General anaesthesia and day-case patient anxiety.

AIM: This paper is a report of a study carried out to uncover the most anxiety-provoking aspects of general anaesthesia and determine what interventions may help to alleviate such anxiety.
BACKGROUND: General anaesthesia has proved to be highly anxiety-provoking. With the rise in elective day surgery, this aspect of patients' experience has become a prominent issue. Indeed, with brief hospital stays, limited contact with healthcare professionals, restricted formal anxiety management and the acute psychological impact of day surgery, such anxiety may be increasing.
METHOD: As part of a larger study, a questionnaire was given on the day of surgery to 1250 adult patients undergoing surgery with general anaesthesia over a two year period from 2005-2007. The issue examined was anxiety in relation to the environment, hospital personnel and general anaesthesia. Participants were requested to return the questionnaire by mail 24-48 hours following surgery, and 460 completed questionnaires were returned.
FINDINGS: A total of 85% of respondents experienced some anxiety on the day of surgery. Immediate preoperative experiences and concerns about unconsciousness were highly anxiety-provoking. Using factor analysis Preoperative Anaesthetic Information, Anaesthetic Catastrophising, Final Support, Personal Support, Imminence of Surgery, Possible Adverse Events and Final Preoperative Experiences were identified as central features. Multiple regression demonstrated Preoperative Anaesthetic Information, Anaesthetic Catastrophising and Imminence of Surgery were statistically significantly associated with an overall increased level of anxiety.
CONCLUSIONS: Focusing on the timely, formal delivery of information about anaesthesia management, emphasizing the notion of 'controlled unconsciousness' and dispelling misconceptions associated with general anaesthesia may help to limit patient anxiety.