Objectives Preoperative anxiety is common and might affect surgical treatment outcomes. The aim was to translate and validate the Serbian version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Methods Following translation and initial evaluation, the Serbian version (S‐APAIS) was administered to 385 patients. Internal consistency, construct validity, prognostic criteria validity, and concurrent validity between S‐APAIS and Visual Analogue Scale for Anxiety (VAS‐A) were evaluated. Results Factor analysis revealed two factors: APAIS‐anesthesia (items 1, 2, 3) and APAIS‐procedure (items 4, 5, 6). The whole scale, APAIS‐anesthesia, and APAIS‐procedure subscales showed an adequate level of internal consistency (Cronbach's αs: 0.787, 0.806, and 0.805, respectively). High concurrent validity was observed between APAIS‐anesthesia and VAS‐A (ρ = 0.628, p < .001). A moderate correlation was found between APAIS‐procedure and VAS‐A scale (ρ = 0.537, p < .001). At the cut‐off point of 9, the area under the curve (AUC) of APAIS‐anesthesia was 0.815 (95% CI: 0.77–0.85, p < .001). For the APAIS‐procedure, AUC was 0.772 (95% CI: 0.73–0.81, p < .001) at the cut‐off point of 8. Conclusion The structure of S‐APAIS substantially differs from the original and allows separate measurement of anesthesia‐ and procedure‐related anxieties. S‐APAIS is a comprehensive, valid, and reliable instrument for the measurement of preoperative anxiety.
Background Preoperative anxiety is associated with increased morbidity and/or mortality in surgical patients. This study investigated the incidence, predictors, and association of preoperative anxiety with postoperative complications in vascular surgery. Methods Consecutive patients undergoing aortic, carotid, and peripheral artery surgery, under general and regional anesthesia, from February until October 2019 were included in a cross‐sectional study. Anesthesiologists assessed preoperative anxiety using a validated Serbian version of the Amsterdam Preoperative Anxiety and Information Scale. Patients were divided into groups with low/high anxiety, both anesthesia‐ and surgery‐related. Statistical analysis included multivariate linear logistic regression and point‐biserial correlation. Results Of 402 patients interviewed, 16 were excluded and one patient refused to participate (response rate 99.7%). Out of 385 patients included (age range 39–86 years), 62.3% had previous surgery. High‐level anesthesia‐ and surgery‐related anxieties were present in 31.2 and 43.4% of patients, respectively. Independent predictors of high‐level anesthesia‐related anxiety were having no children (OR = 0.443, 95% CI: 0.239–0.821, p = 0.01), personal bad experiences with anesthesia (OR = 2.294, 95% CI: 1.043–5.045, p = 0.039), and time since diagnosis for ≥ 4 months (OR = 1.634, 95% CI: 1.023–5.983, p = 0.04). The female sex independently predicted high‐level surgery‐related preoperative anxiety (OR = 2.387, 95% CI: 1.432–3.979, p = 0.001). High‐level anesthesia‐related anxiety correlated with postoperative mental disorders (rpb = 0.193, p = 0.001) and pulmonary complications (rpb = 0.104, p = 0.042). Postoperative nausea (rpb = 0.111, p = 0.03) and postoperative mental disorders (rpb = 0.160, p = 0.002) correlated with high‐level surgery‐related preoperative anxiety. Conclusions Since preoperative anxiety affects the postoperative course and almost every third patient experiences anxiety preoperatively, routine screening might be recommended in vascular surgery.
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