Assessment of anxiety in patients awaiting surgery in a referral hospital in Rwanda

Abstract

BackgroundPreoperative anxiety is a common occurrence in patients awaiting surgery. Preoperative anxiety adversely affects anaesthesia and surgical process and increases the risk of postoperative complications. Level of anxiety in patients awaiting surgical procedures in Rwanda is not well known or documented. Objective To assess preoperative anxiety and associated factors of patients awaiting surgery at a teaching hospital in Kigali. Methods A cross-sectional study design was adopted. A convenience sampling method was used to recruit 151 adult patients, and the instrument entitled "Pre-operative Intrusive Thoughts Inventory (PITI)" anxiety scale was used to assess anxiety. Descriptive and inferential statistics were used to analyse data. ResultsNearly three quarters (72.8%) of participants had a high level of clinically significant preoperative anxiety. Patients awaiting orthopaedic surgery were 10 times more likely to have clinically significant pre-operative anxiety (OR 10.22; 95%; CI 1.144 -91.304; P= 0.037), whereas participants with impending Cesarean (OR: 0.03; 95% CI-0.002-0.568; P=0.018), and older participants had decreased pre-operative anxiety levels (OR: 0.22; 95% CI 0.075 -0.650; P=0.006). ConclusionPatients awaiting surgery had clinically significant pre-operative anxiety level (72.8%) associated with age, medical diagnosis and type of surgical intervention. A preoperative intervention incorporating individual characteristics is needed to reduce preoperative anxiety.

Preoperative anxiety in Ethiopia: a systematic review and meta-analysis

“…This finding is lower than a study conducted in Tunisia [25], Pakistan [23] and Rwanda [27]. This discrepancy might be due to the difference in the study setting and population.…”

Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis

“…Of the total 27 studies (5575 population), all (100%) studies employed cross-sectional study design, and 9 (81.2%) studies published in the past 5 years 14–18 38 52–54. Also, six studies were conducted in Ethiopia,5 14–18 five studies were from Brazil55–59 and three studies were from each of the following countries: Nigeria,38 54 60 Pakistan11 12 61 and India 61–63.…”

“…The results extracted from studies conducted on factors associated with preoperative anxiety among patients undergoing surgery are presented in online supplemental file 5. Associated factors that have been adjusted in the studies included in this review were inconsistent across studies conducted in LMICs 5 12 14–18 52 53 56 58 59 63–68…”

<p>Preoperative Anxiety and Associated Factors Among Adult Elective Surgery Patients in North Wollo Zone, Northeast Ethiopia</p>

“…19 However, the result of this study was lower than the studies done in Pakistan 62%, 24 Brazil 53%, 15 Tunisia 67.5%, 25 and Rwanda 72.8%. 18 The plausible justification for this variation might be due to the use of different assessment tools and a difference in the methodology part. In the same way, the result of this study was lower than studies conducted in Ethiopia; at the University of Gondar hospital 59.6%, 9 Jimma University Specialized Teaching Hospital 70.3%, 20 and in Debre Markos and Felege Hiwot referral hospitals 61%.…”

“…Besides, the prevalence of preoperative anxiety was 53% in Brazil, 15 63% in Pakistan, 16 67% in Tunisia, 17 and 72.8% in Rwanda. 18 In Ethiopia, preoperative anxiety is a common mental health problem and its magnitude ranges from 47% 19 to 70.3%. 20 There are only a few relevant studies on preoperative anxiety among surgical patients in developing countries, particularly in Ethiopia.…”