Calm or not calm: the question of anxiety in the perianesthesia patient

Preoperative anxiety can be a major problem for the patient. Three distinct dimensions of preoperative anxiety are known: fear of the unknown, fear of feeling ill, and fear for life. The aim of this study was to investigate whether patients feel anxiety (calm or not calm) preoperatively before undergoing an elective day care surgery and also to elucidate the factors contributing to a patient's current state of mind. A prospective study with 161 American Society of Anesthesiologists I-II outpatients scheduled for elective surgery was conducted. In a questionnaire the patients were asked to state if they were feeling calm or not and to describe factors contributing to their current mood. If responding that they did not feel calm, the participants were asked to rate the level of anxiety on a Numeric Rating Scale, 1-10. The results showed that 57% (n = 91) of the participants stated that they did not feel calm. A significantly higher proportion of women did not feel calm (65%), P < .05. Significantly more participants with a previous experience of surgery felt calm (90%), P < .01. In all, 190 statements were submitted. The results show that nearly half of the participants felt calm before surgery. The reasons were earlier positive experiences, feeling of security and caring, being well-informed, and having positive expectations. Furthermore, a higher proportion of women did not feel calm preoperatively. This indicates a need before surgery to routinely document and evaluate the individual patient's state of mind and reasons for the state of mind. This individual preoperative care can make it possible to provide emotional support, decrease anxiety, and give the patient a more positive surgical experience.