Assessment of preoperative anxiety amongst patients presenting for elective surgery at the Kenyatta National Hospital

Abstract

Background: Assessment of preoperative anxiety is vital in patients planned for surgery because of its detrimental effects on conduct of anaesthesia and postoperative care period. The assessment of anxiety in patients booked for surgery is not standardized and that done by surgeons and anaesthetists either overestimates or underestimates the level of anxiety. Objective: The broad objective was to assess preoperative anxiety amongst patients presenting for elective surgery at the Kenyatta National Hospital. Subjects: A total of 322 patients scheduled for elective surgery participated in the study between April and May, 2012 in the surgical wards of the Kenyatta National Hospital. The VAS was used as an assessment tool. Method: The study was an observational cross-sectional hospital based study amongst adult patients who were scheduled for elective surgery. The VAS scale was used as the study tool. A VAS score of >/= 45mm to 100mm was considered as occurrence of significant anxiety, 38mm to 44mm was moderate anxiety and less than 37mm was low anxiety. The participants were be visited by the investigator the day before surgery and asked to complete the questionnaire. The questionnaire was handed over the same day. Results: The prevalence of low preoperative anxiety was 57%, that of significant anxiety was 37% and lastly 6 % was contributed by moderate anxiety. The female gender had high incidence of significant anxiety at 46.5% in contrast to males who had an incidence 28.2%. The age group 68 years and above had low anxiety levels with a frequency of 100% amongst this age group. Prior history of anaesthesia was associated with low preoperative anxiety with prevalence of 72% amongst this population of patients. Conclusion: There were generally low anxiety levels amongst the participants as revealed by a high prevalence of low anxiety of 57%. The female gender was associated with higher levels of significant anxiety. The older age group ﾻl= 68 years, prior history of anaesthesia and male gender were associated with low anxiety levels. Patients were more scared of anaesthesia with the prevalence of 37.3% than surgery with the pr.evalence of 30.7% . Fear of not waking from anaesthesia was the most feared factor (44.1%) amongst the patients.