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Prevalence and factors associated with surgery anxiety in hospitalized patients: a point-prevalence study

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Abstract

Background

Preoperative anxiety is a challenging problem in the preoperative care of patients. Identifying risk factors helps nurses provide psychological support during the pre-operative visit so that stress can be reduced.

Aims

This study aimed to determine the prevalence of surgical anxiety and related factors in hospitalized surgical patients.

Methods

This research was designed as a point-prevalence study. The study was completed with 223 patients hospitalized in the surgical clinics of a tertiary hospital in Turkey. Surgical anxiety questionnaire (SAQ) and State-trait anxiety inventory (STAI) were used for the assessment of anxiety.

Results

Preoperative anxiety prevalence was 69.5% according to the SAQ and 49.3% according to STAI. Women, participants with no primary school education, those who were unemployed and had low income, those with no previous surgery, those living in fear of surgery, the participants who underwent major surgery and general anesthesia, and those who did not have knowledge about the surgical procedure and anesthesia had higher anxiety according to the two scales. A highly significant and positive correlation was found between total STAI and total SAQ.

Conclusion

The importance of surgical anxiety for the health system, which affects two out of every three hospitalized patients, should not be underestimated. Therefore, national and global plans should be made to prevent and manage surgical anxiety.

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Data availability

On request.

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References

  1. Topçu SY, Soydaş D, Özkan ZK et al (2023) Turkish validity and reliability study of the surgical anxiety questionnaire for adult patients. J Perianesth Nurs 38(1):127–133. https://doi.org/10.1016/j.jopan.2022.06.014

    Article  PubMed  Google Scholar 

  2. Turzáková J, Sollár T, Solgajová A (2019) Faces anxiety scale as a screening measure of preoperative anxiety: validation and diagnostic accuracy study. Int J Nurs Pract 25(4):e12758. https://doi.org/10.1016/j.jopan.2022.06.014

  3. Mulugeta H, Ayana M, Sintayehu M et al (2018) Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals. Northwest Ethiopia BMC Anesthesiol 18(1):1–9. https://doi.org/10.1186/s12871-018-0619-0

    Article  Google Scholar 

  4. Nigussie S, Belachew T, Wolancho W (2014) Predictors of preoperative anxiety among surgical patients in Jimma University specialized teaching hospital. South Western Ethiopia BMC Surg 14(1):1–10. https://doi.org/10.1186/1471-2482-14-67

    Article  Google Scholar 

  5. Erkilic E, Kesimci E, Soykut C et al (2017) Factors associated with preoperative anxiety levels of Turkish surgical patients: from a single center in Ankara. Patient Prefer Adherence 11:291–296. https://doi.org/10.2147/PPA.S127342

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sigdel S (2015) Perioperative anxiety: a short review. Glob Anesth Perioper Med 1(4):107–8. https://doi.org/10.15761/GAPM.1000126

  7. Ali A, Altun D, Oguz BH et al (2014) The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy. J Anesth 28:222–227. https://doi.org/10.1007/s00540-013-1712-7

    Article  PubMed  Google Scholar 

  8. Wu H, Huang Y, Tian X et al (2019) Preoperative anxiety-induced glucocorticoid signaling reduces GABAergic markers in spinal cord and promotes postoperative hyperalgesia by affecting neuronal PAS domain protein 4. Mol Pain 15:1–15. https://doi.org/10.1177/1744806919850383

    Article  CAS  Google Scholar 

  9. Ji W, Sang C, Zhang X et al (2022) Personality, preoperative anxiety, and postoperative outcomes: a review. Int J Environl Res Public Health 19(19):12162. https://doi.org/10.3390/ijerph191912162

    Article  Google Scholar 

  10. Almalki MS, Hakami OAO, Al-Amri AM (2017) Assessment of preoperative anxiety among patients undergoing elective surgery. Egyptian J Hosp Med 69(4):2329–2333. https://doi.org/10.12816/0041537

  11. Celik F, Edipoglu IS (2018) Evaluation of preoperative anxiety and fear of anesthesia using APAIS score. Eur J Med Res 23(1):1–10. https://doi.org/10.1186/s40001-018-0339-4

