Assessment Of Preoperative Anxiety Research Articles

Assessment of preoperative anxiety and negative automatic thoughts in patients waiting for corneal transplantation

Introduction and aim. In patients waiting for organ transplantation, increased waiting time can increase anxiety by creating negative automatic thoughts. The aim of this study is to examine the relationship between corneal transplant recipients’ negative automatic thoughts and anxiety before organ transplantation. Material and methods. The population of this correlational descriptive study consisted of 108 patients waiting for cornea transplantation in the Eye Bank unit of a hospital in the south east region of Türkiye. The data were obtained from the patients presented to the ophthalmology clinic for transplantation between September and December 2022. A patient information form, the Negative Automatic Thoughts Scale, and the Trait Anxiety Scale were used to collect the data. Percentage distribution, arithmetic mean, logistic regression and correlation analysis were used in the data analysis. Results. It was determined that the mean score of the negative automatic thoughts of the transplant patients participating in the study was 100.69±47.83, and the trait anxiety mean score was 53.06±6.07. There was a positive relationship between neg ative automatic thoughts and trait anxiety at a moderate level, which was statistically significant (p<0.05, r=0.53). Conclusion. It was determined in the study that the patients’ negative automatic thoughts and trait anxiety were high, and their anxiety increased as the negative automatic thoughts increased.

Predicting severe pain after cesarean section: prospective cohort study

BACKGROUND: Severe and unbearable pain after abdominal delivery is recorded in 20% of cases, indicating the limitations of the applied methods of postoperative pain relief and the need for a personalized approach. Tests assessing preoperative pain threshold and anxiety have the greatest sensitivity and specificity as predictors of intense postoperative pain. The informative value of these tests in the Russian obstetric population has not been assessed. OBJECTIVE: This study aimed to determine the optimal method for predicting severe pain after cesarean section (CS). MATERIALS AND METHODS: This prospective cohort study included 212 women who underwent elective CS under spinal anesthesia. The Hospital Anxiety and Depression Scale (HADS) anxiety rating scale, pressure algometry, and cutaneous infiltration anesthesia pain intensity assessment were used as predictors of high-intensity pain. Postoperative pain intensity was assessed using a 10-point Numeric Rating Scale (NRS). The maximum level of pain according to the central pain level at rest (NRSr) and during movement (NRSa) was recorded 24 hour postoperatively. The number of requests for “rescue analgesia” was recorded. The predictive value of the studied methods was determined based on ROC curve analysis. RESULTS: Median (interquartile range) NRSa was 5 [4–5]. Severe pain was recorded in 14% of the patients. The area under the ROC-curve (AUC), reflecting the relationship between severe postoperative pain and pressure-pain threshold, was 0.91±0.03 with 95% confidence interval (CI) of 0.84–0.97 (p 0.001). The relationship between pain intensity during infiltration anesthesia and postoperative pain severity had AUC=0.88 ± 0.04 with 95% CI of 0.81–0.96 (p 0.001). The HADS anxiety score demonstrated the lowest predictive ability (AUC=0.69±0.06; 95% CI, 0.81–0.96; p 0.001). When all three techniques were used together, the AUC was 0.924±0.024 with 95% CI 0.88–0.97 (p=0.001). CONCLUSION: Preoperative pressure-pain threshold and pain severity during infiltration anesthesia are reliable predictors of severe pain after CS. Assessment of preoperative anxiety using HADS has low sensitivity and specificity. However, its use in conjunction with methods for assessing the pain threshold increases the predictive value of the combined model compared with the results of using the methods separately.

Роль корекції психоемоційних розладів у пацієнтів із лійкоподібною деформацією грудної клітки

