Pre-operative Anxiety among Patients undergoing Elective Surgery in Northern state, Sudan, 2024: A Multi-center, Cross-sectional Study (Preprint)

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BACKGROUND Pre-operative anxiety and the desire for information are prevalent conditions among patients undergoing surgery. Understanding the prevalence and associated factors of these psychological states is essential for improving patient care and surgical outcomes. OBJECTIVE This study aimed to assess the prevalence of preoperative anxiety and the desire for information, as well as associated socio-demographic, medical, and surgical factors among elective surgery patients, in Northern state, Sudan METHODS A hospital-based, multi-center cross-sectional study was conducted over four months in Northern State, Sudan, involving patients undergoing elective surgery. Socio-demographic characteristics, medical and surgical history, pre-operative anxiety, and the desire for information were collected through face-to-face interviews using a structured questionnaire and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The data were analyzed using SPSS (version 27), where Chi-square tests, univariate logistic regression, and multivariate logistic regression were used to identify risk factors, with statistical significance set at p<.05. RESULTS Among the 305 participants (Response rate = 80.3%), 56.9% were male, with a median age of 43 years (IQR: 30–64 years). Most were married (67.9%), educated (81.3%), and had family support (83.0%). The majority underwent intermediate (44.6%) or major (46.6%) surgeries under general anesthesia (52.2%), and primarily in public hospitals (55.4%). Most participants lacked insurance (86.6%) and reported good sleep quality the night before surgery (72.5%). The prevalence of pre-operative anxiety was 24.6%, while 23.9% expressed an average desire for information, and 6.2% reported a high desire. Factors significantly associated with pre-operative anxiety included family support (aOR = 7.12, 95% CI: 2.64–19.23, p<.001), surgery in public hospitals (aOR = 4.31, 95% CI: 2.30–8.07, p<.001), poor sleep quality the night before surgery (aOR = 2.85, 95% CI: 1.51–5.38, p=.001), and ASA classification III and IV (aOR = 2.36, 95% CI: 1.00–5.54, p=.049). For the desire for information, significant factors included being educated (aOR = 2.48, 95% CI: 1.00–6.11, p=.049), family support (aOR = 4.10, 95% CI: 1.81–9.30, p=.001), surgery in public hospitals (aOR = 3.57, 95% CI: 1.93–6.61, p<.001), and ASA classification III and IV (aOR = 3.26, 95% CI: 1.39–7.64, p=.007). CONCLUSIONS Pre-operative anxiety and the desire for information are prevalent among patients undergoing elective surgery. Family support, poor sleep quality, and higher ASA classification were significant predictors of pre-operative anxiety, while education, family support, and chronic diseases were associated with a higher desire for information. We recommend developing strategies and targeted interventions to address psychological and informational needs in the pre-operative period.

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