Investigation On Anxiety Level During Waiting Period Among Patients Undergoing Consecutive Surgery

Objective Using questionnaire survey of patients and medical staff professional assessment,the levels of anxiety of the night before operation day,the operation day and the time entering into the operating room were assessed,combined with the measurement of vital signs of patients to understand the anxiety level of patients undergoing consecutive surgery during the waiting period in a third-grade class-A hospital in Ningbo.The influencing factors were analyzed to provide the basis for the individualized nursing intervention.Methods This study was a single-center cross-sectional survey.A total of 288 elective surgery cases were chosen from November 2016 to February 2017 in the hospital,with 144 patients undergoing the first surgery and the other 144 patients undergoing consecutive surgery.State anxiety inventory(S-AI),Hamilton anxiety scale(HAMA)and self-designed general information questionnaire were used to investigate the levels of anxiety of the night before operation day,the operation day and the time entering into the operating room,combined with the measurement of vital signs of patients.All the S-AI and HAMA scores were compared by t test of independent samples,Presenting with the mean value ± standard deviation.The incidence of anxiety of all the patients was described by frequency and percentage.The vital signs and anxiety levels at three time points in the patients undergoing consecutive surgery were compared with variance analysis of repeated measurement data to get the time point of the highest level of anxiety.The correlation between S-AI and HAMA measurements was evaluated by Pearson correlation analysis.The factors influencing the anxiety level of the patients were analyzed by univariate analysis.The variables with statistical difference were used as the independent variables of regression analysis,and the highest level of anxiety S-AI and HAMA scores were used as regression variables to complete the multivariate linear stepwise regression analysis.P value less than 0.05 standed for statistically significant difference.Results 1.The incidence of anxiety was 4.86%among the patients undergoing consecutive surgery at the night before operation day,and the incidence of anxiety was 25.69%on the day of operation.The incidence of anxiety was 63.89%at the time of entering into the operation room.The anxiety levels at three time points among consecutive surgery patients were all higher than those of the first operation patients(all P<0.05).2.The indexes of body temperature,respiration,heart rate,systolic pressure,diastolic pressure,S-AI and HAMA scores of the patients Lundergoing consecutive surgery at the time of entering into the operating room were the highest(P<0.001).S-AI and HAMA scores during waiting time gradually increased as the operation time was near,and the changes in vital signs were consistent with this.3.The Pearson correlation coefficient of S-AI and HAMA scores was 0.812 in patients undergoing elective surgery,and the Pearson correlation coefficient was 0.823 at the time of entering into the operating room,which were statistically significant(all P<0.001).4.There were statistically significant differences in S-AI scores among age(F=3.971,p=0.021),accompanied by family members or not(t＝-2.128,p=0.035),preoperative catheter preparation or not(F＝3.991,P=0.004),and different preoperative waiting time(F=7.505,P＝0.001).Age and waiting time entered the regression equation to explain the total variability of 16.7%.There were statistically significant differences in HAMA scores among age(F＝3.892,P＝0.023),the level of education(F=10.650,P＝0.014),accompanied by family members or not(t＝-2.822,P=0.010),preoperative ASA grade(F=4.270,P=0.016),preoperative catheter preparation or not(F=7.283,P=0.000),and different preoperative waiting time(F＝22.033,P＝0.000).The level of education,preoperative catheter preparation and different waiting time entered the regression equation to explain the total variability of 37.2%.There were significant differences in the scores of HAMA in patients undergoing surgery in different surgical departments(F＝4.003,P=0.009).The score of HAMA was the highest in patients undergoing general surgery and gastrointestinal surgery.Conclusions 1.The level of anxiety during the waiting period among the consecutive surgery patients was worse than that of the first operation patients,and the incidence of anxiety among the consecutive surgery patients on the day of operation and at the time of entering into the operation room was significantly higher than that at the night before operation day.It indicates that the anxiety problem of the patient’s preoperative waiting period should not be neglected and need to be improved.2.The level of anxiety of patients undergoing consecutive surgery was the worst at the time of entering the operating room.The preoperative vital signs could reflect the level of anxiety in a certain extent.It is suggested to eassess the patients entering into the operating room,carry out all-round human care and reduce the patient’s anxiety level.3.S-AI and HAMA scores had a good correlation in the assessment of preoperative waiting anxiety levels in patients undergoing elective surgery.The appropriate assessment method can be selected according to the actual situation of the patients.4.Age,the level of education,preoperative catheter preparation and preoperative waiting time were the main factors which affect the level of anxiety among the patients in operating room.The patient’s anxiety level was positi-vely related to age,preoperative catheter preparation and preoperative waiting time,and it was negatively with the level of education,with greater effect of preoperative waiting time.Patients of department of general surgery,and gastrointestinal surgery had higher level of anxiety.Nursing staff should implement personalized care in order to reduce the anxiety level during waiting time among patients undergoing consecutive surgery.