Patient-reported Surgical Fear and Degree of Worry on the Day of Surgery: Correlation, Predictors, and Implications for Patient-centered Care. A Mixed-methods Study

PURPOSE: Despite being overall safe, the anticipation of anesthesia and surgery causes fear and anxiety in millions of patients each year. Knowing what matters to patients on the day of surgery and the extent of their worry may help health care professionals support them better. This study aimed to examine the correlation between the degree of worry and surgical fear among patients undergoing surgery, and to explore the characteristics and intensity of preoperative concerns.

DESIGN: The study was a multicenter, flash-mob study, where many sites collect data within a short time frame, using a convergent mixed-methods design, with data collected using a cross-sectional electronic survey.

METHODS: On International Patient Safety Day, we surveyed adult patients scheduled for surgery under local, regional, or general anesthesia. The survey contained questions about what mattered to the patient on the day of surgery, their degree of worry, and the eight-item Surgical Fear Questionnaire. We analyzed correlations and agreement between the degree of worry and the Surgical Fear Questionnaire, and explored factors associated with a higher degree of worry and surgical fear. Finally, we quantified and compared qualitative statements from those with the lowest and highest degree of worry and surgical fear with themes identified in a qualitative analysis.

FINDINGS: Of 966 patients, 51% had moderate or high levels of surgical fear. Female gender and younger age were associated with higher levels of worry and surgical fear. Correlation between the degree of worry and Surgical Fear Questionnaire was strong (Spearman's ρ 0.7, P < .0001). Patients with high levels of worry and a high degree of surgical fear were characterized by a need for health care professionals to comfort them, help them through the procedure, be sensitive to their individual needs, and offer them an individualized approach.

CONCLUSIONS: There was a strong correlation between the patients' degree of worry and fear of surgery. Patients with a high degree of worry and a high level of surgical fear needed individualized care. Asking patients how worried they are and what matters to them may help health care professionals identify patients with a high degree of surgical fear, and knowing what matters to the patient may help health care professionals mitigate the patients' fears, resulting in better patient care.