Anxiety in the Preoperative Period: Associated Risk Factors and General Health Condition

Abstract

Anxiety is defined as a terrible experience of fear, apprehension, tension and stress; it is one of the most common events that can happen to patients awaiting surgery. It has many psychological and physiological side effects. Despite the high prevalence rates of Preoperativeanxiety in clinical practice, it is often under recognized and under managed clinical problem.

Aim: The aim of this study is to find out the extent of this type of anxiety with recognition of the factors and health status of patients that are involved in its emergence in the preoperative stage at Al Hussein Teaching Hospital and obstetric hospital in the city of Samawah, which is located In the center of Al-Muthanna Governorate, 270 km south of Baghdad.

Method: A cross-sectional study that started from October 2019 to March 2020 at Al Hussein Teaching Hospital and obstetric hospital, one hundred patients were randomly selected from patients awaiting surgery, and they have given their signature by agreeing to study them. The anxiety level was measured by the State and Trait Anxiety Inventory. Statistical analysis had been done using “SSPS “version 26, descriptive statistics and binary logistic regression analysis “has been used to determine predictors of preoperative anxiety. Correlation strength was examined using OR with “95%confidenceinterval, P-value less than 0.05 were considered as statistically significant.

Results: Total of 100 patients (56 male and 44 female) who participated in the study, 67% of them had high pre-operative anxiety, which was more at the age of 60 years and above (OR=14.815, p-value = 0.012 ), high anxiety when there were no income (OR=3.007, p-value = 0.038) and there were current smoking (OR=3.310, p-value= 0.044). 71% of patients had Fear of postoperative pain, 67% had fear of complications after surgery, and 58% had fear of not regaining awareness after the end of anesthesia. These fears were leading sources of preoperative anxiety. After statistical analysis, the Preoperative anxiety was correlated significantly to many factors, such as:

Fear of become permanently disabled (OR=12.990, p-value=0.000), fear of death (OR=12.267, p-value=0.000),

Fear of not waking up after surgery (OR=5.811, p-value=0.000),

Fear of complication (OR=5.138, p-value=0.000), Supra major surgery (OR=27.389, p-value=0.000),

Fear of postoperative pain (OR=4.870, p-value=0.001), fear of medical errors (OR=3.348, p-value=0.007), fear of nothing orally after surgery (OR=3.220, p- alue=0.01), fear of waking up in middle of the surgery (OR=3.154, p-value=0.008).

Cancer (OR-8.453, p-value=0.008), no history of previous surgery (OR=0.123, p-value=0.00), previous hospitalization (OR=3.910, p-value=0.03), Preoperative pain (OR=3.910, p-value=0.003).

Conclusion: Preoperative anxiety was high in a sample of Iraqi patients. It is linked to several Sociodemographic factors such as: old age, low monthly income, smoking, and it is also linked to several factors that relate to the patient’s evaluation of the severity of the risk he has to face, such as the possibility of disability or death. The general health situation and the grade of the surgery also determine the extent of the appearance of pre-operative anxiety. Patients need to be constantly evaluated about anxiety in the preoperative period and then find ways to reduce it.