Assessing preoperative anxiety using a questionnaire and clinical ratings A prospective observational study

BACKGROUNDPreoperative 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.OBJECTIVETo 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.DESIGNProspective observational study.SETTINGDepartment of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany.PATIENTSTwo hundred seventeen patients scheduled for elective surgery.INTERVENTIONSThe 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 MEASUREDegree of anxiety and need for information, agreement of patients' self-reports and physician's rating.RESULTS18.9% 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).CONCLUSIONThe 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 REGISTRATIONGerman Clinical Trials Register DRKS00003084.