Prevalence of pre-operative anxiety and associated factors among a group of women undergoing gynaecological surgeries at a single unit in a tertiary care hospital in Sri Lanka

Abstract

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.

Preoperative anxiety and associated factors among women admitted for elective obstetric and gynecologic surgery in public hospitals, Southern Ethiopia: a cross-sectional study

“…the result was in line with the study's findings of India at 55% [ 15 ]. However, the finding is higher than studies conducted in Thailand 23.2% [ 13 ], and Seri Lanka 40.6% [ 19 ]. This higher level of preoperative anxiety in this study might be due to the low education status of the women, poor quality of preoperative visits and evaluation, and also living in non-civilized countries like Ethiopia, which makes the patient poor access to perioperative information and education makes the patient anxious [ 35 ], and also obstetric patients become more anxious due to fear and concern for the unborn fetus in addition to themselves.…”

“…The magnitude of preoperative anxiety among surgical patients differs in different countries' reports and operations types are as high as 92.6% [ 12 ] and also preoperative anxiety was highly observed in women in obstetrics and gynecologic procedures which accounts Thailand 23.2% [ 13 ], India 55% to 63.54% [ 14 , 15 ], England 67% [ 16 ], Pakistan 72.7% [ 17 ], Nepal 51.81% [ 18 ] Sir Lanka 40.6% [ 19 ]. Whereas preoperative anxiety among women admitted for obstetrical surgeries in Ethiopia accounts 63% [ 20 ].…”

“…The outcome variable preoperative anxiety was assessed with APAIS, which is widely used to assess pre-operative anxiety, and consists of six questions that assess three components of anxiety; anesthesia-related anxiety, surgery-related anxiety, and information desire component used and validated in different countries like Sri Lanka [ 19 ], and Nepal [ 18 ].…”

Prevalence of Pre-Operative Anxiety and Predictors among Elective Surgical Patients and Their Pre-Operative Hemodynamic Changes at Muhimbili National Hospital

“…Moreover, different studies have demonstrated the association between economic status and pre-operative anxiety which could be reflected as admission category in our study. Higher economic status has been associated with low prevalence of anxiety [12] [19] [24]. A good explanation for such findings in our study could be based on special care, adequate information on both anaesthesia and surgery as well as close follow-up perioperatively given to ex- Patients with prior history of surgery are likely to be less anxious as compared to the ones who are first-time experience [29].…”

Perioperative Ängste und die Angst vor dem Tod

“…Tatsächlich finden sich nur wenige Untersuchungen, bei denen die Operationsangst stärker als die anästhesiebezogene Angst ausfällt. Dies betrifft Operationen, die von den Patienten als schwere, teilweise den Körper verstümmelnde Eingriffe erlebt werden [ 22 ].…”