Anaesthetists and surgeons significantly overestimated their patients' preoperative anxiety compared to patient self-reports (P < 0.05) and poorly predicted their feared conditions.
Observational (n=67)
No
Do anaesthetists and surgeons accurately estimate preoperative anxiety compared to self-reports in adult patients undergoing elective surgery?
Anaesthetists and surgeons significantly overestimate preoperative anxiety and poorly predict patients' specific fears and desires for relief.
p-value: p=< 0.05
BACKGROUND AND OBJECTIVE: Preoperative anxiety is a challenging concept in the preoperative care of patients. The hypothesis of this study was that the doctors are able to estimate their patients' preoperative anxiety. METHODS: A prospective clinical trial was performed on 67 adult patients and 26 paired anaesthetists and surgeons. The patients filled out two separate visual analogue scales for anxiety for the planned anaesthesia and surgery. After that the 'anxiety subscale' of the Hospital Anxiety and Depression's Scale was completed and a list of fearsome items was presented as the patients were asked to choose two conditions they considered the most frightening. Finally the patients were asked to select one or more items from a list of things, which they considered likely to relieve their preoperative anxiety. Similarly, the participating doctors were asked to estimate their patients' anxiety, guess their fearful conditions and their anxiety-relieving requests. RESULTS: Median scores for anxiety as estimated with visual analogue scales by anaesthetists, surgeons and patients for anaesthesia were 34, 36 and 6, respectively; and for surgery 53, 47 and 9, respectively. The anxiety subscale of the Hospital Anxiety and Depression's Scale 8.9 +/- 4.2, 8.6 +/- 4.6 and 6.5 +/- 4.5 (mean +/- SD), respectively. Doctors' scores were significantly higher than the patients' scores (P < 0.05). Thus, the anaesthetists and the surgeons were unable to estimate their patients anxiety on any of the scales used (Kendall's tau < 0.25; P < 0.05). The proportion of correct estimation of the fearsome items was 20% for both the anaesthetists and the surgeons. CONCLUSIONS: Both anaesthetists and surgeons overestimated their patients' preoperative anxiety by a wide margin and poorly predicted their patients' feared conditions and their desire for relief of anxiety.
Fekrat et al. (2006) conducted an observational in Preoperative anxiety in elective surgery (n=67). Doctors' estimation of patients' preoperative anxiety vs. Patients' self-reported anxiety was evaluated on Preoperative anxiety scores measured by visual analogue scales and the Hospital Anxiety and Depression's Scale (p=< 0.05). Anaesthetists and surgeons significantly overestimated their patients' preoperative anxiety compared to patient self-reports (P < 0.05) and poorly predicted their feared conditions.