Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis

Abate, Semagn Mekonnen; Chekol, Yigrem Ali; Basu, Bivash

doi:10.1016/j.ijso.2020.05.010

Cited by 95 publications

(87 citation statements)

References 71 publications

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“…The pooled estimate in the current review was higher when compared with the pooled prevalence reported in a global level systematic review and meta-analysis that included 14 652 study participants (48%). 7 Likewise, the pooled estimate of our review was higher than the estimates from different epidemiological studies conducted in HICs such as the Netherlands reported that 27.9% and 20.3% of patients undergoing hip and knee surgery, respectively, experienced anxiety symptoms before the actual surgery. 8 The variation in the demographic characteristics of participants and may partly explain the observed difference in the pooled estimates.…”

Section: Discussioncontrasting

confidence: 68%

“…For example, a global level systematic review and meta-analysis reported a 48% pooled prevalence of preoperative anxiety among patients undergoing surgery. 7 A facility-based study conducted in Netherland found 27.9% and 20.3% of preoperative anxiety in patients undergoing hip and knee surgery, respectively. 8 Epidemiological studies conducted in low/middle-income countries (LMICs) found that the prevalence of preoperative…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis

2022

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ObjectivesThis review aimed to determine the pooled prevalence of preoperative anxiety and its associated factors among patients undergoing surgery in low/middle-income countries (LMICs).MethodsWe searched PubMed, SCOPUS, CINAHL, Embase and PsychINFO to identify peer-reviewed studies on the prevalence and factors associated with preoperative anxiety among patients undergoing surgery using predefined eligibility criteria. Studies were pooled to estimate the prevalence of preoperative anxiety using a random-effect meta-analysis model. Heterogeneity was assessed using I² statistics. Funnel plot asymmetry and Egger’s regression tests were used to check for publication bias.ResultOur search identified 2110 studies, of which 27 studies from 12 countries with 5575 participants were included in the final meta-analysis. Of the total 27 studies, 11 used the State-Trait Anxiety Inventory to screen anxiety, followed by the Amsterdam Preoperative Anxiety and Information scale, used by four studies. The pooled prevalence of preoperative anxiety among patients undergoing surgery in LMICs was 55.7% (95% CI 48.60 to 62.93). Our subgroup analysis found that a higher pooled prevalence of preoperative anxiety was found among female surgical patients (59.36%, 95% CI 48.16 to 70.52, I2=95.43, p<0.001) and studies conducted in Asia (62.59%, 95% CI 48.65 to 76.53, I2=97.48, p<0.001).ConclusionOur meta-analysis indicated that around one in two patients undergoing surgery in LMICs suffer from preoperative anxiety, which needs due attention. Routine screening of preoperative anxiety symptoms among patients scheduled for surgery is vital.PROSPERO registration numberCRD42020161934.

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Section: Discussioncontrasting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis

2022

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“…A 2020 study found that 48% of surgical patients are anxious before their surgery [5]. This anxiety will have an impact on both the flow of the surgery and the post-operative recovery process [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Preoperative anxiety, feelings of discomfort and tension, along with other physical and autonomic symptoms, therefore results before surgery [ 3 , 4 ]. A 2020 study found that 48% of surgical patients are anxious before their surgery [ 5 ]. This anxiety will have an impact on both the flow of the surgery and the post-operative recovery process [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Anxiety among Adult Patients Undergoing Elective Surgeries at a Tertiary Teaching Hospital: A Cross-Sectional Study during the Era of COVID-19 Vaccination

