Prevalence of preoperative anxiety among surgical patients and the associated factors; a one-year study at Al-Hilla Teaching Hospital, Iraq
Abstract
Background & objective: Preoperative anxiety is an emotional state marked by heightened worry, tension, or fear, that most of the patients experience before surgery. Various factors have been mentioned in the literature, including age, gender, education and previous exposure to the surgery etc. The aim of our study was to evaluate and document the prevalence and determinants of preoperative anxiety among patients undergoing surgical procedures.
Methodology: This cross-sectional study was conducted to evaluate the preoperative anxiety level and its association with sociodemographic factors, knowledge, and previous anesthesia experience, in Al-Hilla Teaching Hospital from June 2024 to June 2025 (using the AMSTERDAMEI scale). 400 patients from either gender, were enrolled under convenient sampling. Structured questionnaires on demographic profiles, previous anesthesia and surgery experiences causing anxiety were used.
Results: Most participants were aged 30–39 years (34.0%). Gender distribution was equivalent (51.0% females, 49.0% males). The largest group of participants was employed (39.5%), followed by unemployed (32.5%). Over half (54.5%) experienced preoperative anxiety. The most frequent type of anesthesia in the previously exposed group was local anesthesia (18.0%), and 58.5% had never received any anesthesia. Psychological fears were high: fear of pain during operation (80.0%), fear of death (53.5%), and the concern regarding the experience of the anesthetist (52.0%). Anxiety was significantly associated with occupation (P = 0.0001) and educational level (P = 0.0001), but there were no significant relationships with age, gender, marital status, or anesthesia type using statistical analysis. Patients with increased levels of previous knowledge about anesthesia and surgery, had lower anxiety scores (5.40 ± 1.49 vs. 4.99 ± 1.61, P = 0.03).
Conclusion: Professional history and education have a big effect on how anxious the are the patients before surgery. On the other hand, informing patients about the conduct of the anesthesia can help lower their anxiety levels.
Keywords: Anxiety; Demographic; Knowledge; Preoperative anxiety.
Citation: Saeed AA. Prevalence of preoperative anxiety among surgical patients and the associated factors; a one-year study at Al-Hilla Teaching Hospital, Iraq. Anaesth. pain intensive care 2026;30(3):308-313. DOI: 10.35975/apic.v30i3.3167
Received: November 24, 2025; Revised: February 24; 2026; Accepted: February 28, 2026
