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Ginekologia i Położnictwo medical project
ISSN 1896-3315 e-ISSN 1898-0759

Evaluation of a level of preoperative anxiety in patients undergoing gynaecological surgeries


Abstract

Author(s): Magdalena Derewianka-Polak, Grzegorz Polak, Marcin Bobiński, Wiesława Bednarek, Jan Kotarski, Krzysztof Kułak, Marcin Olajossy

Introduction. Fear of the surgery is a frequent and common problem in hospitalized patients, which brings various clinical implications. The high levels of anxiety before surgery lead to problems with patient anaesthesia. The post-operative pain, nausea and vomiting are also more common. The consequence of high intensity of preoperative anxiety is an increased risk of postoperative infections, as well as impaired healing of wounds after surgery. Aim. The aim of the study was to evaluate the risk factors of high preoperative anxiety in women preparing to undergo planned gynaecological surgery. Material and methods. The group of 173 women scheduled for the surgery in the First Department of Oncological Gynaecology and Gynaecology, Medical University in Lublin were enrolled into the study. In order to assess their anxiety and information requirement they were asked to complete the Visual Analogue Scale (VAS), the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and State Trait Anxiety Inventory (STAI). To identify the risk factors of high preoperative anxiety patients’ age, menopausal and relationship status, the phase of menstrual cycle, the education level, preoperative diagnosis, the type of planned surgery and the experience of previous surgeries were analysed. Results. Based on VAS and APAIS scores, it was found that women after age 50 have statistically higher preoperative anxiety compared to those aged 30-50. Patients after menopause have higher levels of preoperative fear than premenopausal women according to VAS scores. The phase of the menstrual cycle did not affect the level of anxiety before the surgery. The severity of preoperative anxiety measured with APAIS, STAI X1 and X2 was higher in patients with higher education than in females with the basic one. The level of preoperative anxiety, assessed with VAS, APAIS and STAI-X2, was higher in women living in a town compared to those living in the countryside. Lonely women have statistically higher preoperative anxiety according to VAS scores than females in a relationship. Based on VAS, APAIS as well as STAIX1 and STAI-X2 scores it was found that patients with preoperative diagnosed or suspected malignancy have higher level of anxiety before the surgery than those with the diagnosis of the benign disease. The level of the preoperative anxiety, measured with VAS, APAIS, STAI-X1 and STAI-X2, was statistically higher in females scheduled for the extensive surgery compared to those qualified for the less invasive one. According to VAS scores, women with previous experience of the surgery have a lower preoperative anxiety in comparison to females who had been never operated on before. Conclusions. Higher levels of preoperative anxiety were demonstrated in women after age 50, patients after menopause, with the diagnosis of a malignant process, scheduled for the extensive surgery, lonely, living in the countryside and those with no previous experience of surgery