Preoperative anxiety levels in obstetric patients receiving spinal anaesthesia: Does an information booklet reduce anxiety and improve quality of anaesthesia?

Abstract

OBJECTIVE: To look at levels of preoperative anxiety in patients who are to have caesarian section under spinal anaesthesia and determine if availing an information booklet to the patients would reduce anxiety. MATERIALS AND METHODS: One hundred and twenty patients were included on baseline assessment of anxiety. The anxiety was evaluated using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the Shona version of it was validated. Patients randomly selected into group A received the information booklet the day before surgery while those in group B did not. Anxiety was reassessed on the day of surgery. The day after surgery a survey of the patients’ satisfaction with the spinal anaesthesia was done. RESULTS: Three patients out of the 120 were lost to follow-up for unforeseen reasons. Baseline anxiety assessment showed that 38 out of 60 patients in group A and 45 out of 60 patients in group B were anxious and this was statistically significant (p=0.000). There was an increase in the number of anxious patients in groups A and B on the day of surgery from 38 to 43 and from 45 to 48 respectively. This increase however was not statistically significant (p=0.1307 group A, p=0.1500 group B). Regarding need for information, those with none or little need for information were 42.7% (p=0.099), average need for information 18.8% (p=0.031) and with high need for information 38.5% (p=0.001). Regarding the relationship between anxiety and need for information there was a positive correlation for both group A and B(r=0.638, p=0.000 and r=0.797, p=0.000 respectively). One hundred and eleven (94.9%) of patients were satisfied with the spinal anaesthesia and 110(94.0%) were willing to have it if they were to have subsequent caesarian section. CONCLUSION: There was preoperative anxiety in patients scheduled for caesarian section. The information booklet did not reduce anxiety. The high need for information was significant in the group that did not have access to the booklet. Patients were however satisfied with spinal anaesthesia.