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Prevalence of preoperative anxiety and its contributing factors in adult patients undergoing elective orthopaedic surgery at an academic hospital in South Africa: a pilot study
Southern African Journal of Anaesthesia and Analgesia | Vol 29, No 4 | a1169 |
DOI: https://doi.org/10.36303/SAJAA.2976
| © 2023 G. Lamacraft, C. van Rooyen, L. Raubenheimer, K. Arendse, X. Gama, H.G. Jang, R. Nemakundani, L. Osei-Fofie
| This work is licensed under Other
Submitted: 19 November 2025 | Published: 30 August 2023
Submitted: 19 November 2025 | Published: 30 August 2023
About the author(s)
G. Lamacraft, Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South AfricaC. van Rooyen, Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, South Africa
L. Raubenheimer, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
K. Arendse, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
X. Gama, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
H.G. Jang, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
R. Nemakundani, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
L. Osei-Fofie, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
Full Text:
PDF (96KB)Abstract
Background: Preoperative anxiety potentially results in perioperative anaesthetic complications. This study aimed to determine the prevalence of preoperative anxiety in adult patients scheduled to undergo elective orthopaedic surgery at an academic hospital in South Africa and identify contributory factors.
Methods: This cross-sectional study included all patients scheduled for elective orthopaedic surgery the following day from 25 July to 3 November 2021. An adapted version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used. Four questions determined the patients’ anxiety and two questions their desire for more information about their forthcoming anaesthesia and surgery. A 5-point Likert scale was used to capture the patients’ responses to the APAIS questions. Data on other possible contributory factors to preoperative anxiety were collected using a questionnaire.
Results: Of the 88 patients, 82 (93.2%) were included in the study. A total of 40 (48.8%) patients had an APAIS score of ≥ 11, indicating anxiety. A high need-for-information score (≥ 8) was found in 31 (37.8%) patients. A significant association between patients with a higher anxiety score and a higher need-for-information score (p = 0.0063) was identified. Other non-significant factors associated with a higher anxiety score included a lower level of education and no postoperative home support.
Conclusion: Patients with a high need for information tended to be more anxious on the day before surgery. The APAIS could be introduced in preoperative ward admissions to identify these patients and provide an appropriate level of counselling about their planned procedure. Counselling might reduce their preoperative anxiety, but further research needs to confirm this assertion. Larger studies are recommended to determine the influence of other factors contributing to preoperative anxiety.
Methods: This cross-sectional study included all patients scheduled for elective orthopaedic surgery the following day from 25 July to 3 November 2021. An adapted version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) was used. Four questions determined the patients’ anxiety and two questions their desire for more information about their forthcoming anaesthesia and surgery. A 5-point Likert scale was used to capture the patients’ responses to the APAIS questions. Data on other possible contributory factors to preoperative anxiety were collected using a questionnaire.
Results: Of the 88 patients, 82 (93.2%) were included in the study. A total of 40 (48.8%) patients had an APAIS score of ≥ 11, indicating anxiety. A high need-for-information score (≥ 8) was found in 31 (37.8%) patients. A significant association between patients with a higher anxiety score and a higher need-for-information score (p = 0.0063) was identified. Other non-significant factors associated with a higher anxiety score included a lower level of education and no postoperative home support.
Conclusion: Patients with a high need for information tended to be more anxious on the day before surgery. The APAIS could be introduced in preoperative ward admissions to identify these patients and provide an appropriate level of counselling about their planned procedure. Counselling might reduce their preoperative anxiety, but further research needs to confirm this assertion. Larger studies are recommended to determine the influence of other factors contributing to preoperative anxiety.
Keywords
preoperative anxiety; elective orthopaedic surgery; Amsterdam Preoperative Anxiety and Information Scale; APAIS; perioperative complications
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