Evaluation of Anxiety of Patients Undergoing Cardiac Surgery

Introduction:The waiting of a cardiac surgery increases anxiety and burden patients’ perioperative psychosomatic health. Aim: The aim was to evaluate anxiety levels of patients undergoing cardiac surgery and potential correlations with demographic and clinical characteristics. Material and Method: A descriptive study was performed with a convenient sample consisted of 190 (out of 362 patients) admitted for elective open cardiac surgery in a public hospital in Athens (September 2012-March 2013). Three measurements of anxiety levels were conducted by State-Trait Anxiety Inventory (STAI): (a) The admission day (b) The surgery eve and (c) The discharge day. Differences in changes of state-trait score during the follow up period between the measurements were evaluated using repeated measurements analysis of variance (ANOVA). Multiple linear regression analysis correlated with the changes in state-trait score was conducted in a stepwise method to find independent factors. Statistical significance was set at 0.05 (SPSS 19.0). Results: Participants’ mean age was 65.1 years (SD = 11.0 years) and 73.7% of them were male. Fifty five point six per cent of the patients underwent CABG and 29.4% a valve replacement. Between (a) and (b) measurements, no statistically significant change was recorded on trait (p=0.456) and state score (p=0.669). Between (c) and (b) there was a significant reduction in trait (p=0.016) and state score (p=0.032). Factors associated with reduction of state anxiety were marital status (married patients), patients suffered AMI (<90 days) and those with complications. Factors associated with the reduction of state anxiety (a) were patients with AMI (b=5.37, SE=2.11, p=0.012) and patients with an increased EuroSCORE (b=0.45, SE=0.13, p=0.001). Highest levels of trait score (a) were found in women (b=4.72, SE=1.27, p<0.001) and in patients with increased risk (b=2.06, SE=0.86, p=0.018). Patients with complications (b=4.98, SE=2.06, p=0.017) and Chronic Renal Failure (CRF) (b=11.08, SE=4.16, p=0.008) were associated with increased levels of state anxiety at (c). Multivariate analysis for trait score at (c) showed that the presence of CRF (b=8.45, SE=3.38, p=0.024) and increased risk (b=8.59, SE=3.13, p=0.014) correlated with higher levels of trait anxiety at (c). Conclusions: Patients undergoing cardiac surgery experience more anxiety, which decreases after surgery. Patient groups such as women, married patients, patients with AMI, patients with high EuroSCORE and patients who self-estimate surgery as high risk, suffer from anxiety more than others. It is suggested preoperative assessment of anxiety levels and the implementation of programs for controlling anxiety in sensitive patients groups.