Anesth Pain Med.  2020 Apr;15(2):217-225. 10.17085/apm.2020.15.2.217.

The question of preoperative anxiety and depression in older patients and family protectors

• Lim S
• Oh Y
• Cho K
• Kim Mh
• Moon S
• Ki S

• KMID: 2500975
• DOI: http://doi.org/10.17085/apm.2020.15.2.217

Abstract

Background
Higher levels of anxiety increase the risks of surgery, including morbidity and mortality. The objectives of this study were to measure anxiety and depression during the preoperative period and to identify the degree of knowledge and concerns of older patients and their family protectors regarding anesthesia, and the causes of these concerns.
Methods
We administered a questionnaire to older patients scheduled to undergo surgery and their family protectors one day prior to the surgery. The questionnaire included tools for quantifying anxiety and depression (Anxiety-Visual Analogue Scale, the Amsterdam Preoperative Anxiety and Information Scale, State-Trait Anxiety Inventory Korean YZ Form, and Short Form Geriatric Depression Scale). We also asked about the concrete causes of anxiety using pre-created forms.
Results
There were 140 older patients and family protectors who participated in the study. The majority of older patients (n = 114, 81.4%) undergoing surgery and their family protectors (n = 114, 81.4%) indicated that they were anxious. Most of the older patients and their family protectors responded that they had insufficient knowledge about anesthesia, and they were mostly worried about failure to awaken following surgery, and postoperative pain. Older patients with higher anxiety scores showed higher depression scores. There were significant differences in depression scores depending on the presence of cohabitating family members.
Conclusions
It is important to remember that older patients with higher depression scores have higher anxiety during the preoperative period.

Keyword

Aged; Anxiety; Caregivers; Depression; Preoperative

Figure

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  Fig. 1. Distribution of A-VAS in older patients (A) and family protectors (B). A-VAS: anxiety visual analogue scale.

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  Fig. 2. Degree of knowledge about anesthesia of older patient and family protectors. The answer to the 4th question in the questionnaire, “How much do you know about anesthesia done during surgery?”, orange: the number (%) of persons answered “I have no idea.”, blue: the number (%) of persons answered “I know a little.”, gray: the number (%) of persons answered “I know it well.”

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  Fig. 3. Association between the SGDS score and the A-VAS (A), anxiety subscore of APAIS (B) or STAI-KYZ (C). (A) The red solid line represents linear regression of SGDS vs. A-VAS (A-VAS = 0.2469 × SGDS + 3.392, P < 0.001) and red dotted lines represent 95% confidence interval (CI). Green filled circles show distribution of A-VAS score. (B) The red solid line represents linear regression of SGDS vs. Anxiety subscore of APAIS (Anxiety subscore of APAIS = 0.3743 × SGDS + 10.88, P = 0.001) and red dotted lines represent 95% CI. Blue filled circles show distribution of Anxiety subscore of APAIS score. (C) The red solid line represents linear regression of SGDS vs. STAI-KYZ (STAI-KYZ = 1.178 × SGDS + 46.40, P < 0.001) and red dotted lines represent 95% CI. Grey filled circles show distribution of STAI-KYZ. SGDS: Short Form Geriatric Depression Scale, A-VAS: anxiety visual analogue scale, Anxiety subscore of APAIS: Anxiety subscore of Amsterdam preoperative anxiety information scale, STAI-KYZ: State Trait Anxiety Inventory Korean YZ Form.

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