Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia

Abstract

Background Major life changes are among factors that cause anxiety, and one of these changes is surgery. Hospitalization, regardless of disease, is known to provoke anxiety in the patient admitted for surgery. Anxiety is an unpleasant disturbing experience that involves way of thinking of tension, apprehension, uneasiness and high autonomic activity. Patients with high levels of anxiety require higher doses of anesthetic induction agents and recover poorly. The objective of this study was to investigate the prevalence of preoperative anxiety and its predictors among adult patients scheduled for elective surgery. Methodology Institutional based cross sectional study was conducted using interviewer administered structured questionnaire in Yirgalem zonal hospital in Ethiopia from November 1, to December 30, 2018 on 407 patients scheduled for elective surgery. The study included all patients with age greater than 18 years who were undergoing surgery. Patients with known anxiety disorder and unable to communicate were excluded from the study. State and trait anxiety inventory (STAI) measurement scale was used to assess preoperative anxiety. Statistical analysis was performed using SPSS version 22. Binary logistic regression analysis was performed to determine the predictors of preoperative anxiety. The strength of the association was presented using AOR with 95% confidence interval and p -value < 0.05 was considered as statistically significant. Results Among a total of 402 patients enrolled in the study 228 (56.7%) were male. The prevalence of preoperative anxiety among scheduled patients for elective surgery was 47.0%. Having strong social support (AOR = .16 CI = 0.07, 0.34), harm from doctor or nurse mistake (AOR = 5.03, CI = 2.85, 8.89), unexpected result of operation (AOR = 3.03, CI = 1.73, 5.19), unable to recover (AOR = 2.96, CI = 1.18, 4.87), and need of blood transfusion (AOR = 2.76, CI = 1.65, 4.62) were significantly associated with preoperative anxiety. Conclusion In the current study the prevalence of preoperative anxiety was high (47%). Having strong social support, unexpected result of operation, harm from doctor or nurse mistake, need of blood transfusion, and unable to recover were found to be statistically significant for preoperative anxiety. Patients need to be assessed regularly for anxiety during the preoperative visit. Electronic supplementary material The online version of this article (10.1186/s13037-019-0198-0) contains supplementary material, which is available to authorized users.

Global Prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and Meta-analysis

“…Prevalence of preoperative anxiety among surgical patients in Ethiopia was very which varied from 47-70.3% (21,(34)(35)(36) and other studies in Africa; Nigeria and Tunisia showed that the prevalence of preoperative anxiety was 51 to 90% (10,37,38) and 67.5% respectively (39).…”

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

“…Besides, the prevalence of preoperative anxiety was 53% in Brazil, 15 63% in Pakistan, 16 67% in Tunisia, 17 and 72.8% in Rwanda. 18 In Ethiopia, preoperative anxiety is a common mental health problem and its magnitude ranges from 47% 19 to 70.3%. 20 There are only a few relevant studies on preoperative anxiety among surgical patients in developing countries, particularly in Ethiopia.…”

Preoperative anxiety in Ethiopia: a systematic review and meta-analysis

“…Among these, 6 69 disregarded due to qualitative study, abstracts, and titles. Finally, this meta-analysis includes a total of 6 studies with 1832 subjects [28][29][30][31][32][33] (Figure 1).…”

“…Three regions and Addis Ababa was the settings studies found. Two in Oromia region [30,33], two in Amhara region [31,32], one in Addis Ababa [28], and one in Southern Nation, Nationalities, and People (SNNP) [29]. All included studies done by using the cross-sectional study design (Table 1).…”

“…The pooled prevalence of preoperative anxiety estimated from 6 studies [28][29][30][31][32][33] was 55.54 %( 95% CI, 46.30 to 64.78%)( Figure 2).…”