Summary
Background
Preoperative anxiety has the potential to alter the dynamics of an elective procedure
and has been shown to detrimentally affect patients both cognitively and physiologically.
If mismanaged, it can lead to essential procedures being postponed or canceled, delay
postoperative recovery, and increase patients' requirements for medical intervention
postoperatively. These outcomes have harmful implications both clinically and economically.
Our primary objective was to evaluate the levels of anxiety patients experience immediately
before elective otorhinolaryngologic procedures. Our secondary outcome was to assess
the subjects' views on potential management strategies to tackle their anxiety.
Methods
This is an observational cross-sectional project evaluating 53 patients who were selected
consecutively from a list of elective otorhinolaryngologic procedures. All procedures
were to be completed under general anesthetic, and all patients had received the same
preoperative assessment preparation. 29 male and 24 female patients were included,
aged between 19 and 76 years (mean 45). The Spielberger State-Trait Anxiety Inventory
was used to assess preoperative anxiety directly before the otorhinolaryngologic procedure.
The Service Improvement questionnaire was used to assess whether patients would favor
the introduction of anxiety-reduction measures.
Results
There was neither a significant increase in patient anxiety levels preoperatively
(P = 0.37) nor a significant increase in anxiety levels preoperatively when results
were stratified according to patient gender and age (P = 0.45 and P = 0.27). 54% of the patients felt that their anxiety would have been reduced if they
had read a procedural information leaflet, and 22% felt it would have been reduced
if they had received preoperative behavioral training. 17% of the patients wanted
more information from the surgical team. However, 12% of the patients would have liked
less information from the surgical team preoperatively.
Conclusions
Patients did not have a significant increase in their anxiety levels preoperatively.
On the basis of our findings, we will work to improve the information we provide to
patients preoperatively and to identify patient subgroups that require additional
preoperative support.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of VoiceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Patients' recall of preoperative instruction for informed consent for an operation.J Bone Joint Surg Am. 1991; 73: 160-162
- Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease.Arch Gen Psychiatry. 2008; 65: 62-71
- Anxiety predicts mortality and morbidity after coronary artery and valve surgery—a 4-year follow-up study.Psychosom Med. 2007; 69: 625-631
- Preoperative anxiety and intraoperative anesthetic requirements.Anesth Analg. 1999; 89: 1346-1351
- Predictors of postoperative pain and analgesic consumption: a qualitative systematic review.Anesthesiology. 2009; 111: 657-677
- Hypnosis and daycase anaesthesia: a study to reduce pre-operative anxiety and intra-operative anaesthetic requirements.Anaesthesia. 1988; 43: 466-469
- Preoperative anxiety and postoperative pain in women undergoing hysterectomy. A repeated-measures design.J Psychosom Res. 2000; 49: 417-422
- Preoperative anxiety and postoperative satisfaction in women undergoing elective caesarean section.Int J Obstet Anesth. 2006; 15: 18-23
- Prediction and assessment of the severity of post-operative pain and of satisfaction with management.Pain. 1998; 75: 177-185
- Risk factors for preoperative anxiety in adults.Acta Anaesthesiol Scand. 2001; 45: 298-307
- Surgery information reduces anxiety in the pre-operative period.Rev Hosp Clin Fac Med Sao Paulo. 2004; 59: 51-56
- Patient anxiety and elective gastrointestinal endoscopy.J Clin Gastroenterol. 2004; 38: 35-40
- Manual for the State-Trait Anxiety Inventory.Consulting Psychologists Press, Palo Alto, CA1970
- Manual for the State-Trait Anxiety Inventory STAI.Consulting Psychologists Press, Inc, Redwood City, CA1983
- Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia.Br J Anaesth. 2010; 104: 369-374
- Do patient information booklets increase perioperative anxiety?.Eur J Anaesthesiol. 2001; 18: 620-622
- Drug patient information leaflets in anaesthesia: effect on anxiety and patient satisfaction.Br J Anaesth. 2004; 92: 854-858
- Interventions for reducing anxiety in women undergoing colposcopy.Syst Rev. 2007; (CD006013)
- Effect of informed consent format on patient anxiety, knowledge, and satisfaction.Am Heart J. 2011; 162: 780-785
- Relaxing music as pre-medication before surgery: a randomised controlled trial.Acta Anaesthesiol Scand. 2002; 39: 352-359
- A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate.J Adv Nurs. 2002; 39: 352-359
Article info
Publication history
Published online: May 09, 2018
Accepted:
February 13,
2018
Footnotes
Conflict of interest: The authors report no conflicts of interest.
Author contribution: Each listed author has contributed to the design and implementation of this report.
Ethics, consent to publish, and permissions: All ethical and institutional guidelines have been met and written consent to publish has been provided for all study participants.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
