Caring for the mind and body : peri-operative anxiety and quality of recovery in day surgery patients

Abstract

Background: The amalgamation of mental health status into the peri-operative care of a surgical day case patient is seldom taken into consideration in practice, whilst the research undertaken on peri-operative anxiety relates to in-patients rather than ambulatory surgery patients. Objectives: This study evaluated peri-operative anxiety and the quality of recovery including post-operative pain in patients undergoing day care surgery within a Maltese context. Design: A quantitative non-experimental cross-sectional design. Participants: One hundred and thirty six day surgery patients agreed to participate in the study, yielding a response rate of 90.7%. Settings: Day care surgical unit at Mater Dei hospital. Methods: Participants anonymously completed the Amsterdam pre-operative anxiety and information scale, the Quality of Recovery-40 scale and numerical pain scale. Systolic and diastolic blood pressure, heart rate and oxygen saturations were also measured. Results: The prevalence of pre-operative anxiety was 71.3% where females and patients aged between 32-45 years experienced the highest levels of pre-operative anxiety. Inter-correlation revealed how patients who experienced high levels of preoperative anxiety felt more anxious, experienced difficulty with falling asleep and experienced feelings of depression post-operatively. The majority of the patients (i.e., 45.6%), felt confused and lacked support post-operatively, where females expressed receiving less patient support. High levels of pre-operative anxiety were also associated with high levels of post-operative pain. Gender, pre-operative anxiety, pre-operative emotions and post-operative pain were identified as significant predictors of post-operative anxiety, while gender and post-operative pain were identified as predictors of post-operative comfort. Conclusions: Consequently, providing knowledge about early identification and management of pre-operative anxiety and post-operative pain is significantly important as it aids in reducing post-operative anxiety while promoting postoperative comfort.