Anesth Pain Med.  2023 Jul;18(3):260-269. 10.17085/apm.23016.

Appropriateness of the anxiety subscale of the Hospital Anxiety and Depression Scale for Koreans to measure preoperative anxiety and the effect of preoperative anxiety on postoperative quality of recovery

• Ki M
• Kim DC
• You SW
• Oh J
• Jang J
• Yoo HH

• KMID: 2547034
• DOI: http://doi.org/10.17085/apm.23016

Abstract

Background
The reliability and validity of the anxiety subscale of the Hospital Anxiety and Depression Scale for Koreans (K-HADS-A) has not been studied in Korean surgical patients. This study aimed to validate the usefulness of K-HADS-A for measuring preoperative anxiety in Korean surgical patients. Additionally, the effect of preoperative anxiety on postoperative quality of recovery was evaluated.
Methods
Preoperative anxiety in 126 inpatients with planned elective surgery was measured using the K-HADS-A. The postoperative quality of recovery was measured using the Korean version of the Quality of Recovery-15. The validity and reliability of the K-HADS-A were evaluated. The differences in quality of recovery on the first and seventh day postoperatively were then compared between the anxious and non-anxious groups.
Results
There was a statistical correlation between the K-HADS-A and Anxiety Likert Scale. The goodness-of-fit indices of the structural equation model showed how well the data from the K-HADS-A match their concept. The Kaiser-Meyer-Olkin value was 0.848, and the P value of Bartlett’s test of sphericity was < 0.001. Cronbach’s alpha was high at 0.872. The K-HADS-A had an acceptable level of validity and reliability. Postoperative quality of recovery was significantly lower in the anxious group (postoperative day 1: t = 2.058, P = 0.042; postoperative day 7: t = 3.430, P = 0.002).
Conclusions
The K-HADS-A is an acceptable tool for appropriately assessing preoperative anxiety in Korean surgical patients. Assessing preoperative anxiety is valuable, because preoperative anxiety affects the postoperative quality of mental and physical recovery.

Keyword

Preoperative anxiety; Postoperative recovery; Surgery; Anesthesia; K-HADS-A; QoR-15K

Figure

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  Fig. 1. CONSORT flow diagram. CONSORT: Consolidated Standards for Reporting of Trials, QoR-15K: Korean version of the Quality of Recovery-15.

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  Fig. 2. Structural equation model for Hospital Anxiety and Depression Scale for Koreans (K-HADS-A). Latent variables are theoretical concepts that are not directly observed, and this refers to what K-HADS-A represents. Meanwhile, observed variables are directly measured variables and represent the seven questions of the K-HADS-A. Given that the seven items in the K-HADS-A measure a single latent variable, the modeling focuses on the relationship between these items and the latent variable.

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