The Visual Analog Scale Allows Effective Measurement of Preoperative Anxiety and Detection of Patients’ Anesthetic Concerns
Abstract
UNLABELLED: The advent of managed care, reduction of costs, and advances in medical technology place increasing demands on anesthesiologists. Preoperative anxiety may go unnoticed in an environment that stresses increased productivity. The present study compares different methods for measuring preoperative anxiety, identifies certain patient characteristics that predispose to high anxiety, and describes the quantity and quality of anxiety that patients experience preoperatively. Seven hundred thirty-four patients participated in the study. We assessed aspects of anxiety by means of visual analog scales (VAS) and the State Anxiety Score of the Spielberger State-Trait Anxiety Inventory (STAI). The mean STAI anxiety score was 39 +/- 1 (n = 486) and the mean VAS for fear of anesthesia was 29 +/- 1 (n = 539). Patients feared surgery significantly more than anesthesia (P < 0.001). The VAS measuring fear of anesthesia correlated well with the STAI score (r = 0.55; P < 0.01). Young patients, female patients, and patients with no previous anesthetic experience or a previous negative anesthetic experience had higher anxiety scores. Patients worried most about the waiting period preceding surgery and were least concerned about possible awareness intraoperatively. Factor analysis of various anxiety items showed three distinct dimensions of fear: 1) the fear of the unknown 2) the fear of feeling ill, and 3) the fear for one's life. Among these dimensions, fear of the unknown correlated highest with the anxiety measuring techniques STAI and VAS. The simple VAS proved to be a useful and valid measure of preoperative anxiety. IMPLICATIONS: The study of qualitative aspects of anxiety reveals three distinct dimensions of preoperative fear: fear of the unknown, fear of feeling ill, and fear for one's life. Groups of patients with a higher degree of preoperative anxiety and their specific anesthetic concerns can be identified using the visual analog scale.
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Kain et al. advised taking the m-YPAS at two points in time.
“in their original article validating the m-YPAS, Kain et al. advised taking the measure at two points in time [17].”
The A-VAS measure matches the Phase II RCT and has been well used and validated in this setting.
“We have chosen this measure since it matches the Phase II RCT and has been well used and validated in this setting [15-17].”
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- Authors
- Kindler, C. H., Harms, C., Amsler, F., Ihde-Scholl, T., & Scheidegger, D.
- Affiliations
- University of Basel (CH)
- University of Wisconsin–Madison (US)
- Corresponding author
- Kindler, Christoph H.
- Harms, Christoph
- Amsler, Felix
- Scheidegger, Daniel
- Venue
- Anesthesia & Analgesia
- Published
- 2000-03
- Volume
- 90
- Issue
- 3
- Pages
- 706-712
- ISSN
- 0003-2999 (ISSN-L)
- OpenAlex
- W2153407324
- Cited by
- 632
- References
- 38
- Citations by year
- 2026: 28 · 2025: 32 · 2024: 34 · 2023: 25 · 2022: 50 · 2021: 37 · 2020: 38 · 2019: 26 · 2018: 28 · 2017: 27 · 2016: 27 · 2015: 36 · 2014: 38 · 2013: 22 · 2012: 25
- FWCI
- 11.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anesthesia & Analgesia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- preoperative anxiety, visual analogue scale, fear of anesthesia, State-Trait Anxiety Inventory, anxiety assessment, fear of the unknown, patient characteristics, intraoperative awareness
- MeSH terms
- Adult, Aged, Anesthesia, Anxiety, Female, Humans, Male, Middle Aged, Psychological Tests, Surgical Procedures, Operative
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