Pectus excavatum (PE) is the most common congenital chest deformities. For many patients, this defect caused significant psychological stress which occurs in adolescence and lead to anxiety, low self-esteem and withdrawal from social activities, which significantly affects the quality of life. The need of surgery often accompanied by a patient’s psychological trauma, especially for children. Purpose - to evaluate the role of correction of psycho-emotional disorders in children with PE before surgical intervention to improve treatment results. Materials and methods. Assessment of preoperative anxiety in 28 children aged 10 to 17 years was carried out. The Group I included 11 children who were psychologically ready for surgery, the Group II included 17 children who needed the help of a psychologist. Assessment was performed using the Preoperative Anxiety Scale (SAS) and the Anxiety Inventory for Children (STAIC). Psychotherapeutic correction included: information support, relaxation and physical exercises, game and art therapy. Statistical analysis was performed using SPSS 26.0. Results. After the preliminary survey, most of the children who agreed to the operation had a low or moderate level of anxiety, while the children who needed psychological help had a high level of anxiety. Before psychological correction, according to the results of the STAIC questionnaire, 64.3% of patients had a high level of situational anxiety and a high score of personal anxiety. After completing the course of psychological correction, personal anxiety in 57.1% of children decreased to a low level. Conclusions. Psychological therapy reduces psychological, psychosomatic and psychophysiological symptoms in patients, helps patients prepare for surgery. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the participating institution. Informed consent of the patients was obtained for the research. No conflict of interests was declared by the authors.

Assessment of preoperative anxiety and depression in patients with pulmonary ground-glass opacities: Risk factors and postoperative outcomes.

A large number of patients with pulmonary ground-glass opacities (GGOs) have anxiety and depression. However, the contributing factors and effects of anxiety and depression on postoperative outcomes are still unclear. Clinical data for patients undergoing surgical resection for pulmonary GGOs were collected. We prospectively evaluated levels and risk factors for anxiety and depression in patients with GGOs before surgery. The relationship between psychological disorders and postoperative morbidity was evaluated. Quality of life (QoL) was also assessed. A total of 133 patients were enrolled. Prevalence rates of preoperative anxiety and depression were 26.3% (n = 35) and 18% (n = 24), respectively. Multivariate analysis revealed depression [odds ratio(OR) = 16.27, p < 0.001] and multiple GGOs (OR = 3.146, p = 0.033) to be risk factors for preoperative anxiety. Anxiety (OR = 52.166, p < 0.001), age > 60 (OR = 3.601, p = 0.036), and unemployment (OR = 8.248, p = 0.006) were identified as risk factors for preoperative depression. Preoperative anxiety and depression were associated with lower QoL and higher postoperative pain scores. Our results also revealed that the incidence of postoperative atrial fibrillation was higher in patients with than in those without anxiety. In patients with pulmonary GGOs, comprehensive psychological assessment and appropriate management are required before surgery to improve QoL and reduce postoperative morbidity.

Assessment of Preoperative Anxiety Among Patients of Open-Heart Surgery at Cardiac Centres of Rawalpindi and Islamabad

Anxiety is a complex emotional condition that is often described as a noxious internal disturbance that is accompanied by restlessness. Objectives: To determine the prevalence of preoperative anxiety and to find out main risk factors among patients waiting for open heart surgery. Methods: A cross-sectional study was carried out at cardiac centers of Rawalpindi. A total of 180 respondents who were admitted in hospital for open heart surgery were consecutively selected for the purpose of the study. APAIS and STAI were used to collect data regarding preoperative anxiety. Adjusted odd ratios were determined for the major risk factors. Results: Majority were males (64.4%) and were 20-46 years of age (48.3%). It can be seen that patients who presented low levels of preoperative anxiety were slightly higher in number as compared to those who presented high levels of anxiety. Females, patients of younger age group (20-46 years) and those undergoing valvular surgeries were more prone to develop all subtypes of preoperative anxiety (p value&lt;0.05). While surgery schedule is also a main predictor of anxiety due to anaesthesia and procedure (p value&lt;0.05). Conclusions: Majority of the patients undergoing open heart surgery presented low levels of preoperative anxiety while females, younger patients and those undergoing valvular surgeries were considered more susceptible of developing preoperative anxiety.

