Preoperational anxiety

Preoperational anxiety, or preoperative anxiety, is a common reaction experienced by patients who are admitted to a hospital for surgery. It can be described as an unpleasant state of tension or uneasiness that results from a patient's doubts or fears before an operation.

The State-Trait Anxiety Inventory (STAI) is a widespread method of measuring preoperative anxiety for research purposes. It consists of two 20-item scales on which patients are asked to rate particular symptoms.

The STAI is based on the theory that there are two distinct aspects of anxiety. The State scale is designed to measure the circumstantial or temporary arousal of anxiety, and the Trait scale is designed to measure longstanding personality characteristics related to anxiety. The items on each scale are based on a two-factor model: "anxiety present" or "anxiety absent".

In a 2009 paper in The Journal of Nursing Measurement, researchers argued that fast-paced hospital environments make it difficult to get each patient through all 20 items, especially when other assessments must also be done. Shorter versions of the STAI have been developed. For example, Marteau and Bekker’s six-item version of the State scale was found in 2009 to have "favorable internal consistency reliability and validity when correlated with the parent 20-item State scale".

A variety of fears can cause preoperative anxiety. They include fear of:

Other factors in the intensity of preoperative anxiety are:

Irving Janis separates the factor trends that are commonly seen affecting anxiety into three different levels:

Anxiety can cause physiological responses such as tachycardia, hypertension, elevated temperature, sweating, nausea, and a heightened sense of touch, smell, or hearing.

A patient may also experience peripheral vasoconstriction, which makes it difficult for the hospital staff to obtain blood.

Anxiety may cause behavioral and cognitive changes that result in increased tension, apprehension, nervousness, and aggression.

Some patients may become so apprehensive that they cannot understand or follow simple instructions. Some may be so aggressive and demanding that they require constant attention of the nursing staff.

In research conducted by Irving Janis, common reactions and strategies were separated into three different levels of preoperative anxiety:

Low anxiety

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