Patterns and frequency of anxiety in women undergoing gynaecological surgery.
OBJECTIVE
Within a gynaecological surgical setting to identify the patterns and frequency of anxiety pre- and postoperatively; to identify any correlation between raised anxiety levels and postoperative pain; to identify events, from the patients' perspective, that may increase or decrease anxiety in the pre- and postoperative periods.


BACKGROUND
It is well documented that surgery is associated with increased anxiety, which has an adverse impact on patient outcomes. Few studies have been conducted to obtain the patient's perspective on the experience of anxiety and the events and situations that aggravate and ameliorate it.


METHODS
The study used a mixed method approach. The sample consisted of women undergoing planned gynaecological surgery. Anxiety was assessed using the State Trait Anxiety Inventory. Trait anxiety was measured at the time of recruitment. State anxiety was then assessed at six time points during the pre- and postoperative periods. Postoperative pain was also measured using a 10 cm visual analogue scale. Taped semi-structured telephone interviews were conducted approximately a week after discharge.


RESULTS
State anxiety rose steadily from the night before surgery to the point of leaving the ward to go to theatre. Anxiety then increased sharply prior to the anaesthetic decreasing sharply afterwards. Patients with higher levels of trait anxiety were more likely to experience higher levels of anxiety throughout their admission. Elevated levels of pre- and postoperative anxiety were associated with increased levels of postoperative pain. Telephone interviews revealed a range of events/situations that patients recalled distressing them and many were related to inadequate information.


CONCLUSIONS
This study found higher rates of anxiety than previously reported and anxiety levels appeared raised before admission to hospital. This has important clinical and research implications.


CONCLUSIONS
Patients with high levels of anxiety may be identified preoperatively and interventions designed to reduce anxiety could be targeted to this vulnerable group. Patient experiences can inform the delivery of services to meet their health needs better.
Carr
Eloise
E
Bournemouth University, Institute of Health and Community Studies, Bournemouth, Dorset, UK.
Brockbank
Katrina
K
Allen
Sandra
S
Strike
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D001294:Attitude to Health; D004739:England; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000451:nursing / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D024802:Nurse's Role; D015404:Nursing Methodology Research; D010147:Pain Measurement; D010149:Postoperative Pain / Q000150:complications; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D011300:Preoperative Care / Q000451:nursing / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D036301:Qualitative Research; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014930:Women / Q000523:psychology*