• Arvid S Haugen, Geir E Eide, Marit V Olsen, Berit Haukeland, Asa R Remme, and Astrid K Wahl.
• Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. arvid.haugen@helse-bergen.no
• J Clin Nurs. 2009 Aug 1;18(16):2301-10.

AimsTo estimate the frequency of intraoperative anxiety, the influence of environmental factors on intraoperative anxiety and to study the relationship between intraoperative anxiety and generalised anxiety and depression.BackgroundPrevious research has documented that surgery is associated with increased stress and anxiety, which have an adverse effect on patient outcomes. Few studies have been conducted to obtain patients' perspectives about the influence of the operating theatre environment on anxiety.DesignThe study used a survey design including questionnaires.MethodClinical variables were noted from the anaesthesia medical records. The sample (n = 119) comprised patients undergoing elective surgery and emergency operations within 24 hours of admission. Anxiety was assessed by the Jakobsen's questionnaire and the Hospital Anxiety and Depression scale.ResultsTwenty-three per cent felt anxious on arrival at the operating theatre, 35% were anxious at induction of anaesthesia, while 12% felt anxious after induction. At start of surgery 15% experienced anxiety and during surgery 9% were anxious. Continuous information reduced the experience of anxiety in 49% of the patients and the opportunity to ask questions during the intraoperative period reduced anxiety in 55%. The sight of technical equipment and surgical instruments was reported to increase anxiety in 9% and 6% of the sample, respectively. Patients with higher levels of general anxiety and depression also experienced significantly higher levels of anxiety in the intraoperative period.ConclusionsIn this study patients experience highest level of anxiety at induction of anaesthetics. The operating theatre environments impact on patients' anxiety are in less degree influenced by the sight and hearing of the technical equipment and the surroundings. Continuous information and opportunity to ask questions reduces patients' anxiety. Results indicate that there is a significant positive relationship between generalised anxiety and depression prior to admission and anxiety experienced during the intraoperative period.Relevance To Clinical PracticeGeneralised anxiety and depression prior to surgery should be identified to implement nursing interventions to reduce anxiety in the operating theatre.

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