Prevalence and factors associated with preoperative anxiety among elective surgical patients at University of Gondar Hospital. Gondar, Northwest Ethiopia, 2017. A cross-sectional study

Abstract

Background: Anxiety is defined as an overwhelming experience of fear, worry and nervousness. It is one of the commonest events that can happen to patients waiting for surgical operations. It has multiple psychophysiological adverse effects. Even though, it has variety of unwanted consequences, in clinical practice, preoperative anxiety is commonly neglected by clinicians. The purpose of this study was to determine the prevalence and factors associated with preoperative anxiety among elective surgical patients at the University of Gondar Hospital, Northwest Ethiopia, 2017. Method: Institution-based, cross-sectional study was conducted from March to June, 2017 in University of Gondar Hospital. After obtaining ethical approval from institutional review board, 178 willing adult patients scheduled for elective surgical operations were included in the. Level of anxiety was measured by State and Trait Anxiety Inventory. Statistical analysis was performed using SPSS statistical package version 20. Descriptive statistics, cross-tabs and binary logistic regression analysis were performed to identify predictors of preoperative anxiety. The strength of the association was presented using AOR with 95% confidence interval and p-value < 0.05 was considered as statistically significant. Results: A total of 178 patients (98 female and 80 male) enrolled with 98.34% response rate.We observed preoperative anxiety in 59.6% patients. The mean (± SD) of STAI score was 48.63 ± 17.56. High preoperative anxiety was associated with age 18e30 years (AOR ¼ 6.92, 95% CI ¼ 1.39e33.82), age 31e45 years (AOR ¼ 5.72, 95% CI ¼ 1.61e20.28), no income (AOR ¼ 3.21, 95% CI ¼ 1.01e10.27), low income (AOR ¼ 3.06, 95% CI ¼ 1.18e7.93). Rural residency (AOR ¼ 0.38, 95% CI ¼ 0.16e0.89) was associated with lower risk for preoperative anxiety. Fear of being unable to recover from anesthesia (53.9%), postoperative pain (51.7%), family concerns (43.3%) were leading sources of preoperative anxiety. Significant association with preoperative anxiety found in fear of death (AOR ¼ 2.40, 95% CI ¼ 1.08e5.32), family concern (AOR ¼ 2.15, 95% CI ¼ 1.03e4.50), fear of dependency (AOR ¼ 2.75, 95% CI ¼ 1.57e7.20) and fear of disability (AOR ¼ 2.75, 95% CI ¼ 1.22e6.21). Conclusions: Preoperative anxiety was high in University of Gondar Hospital. Young age, no/low income, urban residence, fear of death, dependency, disability and family concerns were predictors of preoperative anxiety. Patients need to be assessed regularly for anxiety during the preoperative visit and appropriate anxiety reducing methods should be introduced in our Hospital.