采用问卷和临床评分评估术前焦虑：前瞻性观察研究。

Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study.

机构信息

From the Department of Anaesthesiology, University Hospital Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany.

出版信息

Eur J Anaesthesiol. 2013 Dec;30(12):758-63. doi: 10.1097/EJA.0b013e3283631751.

DOI:10.1097/EJA.0b013e3283631751

PMID:23787971

Abstract

BACKGROUND

Preoperative anxiety and need for information can be detected during preoperative consultation via structured and standardised screening by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire.

OBJECTIVE

To identify the prevalence of preoperative anxiety and need for information, with regard to influencing factors such as age, sex, previous operation and grade of surgery, and to examine the level of agreement between patients' self-rating and physicians' ratings.

DESIGN

Prospective observational study.

SETTING

Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany.

PATIENTS

Two hundred seventeen patients scheduled for elective surgery.

INTERVENTIONS

The patients completed questionnaires prior to the interaction with the anaesthesiologist. Physicians were blinded to the patients' ratings and provided their subjective ratings about patients' anxiety and need for information immediately after seeing the patient.

MAIN OUTCOME MEASURE

Degree of anxiety and need for information, agreement of patients' self-reports and physician's rating.

RESULTS

18.9% of patients were classified as 'anxiety cases' (31.8% in women and 10.6% in men). The grade of the intended surgery but no other investigated factor was related to patients' anxiety. Age (older patients) was correlated with information requirement (r = 0.21, P = 0.002). Analysis of agreement showed only weak correlations between patients' self-reports and physicians' ratings, demonstrated in low weighted Kappa-coefficients (0.12 to 0.32).

CONCLUSION

The APAIS is a useful instrument to assess the level of patients' preoperative anxiety and the need for information. Given the relationship between preoperative anxiety and postoperative outcome, it seems justified to incorporate this approach into the preoperative consultation.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00003084.

摘要

背景

术前焦虑和对信息的需求可以通过阿姆斯特丹术前焦虑和信息量表（APAIS）问卷的结构化和标准化筛查在术前咨询中检测到。

目的

确定术前焦虑和对信息的需求的流行程度，以及年龄、性别、既往手术和手术级别等影响因素，并检查患者自我评估和医生评估之间的一致性水平。

设计

前瞻性观察研究。

设置

德国美因茨约翰内斯古腾堡大学医学中心麻醉科。

患者

217 名计划接受择期手术的患者。

干预措施

患者在与麻醉师互动之前完成问卷。医生对患者的评分不知情，并在见到患者后立即对患者的焦虑和对信息的需求进行主观评分。

主要观察结果

焦虑程度和对信息的需求，患者自我报告和医生评分的一致性。

结果

18.9%的患者被归类为“焦虑病例”（女性为 31.8%，男性为 10.6%）。拟行手术的级别而不是其他调查因素与患者的焦虑有关。年龄（年龄较大的患者）与信息需求相关（r=0.21，P=0.002）。一致性分析显示，患者自我报告和医生评分之间仅存在弱相关性，表现为加权 Kappa 系数低（0.12 至 0.32）。