Factors influencing preoperative anxiety among patients undergoing elective surgery in Kenya:the role of nurse anaesthetists

Abstract

Patients awaiting elective surgery often struggle with preoperative anxiety, which has been associated with unfavorable outcomes. In Kenya, despite notable improvements in surgical and anesthesia services, many patients still continue to experience severe anxiety before surgery. This study examined factors influencing preoperative anxiety among patients undergoing elective surgery in a selected referral hospital in Kenya. Specifically, the study assessed the level of preoperative anxiety, identified factors associated with preoperative anxiety, and examined the role of nurse anesthetists in reducing preoperative anxiety. The study employed descriptive cross-sectional research design. Target population comprised adult patients of 18+ years scheduled for elective surgery in Mathare National Teaching and Referral Hospital, Kenya. Purposive technique was used to sample 19 of them, from whom data was collected using a structured questionnaire. Measures of socio-demographic and clinical characteristics, preoperative anxiety, and nurse anesthetists' interventions were incorporated into the questionnaire. Of the 19 respondents, 15 successfully completed the questionnaire, accounting for a 78.9% response rate. Data was analyzed using descriptive statistics, Chi-square tests, and exploratory logistic regression. The findings indicated that elevated preoperative anxiety was experienced by 66.7% respondents. The most predominant concerns included fear that something might go wrong during surgery (73.3%), worrying about anesthesia (66.7%), nervousness about surgery (66.7%), and fear of postoperative pain (60.0%). Younger age, inadequate preoperative information, and absence of previous surgical experience indicated potentially significant correlations with anxiety. However, these did not reach statistical significance due to the small sample size.The study concluded that preoperative anxiety is a significant concern that requires systematic attention during elective surgical care. Recommendations included structured nurse-led preoperative education, routine anxiety screening, individualized counseling, empathetic communication, and targeted reassurance, especially for first-time surgical patients. Larger and broader studies across Kenyan hospitals are suggested to establish more generalizable evidence.