Objective: The psychological impact of healthcare crises is undoubted.
Anxiety has a strong impact on the perioperative patients’ well-being
and their subsequent postoperative recovery. The aim of this survey was
to assess preoperative anxiety and its accentuating factors in patients
undergoing surgery during a healthcare crisis.
Method: This study is a cross-sectional observational study. All adult
patients undergoing elective surgery during December 2021 were
assessed for eligibility. We excluded patients with any diagnosed
psychiatric comorbidities. Anxiety was recorded using the modified
Preoperative Anxiety Scale (mPAS), with permission by the authors [1].
mPAS consists of 4 sections: (i) demographics, (ii) baseline anxiety trait,
(iii) anxiety due to general preoperative factors and (iv) anxiety due
pandemic-specific factors. We summarized the results using descriptive
and inferential statistics.
Results: We included 116 patients, (60 males, 51.7% and mean
age 60.6±15.5 years) who underwent major (27,23.3%), moderate
(49,42.3%), and minor (40,34.5%) surgical interventions. Six patients
were excluded due psychiatric disorders. Based on American Society of
Anaesthesiologists Physical Status (ASA-PS) they were mostly classified
as ASA PS II (62,53.4%) and ASA PS III (29,25%). At baseline, of the
110 patients who completed the questionnaire, 30% (n=33) suffered
from baseline anxiety according to mPAS. Severity of planned surgery
(n=24, 21.8%) represented a major anxiety source, which was statistically
significant for patients undergoing major surgery (p=0.026). However,
pandemic-related factors were responsible of anxiety in 36 (32.7%)
patients. The female gender and the ASA grade were significantly
associated with the levels of COVID-19 anxiety.
Conclusions: During a healthcare crisis 30% of the patients experienced
anxiety before surgery. The preoperative anxiety was further aggravated
due to pandemic-related factors.
Keywords: Anxiety, elective surgery, preoperative anxiety, prospective
study, questionnaire