et al. 2022

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Anxiety in the perioperative period has significant impact on both the flow of surgery and the post-operative recovery process. The aim of this cross-sectional study is to determine the prevalence of preoperative anxiety among adult patients undergoing elective surgical procedures at a tertiary teaching hospital and the effect of COVID-19 and COVID-19 vaccines on preoperative anxiety. We used the Amsterdam Preoperative Anxiety and Information Scale (APAIS) to assess patients’ anxiety toward surgery and their need for more information. Patients with APAIS about anesthesia and surgery (APAIS-A-T) total score <10 were considered as the low preoperative anxiety group, while patients with APAIS-A-T ≥11 were considered as the high preoperative anxiety group. The overall APAIS-A-T score of the 794 included patients was 8.5 ± 4.5. The mean APAIS-A-T score was 7.0 ± 3.8 among males and 9.6 ± 4.6 among female patients (p < 0.001). The APAIS-A-T score for those who had previously underwent surgery under anesthesia was 8.3 ± 4.4, compared to 9.5 ± 4.8 for those who had not (p = 0.002). No significant difference was found between those with a previous history of COVID-19 and those without (p = 0.105), nor between those who were vaccinated and those who were not (p = 0.550). Sixty-four (26.8%) highly anxious patients were afraid of becoming infected with COVID-19 during their hospital stay (p = 0.009). This fear of COVID-19 in-hospital transmission made 19 (7.9%) highly anxious patients and 36 (4.5%) of the total sample hesitant to undergo this surgery (p = 0.002). In conclusion, this study demonstrated that 30.1% of patients had high preoperative anxiety, with fear of pain after surgery being the most common factor related to anxiety on the day of surgery. Controlling the spread of COVID-19 can play a crucial role in decreasing preoperative anxiety during this pandemic.

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“…9,13 Globally, approximately 50% of patients scheduled for elective surgery experienced preoperative anxiety. 14 Studies reported from different countries showed that the prevalence of preoperative anxiety was high. Besides, the prevalence of preoperative anxiety was 53% in Brazil, 15 63% in Pakistan, 16 67% in Tunisia, 17 and 72.8% in Rwanda.…”

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confidence: 99%

<p>Preoperative Anxiety and Associated Factors Among Adult Elective Surgery Patients in North Wollo Zone, Northeast Ethiopia</p>

Wondmieneh¹

2020

OAS

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Background: Higher levels of preoperative anxiety may be associated with life-threatening postoperative complications and increase the risk of postoperative mortality. Therefore, this study aimed to assess the prevalence and associated factors of high level of preoperative anxiety among elective surgical patients in North Wollo Zone, Northeast, Ethiopia. Methods: Hospital-based, cross-sectional study was conducted on 211 patients scheduled for surgery. Participants were selected using a systematic random sampling method. The data were collected using the state-trait anxiety inventory scale. Participants who scored STAI scale >44 were considered as experiencing a high level of preoperative anxiety. Reliability of the questionnaire was assessed (Cronbach's alpha coficient=0.84). The data were entered using EpiData version 4.2 and analyzed using SPSS version 24. Binary logistic regression was computed to determine the predictors of preoperative anxiety. A p-value < 0.05 at 95% Cl was considered as significant predictors of high-level preoperative anxiety. Results: A total of 211 participants were involved in this study with a response rate of 97.7%. The prevalence of high level of preoperative anxiety among elective surgical patients scheduled for surgery was 102 (48.3%). Factors such as fear of death (AOR=6.72, CI=(2.56, 17.66)), fear of unexplained origin (AOR=4.98, 95% (CI: 1.91, 12.97)) and fear of postoperative pain (AOR=4.39 95% (CI=2.17, 8.88)) were significant predictors of preoperative anxiety. Conclusions and Recommendations: The prevalence of high level of preoperative anxiety was high. Fear of death, fear of unknown origin, and fear of postoperative complications were significant predictors of preoperative anxiety. The preoperative nursing care focused on appropriate anxiety-reducing methods such as preoperative education, familycentered preparation for surgery, providing psychological care and medication can be required for surgical patients who develop high levels of preoperative anxiety.

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Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis

Cited by 95 publications

References 71 publications

Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis

Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis

Preoperative Anxiety among Adult Patients Undergoing Elective Surgeries at a Tertiary Teaching Hospital: A Cross-Sectional Study during the Era of COVID-19 Vaccination

<p>Preoperative Anxiety and Associated Factors Among Adult Elective Surgery Patients in North Wollo Zone, Northeast Ethiopia</p>

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