Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Scientific Article

Preoperative education reduces preoperative anxiety in cancer patients undergoing surgery: Usefulness of the self-reported Beck anxiety inventory

A informação no pré-operatório reduz a ansiedade pré-operatória em pacientes com câncer submetidos à cirurgia: utilidade do Inventário Beck de Ansiedade

Marilia F. Lemos; Sylvio V. Lemos-Neto; Louis Barrucand; Nubia Verçosa; Eduardo Tibirica

Downloads: 0
Views: 425


Abstract Background and objectives: Preoperative instruction is known to significantly reduce patient anxiety before surgery. The present study aimed to investigate the effects of preoperative education on the level of anxiety of cancer patients undergoing surgery using the self-reported Beck anxiety inventory. Methods: This study is a short-term observational study, including 72 female patients with a diagnosis of endometrial cancer who were scheduled to undergo surgical treatment under general anesthesia. During the pre-anesthetic consultation 15 days before surgery, one group of patients (Group A, n = 36) was given comprehensive information about their scheduled anesthetic and surgical procedures, while the other group of patients (Group B, n = 36) did not receive any information pertaining to these variables. The Beck anxiety inventory, blood pressure and heart rate were evaluated before and after the preoperative education in Group A. In Group B, these parameters were evaluated at the beginning and at the end of the consultation. Results: The hemodynamic values were lower in the group that received preoperative education, in comparison with the group that did not receive preoperative education. Educating the patients about the procedure resulted in a reduction in the levels of anxiety from mild to minimum, whereas there was no change in the group that did not receive the preoperative education. This latter group kept the same level of anxiety up to the end of pre-anesthetic consultation. Conclusions: Patient orientation in the preoperative setting should be the standard of care to minimize patient anxiety prior to surgery, especially for patients with cancer.


Pre-anesthetic evaluation, Anxiety, Beck anxiety inventory, Cancer


Resumo: Justificativa e objetivos: A informação transmitida no pré-operatório é conhecida por reduzir de modo significativo a ansiedade do paciente antes da cirurgia. O presente estudo teve como objetivo investigar os efeitos da orientação pré-operatória sobre o nível de ansiedade de pacientes com câncer submetidos à cirurgia, utilizando o inventário Beck de ansiedade. Métodos: Estudo observacional de curto prazo, incluindo 72 pacientes do sexo feminino com diagnóstico de câncer endometrial, programadas para receber tratamento cirúrgico sob anestesia geral. Durante a consulta pré-anestésica, 15 dias antes da cirurgia, um grupo de pacientes (Grupo A, n = 36) recebeu informações abrangentes sobre seus procedimentos anestésicos e cirúrgicos, enquanto o outro grupo de pacientes (Grupo B, n = 36) não recebeu qualquer informação referente a essas variáveis. O inventário Beck de ansiedade, a pressão arterial e a frequência cardíaca foram avaliados antes e após a transmissão de informações ao Grupo A. No Grupo B, esses parâmetros foram avaliados no início e no final da consulta. Resultados: Os valores hemodinâmicos foram menores no grupo que recebeu informação pré-operatória, em comparação com o grupo que não recebeu informação pré-operatória. Informar os pacientes sobre o procedimento resultou em uma redução dos níveis de ansiedade de leve a mínimo, enquanto não houve mudança no grupo que não recebeu informação pré-operatória. Esse último grupo manteve o mesmo nível de ansiedade até o final da consulta pré-anestésica. Conclusões: A orientação do paciente no período pré-operatório deve ser o atendimento padrão para minimizar a ansiedade dos pacientes antes da cirurgia, especialmente os pacientes com câncer.


Avaliação pré-anestésica, Ansiedade, Inventário Beck de ansiedade, Câncer


Halaszynski TM, Juda R, Silverman DG. Optimizing postoperative outcomes with efficient preoperative assessment and management. Crit Care Med. 2004;32:S76-86.

Wijeysundera DN. Preoperative consultations by anesthesiologists. Curr Opin Anaesthesiol. 2011;24:326-30.

Ciccozzi A, Marinangeli F, Colangeli A. Anxiolysis and postoperative pain in patients undergoing spinal anesthesia for abdominal hysterectomy. Minerva Anestesiol. 2007;73:387-93.

Weissman C. The metabolic response to stress: an overview and update. Anesthesiology. 1990;73:308-27.

Fell D, Derbyshire DR, Maile CJ. Measurement of plasma catecholamine concentrations: an assessment of anxiety. Br J Anaesth. 1985;57:770-4.

Badner NH, Nielson WR, Munk S. Preoperative anxiety: detection contributing factors. Can J Anaesth. 1990;37:444-7.

