The Overlooked Problem Among Surgical Patients: Preoperative Anxiety at Ethiopian University Hospital

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2022 Aug 19

PMID 35983091

Authors

Yophtahe Woldegerima Berhe

Tadesse Belayneh Melkie

Girmay Fitiwi Lema

Marye Getnet

Wubie Birlie Chekol

Affiliations

Soon will be listed here.

Abstract

Introduction: Anxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia.

Methodology: A hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. Strength of association was described in adjusted odds ratio (AOR), and a -value < 0.05 at 95% confidence interval was considered statistically significant.

Results: A total of 400 patients were included in this study with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40-56.7); age, ≥ 60 years (AOR: 5.7, CI: 1.6-20.4, : 0.007); emergency surgery (AOR: 2.5, CI: 1.3-4.7, : 0.005); preoperative pain (AOR: 2.6, CI: 1.2-5.4, : 0.005); and rural residency (AOR: 1.8, CI: 1.1-2.9, : 0.031) were found significantly associated with preoperative anxiety.

Conclusion: The prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.

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References

Bedaso A, Ayalew M . Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia. Patient Saf Surg. 2019; 13:18. PMC: 6454677. DOI: 10.1186/s13037-019-0198-0. View

Rasouli M, Menendez M, Sayadipour A, Purtill J, Parvizi J . Direct Cost and Complications Associated With Total Joint Arthroplasty in Patients With Preoperative Anxiety and Depression. J Arthroplasty. 2015; 31(2):533-6. DOI: 10.1016/j.arth.2015.09.015. View

Charana A, Tripsianis G, Matziou V, Vaos G, Iatrou C, Chloropoulou P . Preoperative Anxiety in Greek Children and Their Parents When Presenting for Routine Surgery. Anesthesiol Res Pract. 2018; 2018:5135203. PMC: 6051335. DOI: 10.1155/2018/5135203. View

Erkilic E, Kesimci E, Soykut C, Doger C, Gumus T, Kanbak O . Factors associated with preoperative anxiety levels of Turkish surgical patients: from a single center in Ankara. Patient Prefer Adherence. 2017; 11:291-296. PMC: 5338979. DOI: 10.2147/PPA.S127342. View

Ayyadhah Alanazi A . Reducing anxiety in preoperative patients: a systematic review. Br J Nurs. 2014; 23(7):387-93. DOI: 10.12968/bjon.2014.23.7.387. View

Frot M, Feine J, Bushnell C . Sex differences in pain perception and anxiety. A psychophysical study with topical capsaicin. Pain. 2004; 108(3):230-236. DOI: 10.1016/j.pain.2003.11.017. View

Williams J, Alexander K, Morin J, Langlois Y, Noiseux N, Perrault L . Preoperative anxiety as a predictor of mortality and major morbidity in patients aged >70 years undergoing cardiac surgery. Am J Cardiol. 2012; 111(1):137-42. PMC: 3677723. DOI: 10.1016/j.amjcard.2012.08.060. View

Matthias A, Samarasekera D . Preoperative anxiety in surgical patients - experience of a single unit. Acta Anaesthesiol Taiwan. 2012; 50(1):3-6. DOI: 10.1016/j.aat.2012.02.004. View

Roomruangwong C, Tangwongchai S, Chokchainon A . Preoperative anxiety among patients who were about to receive uterine dilatation and curettage. J Med Assoc Thai. 2012; 95(10):1344-51. View

10.

Tluczek A, Henriques J, Brown R . Support for the reliability and validity of a six-item state anxiety scale derived from the State-Trait Anxiety Inventory. J Nurs Meas. 2009; 17(1):19-28. PMC: 2776769. DOI: 10.1891/1061-3749.17.1.19. View

11.

Maheshwari D, Ismail S . Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section. J Anaesthesiol Clin Pharmacol. 2015; 31(2):196-200. PMC: 4411833. DOI: 10.4103/0970-9185.155148. View

12.

Cserep Z, Losoncz E, Balog P, Szili-Torok T, Husz A, Juhasz B . The impact of preoperative anxiety and education level on long-term mortality after cardiac surgery. J Cardiothorac Surg. 2012; 7:86. PMC: 3485128. DOI: 10.1186/1749-8090-7-86. View

13.

Kim W, Byeon G, Song B, Lee H . Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia. Korean J Anesthesiol. 2010; 58(4):328-33. PMC: 2876851. DOI: 10.4097/kjae.2010.58.4.328. View

14.

Lim S, Oh Y, Cho K, Kim M, Moon S, Ki S . The question of preoperative anxiety and depression in older patients and family protectors. Anesth Pain Med (Seoul). 2020; 15(2):217-225. PMC: 7713824. DOI: 10.17085/apm.2020.15.2.217. View

15.

Celik F, Edipoglu I . Evaluation of preoperative anxiety and fear of anesthesia using APAIS score. Eur J Med Res. 2018; 23(1):41. PMC: 6131845. DOI: 10.1186/s40001-018-0339-4. View

16.

Jones A, Al-Naseer S, Bodger O, James E, Davies A . Does pre-operative anxiety and/or depression affect patient outcome after primary knee replacement arthroplasty?. Knee. 2018; 25(6):1238-1246. DOI: 10.1016/j.knee.2018.07.011. View

17.

Kuzminskaite V, Kaklauskaite J, Petkeviciute J . Incidence and features of preoperative anxiety in patients undergoing elective non-cardiac surgery. Acta Med Litu. 2019; 26(1):93-100. PMC: 6586376. DOI: 10.6001/actamedica.v26i1.3961. View

18.

McLean C, Anderson E . Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev. 2009; 29(6):496-505. DOI: 10.1016/j.cpr.2009.05.003. View

19.

Fathi M, Alavi S, Joudi M, Joudi M, Mahdikhani H, Ferasatkish R . Preoperative anxiety in candidates for heart surgery. Iran J Psychiatry Behav Sci. 2014; 8(2):90-6. PMC: 4105610. View

20.

. 36th International Symposium on Intensive Care and Emergency Medicine : Brussels, Belgium. 15-18 March 2016. Crit Care. 2016; 20(Suppl 2):94. PMC: 5493079. DOI: 10.1186/s13054-016-1208-6. View