISTIC regression analysis; SEX distribution; HEALTH; ANXIETY; DESCRIPTIVE statistics; AGE distribution; INFORMATION resources; LONGITUDINAL method; ODDS ratio; OPERATIVE surgery; ELECTIVE surgery; METROPOLITAN areas; STATISTICS; ANESTHETICS; CONFIDENCE intervals; ADULTS

Journal of Perioperative Nursing, 2024, Vol 37, Issue 3, pe-5

2209-1084

Academic Journal

10.26550/2209-1092.1270