Abstract:
Preoperative anxiety is a common phenomenon for patients and is associated with a number of adverse outcomes following surgery. There is currently a lack of wellvalidated, specific assessments of preoperative anxiety. This study aimed to develop a comprehensive self-report measure of surgery-specific anxiety and examine the psychometric properties of the scale. This study involved two separate phases. Phase One aimed to define the content breadth of the construct. Interviews were undertaken with 17 patients who were waiting for surgery at the Manukau Surgery Centre to identify the specific events and factors that contributed to the experience of preoperative anxiety. A thematic analysis on the interview transcriptions revealed five major themes relating to the experience of preoperative anxiety: uncomfortable procedures, surgical complications, fear of symptoms, recovery process, and organisation and delivery of care. During Phase Two of this study, the Surgical Anxiety Questionnaire (SAQ) was developed. To ensure content validity of the scale, the items were developed from the findings in Phase One and reviewed by an interdisciplinary team of experts. One hundred and thirty-five novel patients completed the SAQ as part of a preoperative assessment, along with additional measures of preoperative anxiety, state anxiety, perceived stress, depression, and social desirability, which were used to determine the validity of the scale. A follow-up assessment, completed by 114 patients, was conducted two weeks after surgery to examine surgical recovery and the predictive validity of the measure. The SAQ was subjected to a factor analysis and three dimensions of preoperative anxiety were identified: concerns about health (six items), concerns about recovery (four items), and concerns about procedures (five items). The SAQ presented good internal reliability, construct validity, known groups validity, and predictive validity, and had better psychometric properties for measuring preoperative anxiety than existing measures. The SAQ is an effective tool for measuring preoperative anxiety in patients. Future research could further explore the psychometric properties of the SAQ by developing additional items to potentially strengthen factor stability, employ a confirmatory factor analysis, and examine the test-retest reliability of the scale.