    Article  Google Scholar 

  12. Ekinci M, Gölboyu BE, Dülgeroğlu O et al (2017) The relationship between preoperative anxiety levels and vasovagal incidents during the administration of spinal anesthesia. Rev Bras Anestesiol 67:388–394. https://doi.org/10.1016/j.bjane.2016.07.017

    Article  PubMed  Google Scholar 

  13. Gürler H, Yılmaz M, Türk KE (2022) Preoperative anxiety levels in surgical patients: a comparison of three different scale scores. J Perianesth Nurs 37(1):69–74. https://doi.org/10.1016/j.jopan.2021.05.013

    Article  PubMed  Google Scholar 

  14. Martin D, Mantziari S, Demartines N et al (2020) Defining major surgery: a Delphi consensus among European Surgical Association (ESA) Members. World J Surg 44:2211–2219. https://doi.org/10.1007/s00268-020-05476-4

    Article  PubMed  Google Scholar 

  15. Brummett CM, Waljee JF, Goesling J et al (2017) New persistent opioid use after minor and majör surgical procedures in US adults. JAMA Surg 152:170504. https://doi.org/10.1001/jamasurg.2017.0504

  16. Burton D, King A, Bartley J et al (2019) The surgical anxiety questionnaire (SAQ): development and validation. Psychol Health 34(2):129–146. https://doi.org/10.1080/08870446.2018.1502770

    Article  PubMed  Google Scholar 

  17. Spielberger CD (1983) Manual for the state, trait anxiety ınventory STAI (Form Y). Palo Alto, CA: Mind Garden

  18. Oner N, Le Compte A (1998) Discontinuous (state) trait anxiety inventory handbook, 2nd edn. Boğaziçi University Publications, Turkey

    Google Scholar 

  19. Karadağ Arlı S (2017) Evaluation of the preoperative anxiety with APAIS and STAI-I Scales. Hacettepe Univ J Nursing Faculty 4(3):38–47

    Google Scholar 

  20. Abate SM, Chekol YA, Basu B (2020) Global prevalence and determinants of preoperative anxiety among surgical patients: a systematic review and meta-analysis. Int J Surg Open 25:6–16. https://doi.org/10.1016/j.ijso.2020.05.010

    Article  Google Scholar 

  21. Hellstadius Y, Lagergren J, Zylstra J et al (2016) Prevalence and predictors of anxiety and depression among esophageal cancer patients prior to surgery. Dis Esophagus 29(8):1128–1134. https://doi.org/10.1111/dote.12437

    Article  CAS  PubMed  Google Scholar 

  22. Akinsulore A, Owojuyigbe AM, Faponle AF et al (2015) Assessment of preoperative and postoperative anxiety among elective major surgery patients in a tertiary hospital in Nigeria. Middle East J Anaesthesiol 23(2):235–240

    PubMed  Google Scholar 

  23. Andersson V, Bergstrand J, Engström Å et al (2020) The impact of preoperative patient anxiety on postoperative anxiety and quality of recovery after orthopaedic surgery. J Perianesth Nurs 35(3):260–264. https://doi.org/10.1016/j.jopan.2019.11.008

    Article  PubMed  Google Scholar 

  24. Kuzminskaitė V, Kaklauskaitė J, Petkevičiūtė J (2019) Incidence and features of preoperative anxiety in patients undergoing elective non-cardiac surgery. Acta Med Litu 26(1):93–100

    PubMed  PubMed Central  Google Scholar 

  25. Kassahun WT, Mehdorn M, Wagner TC et al (2022) The effect of preoperative patient-reported anxiety on morbidity and mortality outcomes in patients undergoing major general surgery. Sci Rep 12:6312. https://doi.org/10.1038/s41598-022-10302-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Chen C, Wang H, Zhang L et al (2021) Clinical study of preoperative psychological distress and its related factors in the primary caregivers of patients with glioma. Clin Neurol Neurosurg 200:106364. https://doi.org/10.1016/j.clineuro.2020.106364

