Measures of preoperative anxiety

Abstract

The evaluation of treatment from the patient's perspective (Patient Reported Outcomes, PROs) currently remains one of the most vibrant and dynamically developing fields of research. Among PROs, patient self-assessment of various symptoms, including one's psychological state, is of great importance. Anxiety is one of the most frequently observed psychological reactions among patients awaiting various surgeries, and may occur even in up to 80% of patients scheduled for high-risk surgical procedures. An increased level of preoperative anxiety has been proved to be related to negative consequences, both psychological and somatic, and affecting, in consequence, anaesthesia, postoperative care and treatment, along with the rehabilitation process. It is also considered as a risk factor for mortality in patients after surgeries. Planning of necessary educational, pharmacological and psychological interventions should be preceded by the evaluation of anxiety level which should be considered a routine element of preoperative care. The assessment of anxiety intensity may be performed using psychometric scales. Various factors should be taken into consideration while choosing the scale, including its reliability and accuracy, the aim of the assessment, the patient's age and clinical state, as well as the type of surgery being planned. In the current article, we present standardised and reliable methods which may be used in the evaluation of preoperative anxiety among patients scheduled for surgery, namely: the State-Trait Anxiety Inventory (STAI); the Hospital Anxiety and Depression Scale (HADS); the Amsterdam Preoperative Anxiety and Information Scale (APAIS); and the Visual Analogue Scale (VAS). A detailed description of the scales, including their main advantages and limitations, as well as their usefulness in both clinical evaluation of various patients' groups and scientific research are presented.

Keywords: assessment methods; preoperative anxiety.