Capuzzo M, Alvisi R. Is it possible to measure and improve patient satisfaction with anesthesia?. Anesthesiol Clin. 2008;26:613-26.

Waller A, Forshaw K, Bryant J. Preparatory education for cancer patients undergoing surgery: a systematic review of volume and quality of research output over time. Patient Educ Couns. 2015;98:1540-9.

Mills ME, Sullivan K. The importance of information giving for patients newly diagnosed with cancer: a review of the literature. J Clin Nurs. 1999;8:631-42.

Hoon LS, Chi Sally CW, Hong-Gu H. Effect of psychosocial interventions on outcomes of patients with colorectal cancer: a review of the literature. Eur J Oncol Nurs. 2013;17:883-91.

Guo Z, Tang HY, Li H. The benefits of psychosocial interventions for cancer patients undergoing radiotherapy. Health Qual Life Outcomes. 2013;11:121.

Wakefield CE, Butow PN, Aaronson NA. Patient-reported depression measures in cancer: a meta-review. Lancet Psychiatry. 2015;2:635-47.

Sugarman MA, Loree AM, Baltes BB. The efficacy of paroxetine and placebo in treating anxiety and depression: a meta-analysis of change on the Hamilton Rating Scales. PLOS One. 2014;9:e106337.

Donzuso G, Cerasa A, Gioia MC. The neuroanatomical correlates of anxiety in a healthy population: differences between the State-Trait Anxiety Inventory and the Hamilton Anxiety Rating Scale. Brain Behav. 2014;4:504-14.

Muntingh AD, van der Feltz-Cornelis CM, van Marwijk HW. Is the Beck anxiety inventory a good tool to assess the severity of anxiety?. A primary care study in the Netherlands Study of Depression and Anxiety (NESDA). BMC Fam Pract. 2011;12:66.

Beck AT, Epstein N, Brown G. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893-7.

Gomes-Oliveira MH, Gorenstein C, Lotufo Neto F. Validation of the Brazilian Portuguese version of the Beck Depression Inventory-II in a community sample. Rev Bras Psiquiatr. 2012;34:389-94.

Gorenstein C, Andrade L. Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Braz J Med Biol Res. 1996;29:453-7.

Klafta JM, Roizen MF. Current understanding of patients' attitudes toward and preparation for anesthesia: a review. Anesth Analg. 1996;83:1314-21.

Brown GK, Beck AT, Newman CF. A comparison of focused and standard cognitive therapy for panic disorder. J Anxiety Disord. 1997;11:329-45.

Lee YW, Park EJ, Kwon IH. Impact of psoriasis on quality of life: relationship between clinical response to therapy and change in health-related quality of life. Ann Dermatol. 2010;22:389-96.

Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg. 1999;89:1346-51.

Johnston M. Anxiety in surgical patients. Psychol Med. 1980;10:145-52.

Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology. 1991;74:581-605.

Eren G, Cukurova Z, Demir G. Comparison of dexmedetomidine and three different doses of midazolam in preoperative sedation. J Anaesthesiol Clin Pharmacol. 2011;27:367-72.

Bottomley A. Psychosocial problems in cancer care: a brief review of common problems. J Psychiatr Ment Health Nurs. 1997;4:323-31.

Pitceathly C, Maguire P, Fletcher I. Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients?. A randomised controlled trial. Ann Oncol. 2009;20:928-34.

Galway K, Black A, Cantwell M. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database Syst Rev. 2012;11:CD007064.

Spencer R, Nilsson M, Wright A. Anxiety disorders in advanced cancer patients: correlates and predictors of end-of-life outcomes. Cancer. 2010;116:1810-9.

Ortiz J, Wang S, Elayda MA. Preoperative patient education: can we improve satisfaction and reduce anxiety?. Rev Bras Anestesiol. 2015;65:7-13.

Fitzgerald BM, Elder J. Will a 1-page informational handout decrease patients' most common fears of anesthesia and surgery?. J Surg Educ. 2008;65:359-63.

Bondy LR, Sims N, Schroeder DR. The effect of anesthetic patient education on preoperative patient anxiety. Reg Anesth Pain Med. 1999;24:158-64.

Katz RI, Cimino L, Vitkun SA. Preoperative medical consultations: impact on perioperative management: surgical outcome. Can J Anaesth. 2005;52:697-702.

Klopfenstein CE, Forster A, Van Gessel E. Anesthetic assessment in an outpatient consultation clinic reduces preoperative anxiety. Can J Anaesth. 2000;47:511-5.

Therrien Z, Hunsley J. Assessment of anxiety in older adults: a systematic review of commonly used measures. Aging Ment Health. 2012;16:1-16.

5dcaf95b0e88251e3203b87a rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections