PREOERATIVE ANXIETY AMONG WOMEN UNDERGOING ELECTIVE CAESAREAN SECTION AT HOSPITALS IN ADDIS ABABA, ETHIOPIA
Abstract
Background: Preoperative anxiety is one of the common emotional responses recognized as an important problem that is accompanied with potential negative consequences both before and after the surgical procedure. The purpose of this study was to generate information and documenting the extent of preoperative anxiety among pregnant women waiting for elective cesarean section (CS) deliveries and identifying potential associated factors.
Methods: Hospital-based, cross-sectional design was used to interview 384 pregnant women scheduled for elective caesarean section delivery. Preoperative anxiety was assessed by using the state-trait anxiety inventory (STAI). Means and proportions where computed followed by bivariate analysis. Multivariate binary logistic regression was used to identify predicators of preoperative anxiety. Odds ratio with 95% confidence interval was used to estimate strength of association.
Results: The prevalence of preoperative anxiety in this study was 45.6% (95% CI 40.7-50.6%). The mean age was 26.7 years and 97.7% of the participants were married with 75% attaining secondary and above schooling. Over 80% did not obtain any information related to their caesarean section during the preoperative time. The common reasons for worry were fear of unexpected outcome (46.9%), fear of complications (33.6%) and concern about family (32.0%). Bivariable analysis suggested that age, education level, paid job, gravidity, trait anxiety and previous CS were statistically associated with preoperative state anxiety. Multivariable logistic regression showed not receiving information about the procedure of the planned operation (AOR 10.49; 95% CI 1.84-88.51), fear of unexpected outcome (AOR 2.07; 95% CI 1.11-3.88), concern about postoperative pain (AOR 1.91; 95% CI 1.00-3.70), fear of death (AOR 4.44; 95% CI 2.07-10.0) and preexisting disposition to anxiety trait (AOR 4.53; 95% CI 2.53-8.26) had statistically significant association with having preoperative anxiety.
Conclusion: The prevalence of preoperative anxiety was significant (45.7%). The study revealed the deficit of provision of information to the patients about the surgery and corroborated many of the risk factors (fear of death, fear of unexpected outcome, fear of pain, lack of information, family concern, and predisposition to anxiety) identified in many other studies in different settings and countries. Assessment and detection of anxiety should, thus, be part of the preoperative consultation.