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Anaesthetists' and surgeons' estimation of preoperative anxiety by patients submitted for elective surgery in a university hospital

Published online by Cambridge University Press:  24 January 2006

F. Fekrat ,
A. Sahin ,
K. M. Yazici  and
U. Aypar
F. Fekrat
Affiliation:
Hacettepe University Hospital, Department of Anaesthesiology, Ankara, Turkey
A. Sahin
Affiliation:
Hacettepe University Hospital, Department of Anaesthesiology, Ankara, Turkey
K. M. Yazici
Affiliation:
Hacettepe University Hospital, Department of Psychiatry, Ankara, Turkey
U. Aypar
Affiliation:
Hacettepe University Hospital, Department of Anaesthesiology, Ankara, Turkey
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Extract

Summary

Background and objective: Preoperative anxiety is a challenging concept in the preoperative care of patients. The hypothesis of this study was that the doctors are able to estimate their patients' preoperative anxiety. Methods: A prospective clinical trial was performed on 67 adult patients and 26 paired anaesthetists and surgeons. The patients filled out two separate visual analogue scales for anxiety for the planned anaesthesia and surgery. After that the ‘anxiety subscale’ of the Hospital Anxiety and Depression's Scale was completed and a list of fearsome items was presented as the patients were asked to choose two conditions they considered the most frightening. Finally the patients were asked to select one or more items from a list of things, which they considered likely to relieve their preoperative anxiety. Similarly, the participating doctors were asked to estimate their patients' anxiety, guess their fearful conditions and their anxiety-relieving requests. Results: Median scores for anxiety as estimated with visual analogue scales by anaesthetists, surgeons and patients for anaesthesia were 34, 36 and 6, respectively; and for surgery 53, 47 and 9, respectively. The anxiety subscale of the Hospital Anxiety and Depression's Scale 8.9 ± 4.2, 8.6 ± 4.6 and 6.5 ± 4.5 (mean ± SD), respectively. Doctors' scores were significantly higher than the patients' scores (P < 0.05). Thus, the anaesthetists and the surgeons were unable to estimate their patients anxiety on any of the scales used (Kendall's τ < 0.25; P < 0.05). The proportion of correct estimation of the fearsome items was 20% for both the anaesthetists and the surgeons. Conclusions: Both anaesthetists and surgeons overestimated their patients' preoperative anxiety by a wide margin and poorly predicted their patients' feared conditions and their desire for relief of anxiety.

Keywords

BEHAVIOUR AND BEHAVIOUR MECHANISMS, EMOTIONS, anxiety, fearHEALTH CARE EVALUATION MECHANISMS, patient satisfactionHEALTH PERSONNEL, physiciansHEALTH SERVICES, PATIENT CARE, preoperative careMEDICINE, SPECIALITIES, anaesthesiology, surgery
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 3 , March 2006 , pp. 227 - 233
Copyright
© 2006 European Society of Anaesthesiology

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References

Mathews A, Ridgeway V. Personality and surgical recovery: a review. Br J Clin Psychol 1981; 20: 243–260.Google Scholar
Marantets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg 1999; 89: 1346–1351.Google Scholar
Anderson EA, Masur FT. Psychological preparation for invasive medical and dental procedures. J Behav Med 1983; 6: 1–40.Google Scholar
Thomas V, Heath M, Rose D, Flory P. Psychological characteristics and effectiveness of patient of patient-controlled analgesia. Br J Anaesth 1995; 74: 271–276.Google Scholar
Wells JK, Howard GS. Presurgical anxiety and postsurgical pain and adjustment: effects of a stress inoculation procedure. J Consult Clin Psychol 1986; 54: 831–835.Google Scholar
Leigh JM, Walker J, Janganathan P. Effect of preoperative visit on anxiety. BMJ 1977; 2: 987–989.Google Scholar
Egan KJ, Ready LB, Nelssy M, Geer BE. Self-administration of midazolam for postoperative anxiety: a double blinded study. Pain 1992; 49: 3–8.Google Scholar
Cushman LA, Dijkers MP. Depressed mood in spinal cord injured patients: staff perceptions and patient realities. Arch Phys Med Rehabil 1990; 71: 191–196.Google Scholar
Lawson NC. Significant events in the rehabilitation process: the spinal cord patient's point of view. Arch Phys Med Rehabil 1978; 59: 573–579.Google Scholar
Pepper GA. The person with a spinal cord injury: psychological care. Am J Nurs 1977; 77: 1330–1336.Google Scholar
Aitken RCB. Measurement of feelings using visual analog scales. Proc R Soc Med 1969; 62: 17–24.Google Scholar
Zigmond A, Snaith R. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361–370.Google Scholar
von Essen L, Burström L, Sjöden P-O. Perceptions of caring behaviors and patient anxiety and depression in cancer patient-staff dyads. Scand J Caring Sci 1994; 8: 205–212.Google Scholar
Shafer A, Fish MP, Gregg KM, Seavello J, Kosek P. Preoperative anxiety and fear: a comparison of assessments by patients and anesthesia and surgery residents. Anesth Analg 1996; 83: 1285–1291.Google Scholar
Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients' anesthetic concerns. Anesth Analg 2000; 90: 706–712.Google Scholar
Tolksdorf W, Merkel G, Rehder H, Rey ER, Berlin J. Psychologische Aspekte der Spinalanaesthesie. Anaesthesist 1984; 33: 307–310.Google Scholar
Vogelgsang J. The visual analog scale: an accurate and sensitive method for self-reporting preoperative anxiety. J Post Anesth Nursing 1988; 3: 235–239.Google Scholar
Hicks JA, Jenkins JG. The measurement of preoperative anxiety. J Roy Soc Med 1988; 81: 517–519.Google Scholar
Lampic C, von Essen L, Peterson VW, Larsson G, Sjöden P-O. Anxiety and depression in hospitalized patients with cancer: agreement in patient-staff dyads. Cancer Nurs 1996; 19: 419–428.Google Scholar
Shevde K, Panagopoulos G. A survey of 800 patients' knowledge, attitudes, and concerns regarding anaesthesia. Anesth Analg 1991; 73: 190–198.Google Scholar
Domar AD, Everett LL, Keller MG. Preoperative anxiety: is it a predictable entity? Anesth Analg 1989; 69: 763–767.Google Scholar
Cowan SA, Engbaek J, Kyst A, Rosenstock CV, Jensby K, Jensen L. Information, satisfaction and anxiety in connection with anesthesia. A questionnaire study. Ugeskr Laeger 2000; 162: 1231–1235.Google Scholar
Brock G, Guerkas V, Deom P. Denial among cancer patients. Can Fam Physician 1993; 39: 2581–2584.Google Scholar
Dansak D, Cordes R. Cancer: denial or suppression? Int J Psychiatry Med 1978–1979; 9: 257–262.Google Scholar
Collins R, Taylor S, Skokan L. A better world or a shattered vision? Changes in life perspectives following victimization. Soc Cogn 1990; 8: 263–285.Google Scholar
Keany KH, Glueckauf R. Disability and value changes: an overview and reanalysis of acceptance of loss theory. Rehabil Psychol 1993; 38: 199–210.Google Scholar
Taylor C, Crisler J. Concerns of persons with cancer as perceived by cancer patients, physicians, and rehabilitation counselors. J Rehabil 1988; 54: 23–28.Google Scholar
Breetvelt I, van Dam F. Underreporting by cancer patients: the case of response-shift: Soc Sci Med 1991; 32: 981–987.Google Scholar
Caumo W, Schmidt AP, Schneider CN et al. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand 2001; 45: 298–307.Google Scholar