  27. Li XR, Zhang WH, Williams JP et al (2021) A multicenter survey of perioperative anxiety in China: pre- and postoperative associations. J Psychosom Res 147:110528. https://doi.org/10.1016/j.jpsychores.2021.110528

  28. Forlani M, Morri M, Belvederi Murri M et al (2014) Anxiety symptoms in 74+ community-dwelling elderly: associations with physical morbidity, depression and alcohol consumption. PLoS One 9:e89859. https://doi.org/10.1371/journal.pone.0089859

  29. Mavridou P, Dimitriou V, Manataki A et al (2013) Patient’s anxiety and fear of anesthesia: Effect of gender, age, education, and previous experience of anesthesia. A survey of 400 patients. J Anesth 27:104–108. https://doi.org/10.1007/s00540-012-1460-0

    Article  PubMed  Google Scholar 

  30. Domar AD, Everett LL, Keller MG (1989) Preoperative anxiety: Is it a predictable entity?. Anesth Analg 69:763–767

    Article  CAS  PubMed  Google Scholar 

  31. Prado-Olivares J, Chover-Sierra E (2019) Preoperatory anxiety in patients undergoing cardiac surgery. Diseases 7(2):46. https://doi.org/10.3390/diseases7020046

    Article  PubMed  PubMed Central  Google Scholar 

  32. Maheshwari D, Ismail S (2015) Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section. J Anaesthesiol Clin Pharmacol 31:196–200. https://doi.org/10.4103/0970-9185.155148

    Article  PubMed  PubMed Central  Google Scholar 

  33. King A, Bartley J, Johanson DL et al (2019) Components of preoperative anxiety: a qualitative study. J Health Psychol 24(13):1897–1908. https://doi.org/10.1177/1359105317709512

    Article  PubMed  Google Scholar 

  34. Kim WS, Byeon GJ, Song BJ et al (2010) Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia. Korean J Anesthesiol 58(328):333. https://doi.org/10.4097/kjae.2010.58.4.328

    Article  Google Scholar 

  35. Williams JB, Alexander KP, Morin JF et al (2013) Preoperative anxiety as a predictor of mortality and major morbidity in patients aged >70 years undergoing cardiac surgery. Am J Cardiol 111:137–142. https://doi.org/10.1016/j.amjcard.2012.08.060

    Article  PubMed  PubMed Central  Google Scholar 

  36. Takagi H, Ando T, Umemoto T (2017) Perioperative depression or anxiety and postoperative mortality in cardiac surgery: a systematic review and meta-analysis. Heart Vessel 32:1458–1468. https://doi.org/10.1007/s00380-017-1022-3

    Article  Google Scholar 

  37. Gao Q, Mok HP, Zhang HY et al (2021) Inflammatory indicator levels in patients undergoing aortic valve replacement via median sternotomy with preoperative anxiety and postoperative complications: a prospective cohort study. J Int Med Res 49:0300060520977417. https://doi.org/10.1177/03000605209774

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Mishra PK, Mathias H, Millar K et al (2010) A randomized controlled trial to assess the effect of audiotaped consultations on the quality of informed consent in cardiac surgery. Arch Surg 1(45):383–388. https://doi.org/10.1001/archsurg.2010.45

    Article  Google Scholar 

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Acknowledgements

The authors thank all participants for their support and participation in this study.

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Authors and Affiliations

Authors

Contributions

Study conception and design: ATH, Data collection: ATH, Data analysis and interpretation: ATH, Drafting of the article: ATH, Critical revision of the article: ATH.

Corresponding author

Correspondence to Ayşe Topal Hançer.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethics Committee of Sivas Cumhuriyet University (No:2023–01/02).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The author declares no competing interests.

Research involving human participants and/or animals

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethics Committee of Sivas Cumhuriyet University (No:2023–01/02).

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Cite this article

Topal Hançer, A. Prevalence and factors associated with surgery anxiety in hospitalized patients: a point-prevalence study. Ir J Med Sci 192, 2095–2103 (2023). https://doi.org/10.1007/s11845-023-03475-7

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  • DOI: https://doi.org/10.1007/s11845-023-03475-7

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