Preoperative Anxiety in the Surgical Transfer and Waiting Area: A Cross-Sectional Mixed Method Study

Severe preoperative anxiety (SPA) in surgical patients may have clinical consequences and worsen satisfaction. Some institutions have a surgical transfer and waiting area (TWA) for patient reception/dispatch to operating rooms. We measured the frequency of SPA, investigated predicting factors, and quantified the effect of the TWA stay on anxiety levels in a single centre cross-sectional study. Preoperative anxiety was assessed using three scales. Patients' perceptions/suggestions were studied by a psychoanalyst. A total of 933 adult patients, undergoing elective procedures, were interviewed. SPA was detected in 24.7%, non-modified by anxiolytic premedication. Patients' median stay was 9 min, and anxiety level was decreasing in those with SPA. In multivariable analysis, female sex, inpatient settings, and pain before the procedure were predictive for SPA. Previous operating room experience, and a supine arrival position were associated with less SPA. Patients complained about a lack of information, and an uncomfortable environment in the waiting area. To reduce anxiety, they mainly asked for warm blankets/music (physical/sound barriers), and extra sedative agents. The holding area may be a place to measure patients' anxiety by paramedical staff, and to apply simple non-pharmacological interventions. The psychological concept of psychical envelopes may be useful for the development and investigation of such interventions in improving patients' experience.