Anxiety and quality of recovery in day surgery: A questionnaire study using Hospital Anxiety and Depression Scale and Quality of Recovery Score

Abstract

The aims of this study were (i) to examine the association between preoperative and postoperative anxiety, and (ii) to examine the association between preoperative anxiety and postoperative recovery, following day surgery under general anaesthesia. Day surgery has become more commonplace owing to advances in pharmacology, anaesthetic and surgical techniques, as it has recognized benefits, such as lower costs and reduced incidence of infection. Recent years have seen increased complexity of day surgery undertaken on a broader range of patients, but with reduced pre-surgery contact with the hospital environment. These recent service changes might have had an effect on the preparation of patients for day surgery, and this in turn might have affected their postoperative recovery. This pilot study used survey methods to examine potential associations between preoperative and postoperative anxiety, and between preoperative anxiety and postoperative recovery. Data were collected in 2008 from a convenience sample of 54 day surgery patients. The instruments used were the Hospital Anxiety and Depression Scale (HADS) and the Quality of Recovery Score (QoR-40). There was a statistically significant relationship between preoperative and postoperative anxiety (χ(2) =11.899, d.f.=1, P=0.001). The T-test showed a statistically significant difference in the mean scores for QoR-40 score for gender, and for the postoperative anxiety and QoR-40. A relationship between preoperative anxiety and postoperative recovery was not shown. Although challenging to implement in view of restricted timescales, appraisal and revision of pre-assessment processes to incorporate an anxiety measurement tool, such as the HADS, should be considered.

Comparison of Patient Satisfaction Between General and Spinal Anaesthesia in Emergency Caesarean Deliveries

“…A study from India showed that preoperative contact did not decrease anxiety; however, intraoperative psychological support, showing the baby to her mother and early breastfeeding were related to patient satisfaction in patients undergoing caesarean delivery under spinal anaesthesia (16). Another analysis including 1793 patients in 22 studies showed that when women were asked which mode of anaesthesia they would prefer in subsequent surgery, those who received general anaesthesia stated that they would prefer general anaesthesia again (17 A study from England evaluated anxiety levels and recovery scores and showed that anxiety levels were high in women preoperatively and dropped significantly postoperatively (9). The same study concluded that preoperative anxiety had no effect on recovery scores, but postoperative anxiety levels were correlated with recovery scores.…”

“…Further, satisfaction with the mode of anaesthesia was related to emotional status and pain subgroups of QoR-40 in Group SA. There was no relationship (9,10). Emergency caesarean delivery is an immediate decision; psychological or preoperative preparation is not sufficient in such cases and it is associated with a risk of foetal-maternal mortality and morbidity.…”

“…Emergency operations and female gender are factors that increase anxiety preoperatively (9,10). Patients admitted for emergency caesarean delivery are neither physically nor psychologically prepared for the operation.…”

Addressing the Barriers to Pain Management in Ambulatory Surgery

“…Anxiety should be identified as a risk factor and predictor of suboptimal outcomes and should not be ignored. 9 Patients who have a lack of knowledge into their postoperative recovery trajectory can have compromised comfort and satisfaction levels as this gap can exacerbate anxiety and hinder their recovery. 1 PA nurses are the ambassadors for patient safety, ensuring that health teaching is one of the multimodal pain management strategies used to facilitate a smooth recovery process at home.…”

The experience of being awake during orthopaedic surgery under regional anaesthesia

“…Waiting for and undergoing day surgery might lead to feelings of anxiety and fear (McIntosh and Adams, 2011). According to Haugen et al (2009) patients with regional anaesthesia experienced the highest level of anxiety at induction of anaesthesia.…”