Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
J Clin Anesth. 2011 Aug;23(5):372-8. doi: 10.1016/j.jclinane.2010.12.011.
To determine the changes in anxiety level and need for information at three different time points before surgery.
Prospective observational study.
Ward (T(1)), preoperative holding area (T(2)), and operating room (T(3)) of a university hospital.
201 adult, ASA physical status 1 and 2 patients scheduled for elective operations.
Level of anxiety and need for information about surgery and/or anesthesia were assessed with the Amsterdam Preoperative Anxiety and Information Scale (APAIS) three times before the start of surgery: in the ward, the preoperative holding area, and the operating room.
The psychometric characteristics of the APAIS were similar to its original Dutch version. The frequency of patients with high preoperative anxiety peaked at the preoperative holding area. The median score on need for information decreased from T(1) [4; interquartile range (IR) 2-5] to T(2) (3; IR 2-4) (P < 0.005) and T(3) (3; IR 2-4) (P < 0.01). While the mean anxiety scores for anesthesia were significantly (P < 0.001) higher than for the surgical procedure at all three time points, when patients were still in the ward their need for information about their surgical procedure was significantly (P < 0.05) greater than it was for the anesthesia. Patients who were more desirous of information also were more anxious (P < 0.001). Predictors of high anxiety were female gender [odds ratio (OR) 4; 95% confidence interval (CI) 1.09-14.94] and need for general anesthesia (OR 7.1; 95% CI 0.93-54.98). The characteristics, general anesthesia (OR 3.3; 95% CI 1.1-10.0), younger age (≤ 30 yrs; OR 2.9; 95% CI 1.3-6.4), education (>12 yrs; OR 2.6; 95% CI 1.2-5.4), and no previous surgery (OR 2.6; 95% CI 1.2-5.5), correlated with greater need for information.
The frequency of anxious patients is variable at different time points before surgery. The factors correlating with anxiety before surgery are nonmodifiable. Providing information to those individuals is the only modifiable option.
在手术前三个不同时间点确定焦虑水平和信息需求的变化。
前瞻性观察研究。
大学医院的病房（T1）、术前等候区（T2）和手术室（T3）。
201 名择期手术的成年 ASA 身体状况 1 级和 2 级患者。
在手术开始前三次使用阿姆斯特丹术前焦虑和信息量表（APAIS）评估焦虑程度和对手术和/或麻醉的信息需求：在病房、术前等候区和手术室。
APAIS 的心理计量特性与原始荷兰语版本相似。术前焦虑高的患者频率在术前等候区达到高峰。信息需求中位数评分从 T1[4；四分位距（IR）2-5]下降至 T2（3；IR 2-4）（P<0.005）和 T3（3；IR 2-4）（P<0.01）。虽然在所有三个时间点麻醉的平均焦虑评分显著（P<0.001）高于手术程序，但当患者仍在病房时，他们对手术程序的信息需求明显（P<0.05）高于麻醉。信息需求更高的患者也更焦虑（P<0.001）。焦虑程度高的预测因素为女性[优势比（OR）4；95%置信区间（CI）1.09-14.94]和需要全身麻醉（OR 7.1；95%CI 0.93-54.98）。特征、全身麻醉（OR 3.3；95%CI 1.1-10.0）、年龄较小（≤30 岁；OR 2.9；95%CI 1.3-6.4）、教育程度较高（>12 年；OR 2.6；95%CI 1.2-5.4）和无既往手术史（OR 2.6；95%CI 1.2-5.5）与信息需求增加相关。
手术前不同时间点焦虑患者的频率不同。与术前焦虑相关的因素是不可改变的。向这些人提供信息是唯一可改变的选择。
