Abstract
BackgroundPreoperative anxiety is common among the oncological surgical population. Due to its psychological and physiological detrimental effects, identifying and addressing it is of uttermost importance to improve anesthetic management and patient’s outcomes. The aim of this study is to validate the Portuguese version of Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the oncological population.MethodsFollowing forward and backward translation of the original APAIS scale, further adaptation was obtained through cognitive interviewing. The resulting instrument was tested on the day before surgery on a sample of adult cancer surgical patients from a Portuguese oncology centre. Psychometric evaluation was derived from inter-item correlation, confirmatory factor analysis, Cronbach’s alpha, correlation with comparative scales, receiver operating characteristic curve and Youden index.Results109 patients (58 males, 51 females) were included. A three-dimensional model—anxiety about anesthesia, anxiety about surgery and desire for information, showed the best fit to the data. The questionnaire revealed high internal consistency (Cronbach alpha 0.81) and good inter-item correlation. Also, Portuguese APAIS correlated well with the gold standard anxiety scale. Therefore, the psychometric properties of this scale version make it a valid and reliable instrument. The optimal cutoff to maximize both sensitivity and specificity was 12 for the APAIS global anxiety score.ConclusionsPortuguese APAIS version is an accurate tool to identify preoperative anxiety among cancer patients and might impact its management, from premedication choice to provision of information and reassurance about either anesthesia or surgery.
Highlights
Preoperative anxiety is common among the oncological surgical population
The scale The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a simple questionnaire consisting of six items, four regarding the anxiety about the surgical procedure and the fear of anesthesia, and two regarding the need for information (Table 1)
We report the fit indices derived from this robust approach chi-square test of exact fit (p > 0.05 indicates good fit), Tucker Lewis Index, comparative fit index and the root mean square error of approximation and its 90% confidence interval
Summary
Preoperative anxiety is common among the oncological surgical population. Due to its psychological and physiological detrimental effects, identifying and addressing it is of uttermost importance to improve anesthetic management and patient’s outcomes. Excessive anxiety leads to psychological and physical adverse stress reactions. It causes a greater consumption of anesthetic [3, 4] and analgesic drugs [5], intra- and post-operatively. Causes may include fear of anesthesia, concern about surgical outcomes, anticipation of post-operative pain and hospital environment hostility [8]. It is influenced by socio-demographic and psychosocial factors, which may be of great significance and challenging to evaluate [9, 10]
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