Dataset Information

Prevalence of pre-operative anxiety and associated risk factors among patients awaiting elective surgery in a tertiary care hospital.

ABSTRACT:

Background

Patients undergoing surgery have a fear of anesthesia and surgical procedures that results in anxiety. The global incidence of pre-operative anxiety is estimated at 60-92%. Age, gender, education, marital status, type of family, type of anesthesia and surgery, and history of surgery are the contributing factors. High levels of anxiety during the pre-operative period has negative impacts on surgical outcomes. The main objective of this study was to find out the prevalence of pre-operative anxiety and associated risk factors in a hospital setting of a developing country.

Methods

This was a single center, analytical, cross-sectional study conducted among the admitted patients scheduled for elective surgeries in a tertiary care hospital. Non-probability convenience sampling was adopted and a total of 205 cases were included. The researchers themselves collected the data on the day before surgery using questionnaires comprised of two parts: semi-structured questionnaires prepared via literature review and Amsterdam Pre-operative Anxiety and Information Scale (APAIS). Data were analyzed in SPSS version 23. Bivariate and multivariate analyses were performed appropriately.

Results

The prevalence of pre-operative anxiety was 25.85%. The median anaesthesia related, surgery related, and total anxiety scores were 4.00, 5.00 and 9.00 respectively. Likewise, the median score of information desired component scale was 5.00. Different anxiety scores were positively correlated with the information desire component score. The patients living in a nuclear family (adjusted OR, 2.480; 95% CI, 1.272-4.837, p = 0.008) and those without past history of surgery (adjusted OR, 2.451; 95% CI, 1.107-5.424, p = 0.027) had approximately 2.5 times higher risk of having pre-operative anxiety compared to those from a joint family and those having past history of surgery respectively. Those receiving spinal anesthesia had approximately two times lower risk of anxiety (adjusted OR, 0.511; 95% CI, 0.265-0.985, p = 0.045).

Conclusions

One fourth of the patients had pre-operative anxiety. Type of family, type of anesthesia and past history of surgery were found to be the independent predictors of anxiety.

SUBMITTER: Adhikari SP

PROVIDER: S-EPMC10839854 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Prevalence of pre-operative anxiety and associated risk factors among patients awaiting elective surgery in a tertiary care hospital.

Adhikari Suman Prasad SP Pathak Bishnu Deep BD Ghimire Bhuwan B Baniya Sunil S Joshi Prabhas P Kafle Pooja P Adhikari Prawesh P Rana Aakanksha A Regmi Laxmi L Dhakal Bishal B Simkhada Nabin N Tandon Om Prakash OP Pathak Indra Dev ID Rawal Namrata Mahara NM

F1000Research 20231212

<h4>Background</h4>Patients undergoing surgery have a fear of anesthesia and surgical procedures that results in anxiety. The global incidence of pre-operative anxiety is estimated at 60-92%. Age, gender, education, marital status, type of family, type of anesthesia and surgery, and history of surgery are the contributing factors. High levels of anxiety during the pre-operative period has negative impacts on surgical outcomes. The main objective of this study was to find out the prevalence of pr ...[more]

PMID: 38318155

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Project description:Background: Surgery-related anxiety is universal, leading to complications. The objective of this study was to assess the prevalence of pre-operative anxiety levels among a group of patients. Methods: A descriptive cross-sectional study of 64 women was conducted in a tertiary care hospital, Sri Lanka. Patients who underwent emergency surgeries, those with mental illnesses or those aged <18 years were excluded. Pre-operative assessment was done one day prior to the surgery using a self-administered Sinhala validated Amsterdam-Preoperative-Anxiety-and-Information-Scale (APAIS), Hospital Anxiety and Depression Scale (HADS) and Visual-Analogue-Scale (VAS). The APAIS consists of six questions which assess three anxiety components: anesthesia-related-anxiety (Sum A), surgery-related-anxiety (Sum S) and information-desire-component (Sum IDC). The combined score (Sum C) is given by the total of Sum A and Sum S. A Sum C of ≥11 indicates significant anxiety. Results: The mean age of participants was 38.03 years (SD=13.53 years). The mean total score of APAIS was 10.36 (4.06), of HADS was 5.734 (4.487) and of VAS was 3.156 (2.773). All scores were higher in participants <50 years. There were negative correlations between age and anxiety levels in VAS and APAIS scales; the Sum IDC in APAIS (r=-0.416, p=0.001) and VAS scores (r=-246, p=0.050) showed significant negative correlations. Excepting Sum IDC all APAIS, HADS and VAS scores were higher among the group without insurance; despite free healthcare. However only Sum S (t=-3.716, p=0.000) and Sum C (t=-2.281, p=0.026) in APAIS, HADS (t=-3.412, p=0.001) and VAS (t=-2.135, p=0.037) had statistically higher values. Anxiety scores were higher in the group that underwent minor surgeries but where not significantly related to education level, marital status, income, employment or living status. Conclusions: Pre-operative anxiety is common. Age <50 years, lacking insurance cover and undergoing minor surgeries are associated with increased pre-operative anxiety levels. Screening and appropriate interventions would be beneficial.