Assessment of Preoperative Anxiety Among Surgical Patients

Assessment of Preoperative Anxiety Among Surgical Patients

Assessment of Preoperative Anxiety among Patients Attending a Preanaesthetic Check-up Clinic at a Tertiary Care Hospital, Odisha: A Cross-sectional Study

Introduction: Anxiety during the preoperative period predisposes to postoperative complications such as increase in postoperative pain, delay of healing and prolonged hospital stay.Further, patients with a high level of preoperative anxiety require higher doses of anaesthetic agents and recover poorly. Due to these factors, each tertiary care hospital should have an idea about the prevalence of preoperative anxiety in their setting, so that appropriate preventive measures can be planned. Aim: To assess the prevalence of preoperative anxiety in patients attending the Preanaesthetic Check-up (PAC) clinic for elective surgeries and to find out the factors associated with anxiety among them. Materials and Methods: This hospital-based, cross-sectional study was conducted in the PAC Clinic at Kalinga Institute of Medical Sciences (tertiary care hospital), Bhubaneswar, Odisha, India, from May to July 2018. The study included hundred patients, using convenient sampling technique, undergoing preanaesthetic check-up, before the proposed elective surgeries. A researcher made study tool, using Hamilton-A scale for assessing preoperative anxiety was used. Data was analysed using Epi Info software. A p-value &lt;0.05 was considered as statistically significant. Results: Among the sampled 100 study participants, preoperative anxiety was found to be present in 97, 72 of the study participants had mild anxiety, 14 had mild to moderate and 11 moderate to severe anxiety. Of the 97 participants who had preoperative anxiety, 7 (14.89%) of the females had moderate to severe anxiety as compared to 4 (8%) of males. The age group of 60-69 years and Christianity religion were found to be statistically significant factors associated with anxiety in the study population. Conclusion: The prevalence of preoperative anxiety among the study participants was found to be high. Preventive measures like counselling sessions to address their apprehensions should be planned to decrease the anxiety.

Assessment of Pre-Operative Anxiety among Patients in Selected Hospitals of Rupandehi, Nepal

Introduction: The prevalence of pre-operative anxiety among patients undergoing various surgeries is as high as 60% to 90%. The pre-operative anxiety have serious outcomes and can increase the risk of post-operative complications like pain, prolonged recovery, and longer hospitalization. Pre-operative anxiety may be transient or chronic and can lead to aggressive reactions and undue stress as well.&#x0D; Material And Method: A descriptive study was designed to assess the level and contributing factors to anxiety among preoperative patients. Non-probability purposive sampling technique was used to select the patients from Devdaha Medical College and Research Institute, Bhaluhi and Mercy City Hospital, Butwal, Rupendehi district. Semi-structured interview schedule and Beck Anxiety Inventory Scale (BAI) were used to collect data. The collected data were analyzed by using descriptive and inferential statistics with Statistical Package for Social Sciences (SPSS) software version 16.&#x0D; Results: Among 150 respondents 57.3%, 26.6%, and 16% respondents had severe, moderate and low anxiety levels respectively. The contributing factors for pre-operative anxiety were respondents having no history of previous surgery (20.7%), less number of days of hospital admission (44% and 44%), had major surgery(48.7%). Respondents felt fear about the pain due to surgery in 91.3% cases, death in 36% and blood transfusion in 13.3% cases. 62.7% respondents had no any doubt regarding competency of health personnel.&#x0D; Conclusion: Based on the study findings, there are varying levels of anxieties among preoperative patients. It is recommended to surgeon and other health personnel that information needs to be provided related to surgery before surgery to reduce pre-operative anxiety.

TRANSLATION AND VALIDATION OF THE AMSTERDAM PREOPERATIVE ANXIETY AND INFORMATION SCALE (APAIS) INTO HAUSA LANGUAGE

Objectives: The objectives of this study ware to translate and validate the Amsterdam Preoperative Anxiety and Information Scale into Nigerian Hausa Language to be used in assessing Hausa speaking surgical patients’ preoperative anxiety before undergoing elective surgery. Methods: Forward and backward translation method was adopted to translate APAIS into Hausa Language so as to produce a Hausa version of the scale (APAIS-H). The Hausa version was tested on thirty patients scheduled for elective surgery at Federal Medical Centre, Nguru-Yobe State, Nigeria. The authors performed factor analysis, internal consistency and correlated the translated Hausa version with Spielberger’s State Trait Anxiety Inventory (STAI-State). Findings: The translated Hausa version of the scale produced high internal consistency for the two subscales (Cronbach’s alpha 0.82 for anxiety related to surgery subscale and 0.71 for information desire subscale respectively). APAIS-H&nbsp; correlated well with Spielberger's state Trait Anxiety Inventory STAI-state with a correlation coefficient of&nbsp; (r = 0.81), Conclusion: APAIS-H has been found to be valid and reliable instrument to be used in the assessment of preoperative anxiety in Hausa speaking patients scheduled to undergo surgical operation.

