Communication Training for the Preoperative Anesthesia Consultation Reduces Anxiety: A Prospective, Patient-Blinded Pre–Post Intervention Study

BACKGROUND: The preoperative anesthesia consultation and risk disclosure required for informed consent can lead to negative patient expectations about their surgery, with resulting nocebo effects. Negative consequences are closely linked to patient anxiety, which further contributes to poor outcomes. Therefore, instruction in specific communication skills is essential for reducing preoperative anxiety. METHODS: Patient anxiety levels were measured before and after the preoperative anesthesia consultation using the State-Trait Anxiety Inventory (STAI-S), a numeric rating scale (NRS), and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in a single institution study. Following an initial data collection period for the control group, a single 1-hour education session on specific communication skills was offered to the Anaesthesiology Department. Patients seen by anesthesiologists who underwent this training constituted the intervention group. Central to the education was an emphasis on positive aspects, such as treatment benefit, prophylaxis, monitoring, and treatability of adverse reactions, alongside risk information. RESULTS: The preoperative consultation resulted in an anesthesia-related anxiety reduction in 85% of all patients (573 out of 673 patients). Anxiety reduction was more pronounced in the intervention group, where anesthesiologists had received the risk communication training (274 out of 306 ≈ 89.5%) compared to the control group (299 out of 367 = 81.5%), p = 0.003. Anxiety scores decreased by approximately 6% in the control and 7.5% in the intervention group. The most significant change was observed in anesthesia-related anxiety (decrease from 3.5 ± 1.6 to 3.1 ± 1.3 ≈ -11%, p = 0.016). Initial surgery-related anxiety was higher (5.0 ± 2.2) than anesthesia-related anxiety with a similar decrease post-consultation. Decrease in preoperative anxiety was most pronounced in patients with high preexisting anxiety (a drop by 4.9 in the STAI-S vs. 3.3 in the control, p = 0.033). CONCLUSION: A single session of risk communication training for anesthesiologists can significantly enhance the reduction of anesthesia-related anxiety in patients. This finding shows that evidence-based educational interventions on risk communication are feasible and effective when transferred from the study setting to clinical practice.