The effect of preoperative instruction on state anxiety

State anxiety was measured in 81 patients scheduled for back and neck surgery before and after preoperative instruction. Anxiety levels were significantly reduced after instruction was given. In 12 patients, anxiety level increased after instruction, possibly because of the removal of denial as a coping mechanism or because these patients were generally more anxious. There was no difference in hospital stay or number of analgesics received postoperatively between the group whose scores decreased and the group whose scores increased. The Increased Score Group, however, displayed more behavioral manifestations of anxiety after instruction and postoperatively. This study provides further evidence of the psychological benefit of preoperative instruction. Instruction should be provided on a consistent basis utilizing a structured format and including the patient's family.