Patient’s Perspective of Preoperative Anxiety and Need for Support- An Observational Study
Dr. Ravi Madhusudhana,
Professor and Head, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Kolar-563101, Karnataka, India.
Introduction: Majority of the patients undergoing elective surgery generally experience anxiety. Preoperative anxiety causes emotional distress and needs support to cope.
Aim: To evaluate the prevalence of preoperative anxiety in patients undergoing elective surgery and to examine association between the intensity of anxiety and need for assistance.
Materials and Methods: An observational study was conducted at Sri Devaraj Urs Medical College, Kolar, Karnataka, India on 100 participants. The inclusion criteria were - age >18 years of either sex belonging to American Society of Anaesthesiologists (ASA)- Physical Status (PS) grade I or II and undergoing elective surgery. After obtaining informed consent, a questionnaire including both Amsterdam Preoperative Anxiety Information Scale (APAIS) and Numeric Rating Scale (NRS) to measure anxiety was given to the patients in preanaesthetic evaluation clinic by anaesthesiology resident one day prior to the scheduled surgery. The questionnaire included a semi dichotomous scale (yes/no) for anxiety assessment; to quantify the intensity of anxiety levels the questions on APAIS were given on 5-item scale (not at all/somewhat/moderate/moderately-high/extremely) and NRS on 4-item scale (no anxiety/mild/moderate/severe).
Results: The prevalence of anxiety was 100%.The mean age was 43.3±11.9 years. The majority (53%) were females. According to NRS, majority of patients undergoing major surgeries had higher mean anxiety levels (6.95±1.96). APAIS anxiety about anesthesia was 4.78±2.1 and about surgery was 5.52±1.9. A cut-off of 13 on the APAIS anxiety scale had a sensitivity of 90% and a specificity of 81.1%. A cut-off of 3.5 on the NRS scale had a sensitivity of 72.7% and a specificity of 65.2%.
Conclusion: All the patients undergoing elective surgery should be subjected for preoperative anxiety assessment and those with higher anxiety levels requiring support should be addressed to have better postoperative outcomes. Grade of surgery had a significant role in causing anxiety. Hence both Anaesthesiologist and Surgeons should be involved in counselling the patient.