Assessment of Pre-and Post Operative Anxiety Among Elective Major Surgery Patient in Kirkuk General Hospital.

Preoperative anxiety

Abstract

Background: Preoperative anxiety is the most common problem associated with a number of postoperative complications, such as increased postoperative pain, delayed recovery, and prolonged hospital stay. Low levels of anxiety are commonly an expected reaction to unexpected, potentially life-threatening circumstances, especially during a patient's first surgical experience. It is a response to external or internal stimuli that may cause behavioral, emotional, cognitive, and physical symptoms. This study aimed to determine the prevalence of anxiety among preoperative and postoperative patients attending the hospital in Kirkuk and its associated factors.

Objectives: To assess the anxiety level and identify the association between sociodemographic characteristics and patients’ anxiety.

Method: A cross-sectional hospital-based study was conducted on 100 patients arranged for surgery at governmental hospitals of Kirkuk City by using a systematic random sampling procedure. Collecting data was performed from the 7th of January to the end of March 2025 by direct interview after informed consent was taken, and a proper questionnaire was used for the study. The data entry and analysis were done by using SPSS version 23 (IBM STATA). Frequency percentage was used, and Chi-square was performed to assess the effect of association of variables. A p-value ≤ 0.05 was considered statistically significant.

Results: The study cohort (N = 100) consisted of elective major surgery patients with a mean age of 44.2±16.8 years (range: 18–45 years). Assessment using the State-Trait Anxiety Inventory (STAI-S) revealed a mean preoperative anxiety score of 52.4±8.7, significantly exceeding the normal range threshold of 39 (p < 0.001). Severe anxiety (scores ≥60) was present in 28% of patients, moderate levels (40–59) in 56%, and only 16% scored within the normal ranges. Patients undergoing surgery for the first time scored an average of 7.3 points higher than those with prior surgical experience (p = 0.012). The highest specialty-specific scores occurred in gynecology (58.1±6.8) and general surgery patients (54.9±7.2), possibly reflecting procedure-specific fears.

Conclusion: Integrating psychological support into perioperative care is crucial. While surgery can reduce preoperative anxiety, managing postoperative stress is essential for better recovery and patient satisfaction. Anxiety is linked to education level, fear of death, awareness during surgery, and postoperative pain. Therefore, routine preoperative anxiety screening and targeted interventions are recommended for all hospitals.