Understanding preoperative anxiety in patients before elective surgical intervention
Desu Ramamohan1, S Indira2, Sreeram Sateesh3, S Satish Kumar1, Prashant Bhandarkar4, NR Sahana Bhat1, Radhika Gorantla1, M Jahnavi5, Meena Nathan Cherian6, Amit Agrawal5
1 Department of Hospital Administration, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
2 College of Nursing, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
3 Department of General Surgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
4 Department of Statistics, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
5 Department of Neurosurgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
6 Director Integrated Emergency & Surgical Care Program, Geneva Foundation of Medical Education and Research, Geneva, Switzerland
Dr. Amit Agrawal
Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore - 524 003, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Background: Understanding the preoperative fears and anxieties in patients who are planned for surgical procedure is of paramount importance.
Objective: To know the preoperative levels of anxiety in patients who received versus who did not receive The World Health Organization (WHO) tool before undergoing elective surgical intervention.
Materials and Methods: The present study was conducted in the departments of surgical disciplines of Narayana Medical College and Hospital, Nellore. For the project, a total of 100 (50 in each group) adult patients (>18 years and <60 years) who were planned for elective surgical intervention were included in the study. Informed consent was obtained from the patients. The WHO's “Patient Communication Tool: What you need to know before and after surgery” which helps the surgical patients to ask the questions related to their surgery and related events was used to provide information. “The Amsterdam Preoperative Anxiety and Information Scale” which is a 6-item questionnaire with the scores ranging from 4 (not anxious) to 20 (highly anxious) was used to measure the preoperative anxiety. The patients were divided in two groups: Group A (those who did not receive the questionnaire) and Group B (those who received the questionnaire). SPSS (version 24.0 for Macintosh) was used for data analysis.
Results: Median age of all the participants was 49 years. Age, gender, and education status, both the groups were not statistically significant. Based on the analysis, it was found that in Group A, patients had slighter higher response score than that of Group B. However, mean difference between both the groups was not found to be statistically significant. Mean response score of individual question, between both the groups, were significantly different in half questions, while not significant in remaining half of the questions. Among six questions, statistically significant (P = 0.017) difference was found in anesthesia-related responses. While for procedure-related responses, difference in mean responses was not statistically significant (P = 0.331).
Conclusion: Effective physician–patient communication is the key in establishing trust, resulting in delivering a satisfactory care to the patient. There is a need to carry out further studies with an inclusion of a larger number of participants with a more precise tool to impart the knowledge about the surgical intervention and to ameliorate the peri-operative anxiety in patients who are undergoing surgical intervention.
The following core competencies are addressed in this article: Patient care, Communication skills, Practice based learning and improvement.