Project description:BackgroundAn ageing population has resulted in a rise in the number of hip and knee replacement surgeries in the UK. The pre-operative pathway is plagued with issues causing long delays and cancellations. Virtual healthcare technologies have a growing evidence base to help solve these issues. One problem of implementing these technologies is the resistance to change mentality from healthcare professionals. By getting their opinions on the place of these technologies within the pre-operative pathway, a united front can be formed to help deliver change.MethodsSixteen semi-structured interviews were conducted with key stakeholders within the orthopaedic pre-operative pathway at Imperial College Healthcare NHS Trust. General topics included the different technologies that could be used within the pathway, their uses and associated benefits and problems. Interviews were audio-recorded, before being manually transcribed and then analysed to form categories and themes.ResultsVarious uses, benefits and problems were identified by healthcare professionals for each modality of technology. E-forms were seen as a high reward, low-risk intervention. Remote patient monitoring and teleconsultations had their bonuses, but feasibility was a primary concern. Web-based interventions were seen as an intervention of the past, whereas virtual reality was seen as perhaps being ahead of its time. M-health was very positively viewed due to its all-encompassing nature. Digital illiteracy emerged as a consistent problem for most technologies.ConclusionsCurrent literature, the results from this study and technology trends within society highlight both M-health and E-forms as the 2 most promising virtual healthcare technologies for use in the pre-operative pathway for orthopaedics. Areas such as pre-operative assessment, triaging and prehabilitation are prime candidates for virtual intervention. Future research should also consider including patient opinions on any proposed interventions, as well as taking into account barriers to implementation.

Project description:BackgroundWe determined the rate of incarceration of inguinal hernia among infants and young children waiting for elective surgery and examined the relation to wait times. We also explored the relation between wait times and the use of emergency department services before surgery.MethodsWe used linked data from administrative databases to identify infants and children less than 2 years of age who underwent surgical repair of an inguinal hernia between Apr. 1, 2002, and Mr. 31, 2004. We determined the rate of hernia incarceration during the wait for surgery and stratified the risk by patient age and sex. We used logistic regression analysis to examine factors associated with hernia incarceration and wait times.ResultsA total of 1065 infants and children less than 2 years old underwent surgical repair of an inguinal hernia during the study period. The median wait time was 35 days (interquartile range 17-77 days). Within 30 days after diagnosis, 126 (11.8%) of the patients had at least 1 emergency department visit; 23.8% of them presented with hernia incarceration. The overall rate of hernia incarceration was 11.9%. The rate was 5.2% with a wait time of up to 14 days (median time from diagnosis to first emergency department visit), as compared with 10.1% with a wait time of up to 35 days (median wait time to surgery) (p < 0.001). Factors associated with an increased risk of incarcerated hernia were age less than 1 year (odds ratio [OR] 2.07, 95% confidence interval [CI] 1.32-3.23), female sex (OR 1.75, 95% CI 1.04-2.93) and emergency department visits (1 visit, OR 2.73, 95% 1.65-4.50; > or = 2 visits, OR 3.77, 95% CI 1.89-7.43). Children less than 1 year old who waited longer than 14 days had a significant 2-fold risk of incarcerated hernia (OR 1.92, 95% CI 1.11-3.32).InterpretationA wait time for surgery of more than 14 days was associated with a doubling of the risk of hernia incarceration among infants and young children with inguinal hernia. Our data support a recommendation that inguinal hernias in this patient population be repaired within 14 days after diagnosis.

Project description:BackgroundMajor life changes are among factors that cause anxiety, and one of these changes is surgery. Hospitalization, regardless of disease, is known to provoke anxiety in the patient admitted for surgery. Anxiety is an unpleasant disturbing experience that involves way of thinking of tension, apprehension, uneasiness and high autonomic activity. Patients with high levels of anxiety require higher doses of anesthetic induction agents and recover poorly. The objective of this study was to investigate the prevalence of preoperative anxiety and its predictors among adult patients scheduled for elective surgery.MethodologyInstitutional based cross sectional study was conducted using interviewer administered structured questionnaire in Yirgalem zonal hospital in Ethiopia from November 1, to December 30, 2018 on 407 patients scheduled for elective surgery. The study included all patients with age greater than 18 years who were undergoing surgery. Patients with known anxiety disorder and unable to communicate were excluded from the study. State and trait anxiety inventory (STAI) measurement scale was used to assess preoperative anxiety. Statistical analysis was performed using SPSS version 22. Binary logistic regression analysis was performed to determine the predictors of preoperative anxiety. The strength of the association was presented using AOR with 95% confidence interval and p-value < 0.05 was considered as statistically significant.ResultsAmong a total of 402 patients enrolled in the study 228 (56.7%) were male. The prevalence of preoperative anxiety among scheduled patients for elective surgery was 47.0%. Having strong social support (AOR = .16 CI = 0.07, 0.34), harm from doctor or nurse mistake (AOR = 5.03, CI = 2.85, 8.89), unexpected result of operation (AOR = 3.03, CI = 1.73, 5.19), unable to recover (AOR = 2.96, CI = 1.18, 4.87), and need of blood transfusion (AOR = 2.76, CI = 1.65, 4.62) were significantly associated with preoperative anxiety.ConclusionIn the current study the prevalence of preoperative anxiety was high (47%). Having strong social support, unexpected result of operation, harm from doctor or nurse mistake, need of blood transfusion, and unable to recover were found to be statistically significant for preoperative anxiety. Patients need to be assessed regularly for anxiety during the preoperative visit.

Dataset Information

Prevalence of pre-operative anxiety and associated risk factors among patients awaiting elective surgery in a tertiary care hospital.

Background

Methods

Results

Conclusions

Publications

Prevalence of pre-operative anxiety and associated risk factors among patients awaiting elective surgery in a tertiary care hospital.

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