Assessment of Preoperative Anxiety among Patients Undergoing Elective Surgery

Introduction: Although patients undergoing elective surgery are assumed to have a lower level of preoperative anxiety, studies reported a high level of anxiety among those patients. . This study aimed at assessing the level of preoperative anxiety and its predictors in adult patients undergoing elective surgery. Methods: This study is a cross-sectional design conducted among patients admitted for elective surgery. A total of 278 patients with non-life-threatening surgeries were included and those who had mental or psychological problems were excluded from this study. Sample type and sample size. The data collected through a questionnaire about demographics, preoperative knowledge and anxiety in the preoperative room 24 hours before the operation. The frequencies, percentages, mean and SD were calculated, and t-test was used to detect significant associations. Results: The overall preoperative anxiety score had a mean ±SD of 18.2±5.8 and the questions regarding knowledge component reported higher scores than those about anxiety component. The components of anxiety about surgery reported higher scores than those of anxiety about anesthesia. Age, gender, availability of family support and type of surgery were found as significant predictors for preoperative anxiety prior to elective surgery. However, the association between preoperative anxiety and marital status and previous experience of surgery were found statistically non-significant. Conclusion: This study concluded that patients underwent elective surgery had high preoperative anxiety. The patients with younger age, female gender, patients under general anesthesia, or those who had no family support showed a higher level of preoperative anxiety.

Assessment of Preoperative Anxiety in Cardiac Surgery Patients Lacking a History of Anxiety: Contributing Factors and Postoperative Morbidity

The aim of this study was to measure the level of preoperative anxiety in patients scheduled for cardiac surgery, identify any influencing clinical factors, and assess the relationship between anxiety and postoperative morbidity. A prospective and consecutive study. A single university hospital. The study comprised 200 patients scheduled for cardiac surgery. Each patient was asked to grade his or her preoperative anxiety level using the Visual Analogue Scale for Anxiety, Amsterdam Preoperative Anxiety and Information Scale, and set of specific anxiety-related questions. Demographic data (age, sex, body mass index) and anesthetic and surgical data (American Society of Anesthesiologists physical status, EuroSCORE surgical risk, preoperative length of stay, and previous anesthetic experience) were registered. Also, postoperative morbidity was assessed. Twenty-eight percent of the patients developed high preoperative anxiety. The mean Amsterdam Preoperative Anxiety and Information Scale score was 11.4 ± 4.3, and the mean Visual Analogue Scale for Anxiety score was 48 ± 21. Patients scheduled for coronary artery bypass surgery, who had no previous anesthetic experience, and who were hospitalized before surgery, had higher anxiety scores. Coronary bypass surgery (odds ratio 3.026; 1.509-6.067; p = 0.002) was associated independently with preoperative high-level anxiety. Anxiety most commonly was caused by waiting for surgery, not knowing what is happening, fearing not being able to awaken from anesthesia, and being at the mercy of staff. Anxiety did not modify the postoperative course. In patients waiting to undergo cardiac surgery, both fear of the unknown and lack of information, especially related to the surgery, are crucial factors in high levels of preoperative anxiety in cardiac surgery. Coronary bypass surgery is a determining factor for preoperative anxiety. The anxiety level did not modify the postoperative course in these patients.

Reliability and validity of the Chinese version of the Amsterdam preoperative anxiety and information scale

Objective To determine the reliability and validity of the Chinese edition of the Amsterdam preoperative anxiety and information scale (APAIS) for the assessment of preoperative anxiety of Chinese patients. Methods The APAIS was translated into Chinese version. One hundred and thirty patients undergoing elective surgery were enrolled to complete the APAIS, STAI-S, VAS-A at the day before surgery, and thirty subjects received a re-test of APAIS at the day of surgery. Results The average score of Chinese version of APAIS anxiety scale and information scale were (7.37±3.51) and (3.67±1.94), respectively. Cronbach α for the anxiety scale was 0.84 and information scale was 0.78, respectively. Test-retest reliability were r=0.746(P<0.01) and r=0.655(P<0.01), respectively. Factor analysis showed anxiety and the desire for information were found, which explained 73.82% of variance. The anxiety scale of APAIS significantly correlated with STAI-S and VAS-A, Correlation Coefficient were r=0.720(P<0.01) and r=0.641(P<0.01), respectively. Conclusion The Chinese version of the APAIS has good reliability and validity to quick measure the preoperative anxiety and desire for information of patients. Key words: Amsterdam preoperative anxiety and information scale; Preoperative anxiety; Reliability; Validation

Assessment Of Preoperative Anxiety Using Visual Facial Anxiety Scale: An Alternative To The Verbal Rating Scale?

Background: Evaluating preoperative anxiety level can be a difficult task for physicians. The Visual Facial Anxiety Scale (VFAS) was designed as an alternative to the Verbal Rating Scale (VRS) for assessing the level of preoperative [state] anxiety. We hypothesized that the VFAS would provide a stronger correlation between the patient and anesthesiologist categorical anxiety assessments than the VRS. Methods: After obtaining IRB approval, 200 elective surgery patients were evaluated in the preoperative holding area. Patients were asked to evaluate their current anxiety level using the VFAS and the VRS, as well as to categorize their anxiety level as mild, moderate, or severe. The anxiety level was also assessed using the same categorical rating scale by the attending anesthesiologist. The anesthesiologists were also asked if they routinely evaluate the patient’s anxiety level during the preoperative visit. Results: A significant correlation was found between the VRS and VFAS for both patients (r=0.79, p<0.0001) and anesthesiologists (r=0.92, p<0.0001), but utilization of the VFAS resulted in 58% concordance of anxiety level between the patient and anesthesiologist (vs. only 35% with the VRS). Interestingly, 70% of anesthesiologists did not routinely evaluate the patients’ preoperative anxiety level. Conclusion: The VFAS is a simple tool which could be used for assessing preoperative anxiety. Anesthesiologists do not routinely evaluate patients’ anxiety levels preoperatively.

Preoperative Anxiety in Adolescents Undergoing Surgery

Summary Objectives: The purpose of this study was to conduct a prospective assessment of preoperative anxiety in adolescents undergoing surgery. Aim: To systematically conduct a multimodal evaluation of preoperative anxiety in adolescents undergoing surgery. Background: The existing literature on preoperative anxiety in children has overwhelmingly ignored adolescents in the surgical setting, yet adolescents may be at risk for under treatment of preoperative anxiety. Methods: A total of 59 adolescents aged 11–18 were recruited. Behavioral and physiological manifestations of anxiety were assessed with a visual analog scale and an ambulatory physiological data recorder that collected heart rate (HR), skin conductance level (SCL), and blood pressure data. Baseline emotional and behavioral functioning (child behavior checklist [CBCL]) as well as temperament (early adolescent temperament questionnaire-revised – parent version) and other potential risk factors were also assessed. Results: Over 80% of adolescents reported significant anxiety at the time of induction. Self-reported anxiety increased significantly at each time point (holding, separation from parents, and mask introduction), P = 0.001. Significant increases in both HR (P = 0.02) and SCL (P < 0.001) were found from holding to mask introduction. Several risk factors were found to predict higher anxiety at mask introduction, including baseline anxiety and depression (CBCL, Internalizing, P = 0.04), somatizing problems (P = 0.05), and fearful temperament (P = 0.03). Conclusions: A large proportion of adolescents experience significant anxiety that increases from the preoperative holding area to anesthesia induction. Underlying baseline anxiety and depression as well somatization and fearful temperament are predictors of this phenomenon.

Assessment of preoperative anxiety: comparison of measures in patients awaiting surgery for breast cancer

We have compared three measurements of anxiety to determine their equivalence in assessing anxiety before surgery. Forty-four patients awaiting breast cancer surgery completed the state scale of the state-trait anxiety inventory (STAI), the hospital anxiety and depression scale (HAD) and a 100-mm visual analogue scale (VAS). Analysis restricted to correlations between the scales gave the misleading impression that VAS scores were inconsistent with those of the HAD and STAI. However, when scores were considered in relation to normative cut-off values to categorize anxiety levels, the three scales showed good agreement. We conclude that the scales were equivalent in their assessment of anxiety before surgery, but that reference to normative data was important in establishing such equivalence and in determining the patient's state.