Validation of the Turkish Version of the Surgical Fear Questionnaire

The Effect of Internet Information Pollution on Surgical Fear in Patients Undergoing Surgery

PURPOSE

This study aimed to determine the effect of internet information pollution on levels of surgical fear among patients undergoing surgery.

DESIGN

Observational study.

METHODS

This study was conducted with 407 patients scheduled for surgery in the surgical wards of a university hospital. Data were collected preoperatively using a patient information form, the Internet Information Pollution Scale, and the Surgical Fear Questionnaire.

FINDINGS

A very weak positive correlation was found between total internet information pollution score and total surgical fear score (r = 0.184; P < .001). In regression analysis of the impact of internet information pollution on total surgical fear score, the regression model was significant (F = 13.183; P < .001), with 2.9% of the total change in surgical fear score explained by the total internet information pollution score (R2 = 0.029).

CONCLUSIONS

The results of this study suggest that the information pollution surgical patients encounter on the internet may increase their surgical fear. We recommend directing patients to reliable information sources and attempting to control unreliable data sources to prevent online information pollution and reduce patients' surgical fear.

The relationship between spiritual well-being and surgical fear in elderly patients with gonarthrosis

BACKGROUND

Gonarthrosis is a chronic degenerative joint disease characterised by prolonged pain, affecting ~10% of men and 18% of women aged 60 and older worldwide. Surgical interventions are commonly employed in patients with gonarthrosis to minimise disability, alleviate pain, and improve overall quality of life. However, surgical treatment remains a feared experience. This study was conducted to identify the levels of spiritual well-being and surgical anxiety in elderly patients diagnosed with gonarthrosis who are scheduled for surgical intervention. The aim was to examine the relationship between these factors and identify influencing elements.

METHODS

This descriptive and correlational study was conducted between September 2022 and June 2023 in the orthopaedics and traumatology service of a state hospital, involving 105 patients aged 65 and above with gonarthrosis and admitted for treatment. Data were collected using the Personal Information Form, Surgical Fear Questionnaire, and Three-Factor Spiritual Well-being Scale. Data were analyzed with descriptive statistical tests, Mann-Whitney U-test, Kruskal-Wallis test, and Spearman correlation analysis.

RESULTS

The short-term surgical fear of patients was 11.69 ± 7.55, the long-term surgical fear was 10.70 ± 9.53, and the total surgical fear was 22.40 ± 14.69 points, indicating a low level. Single and inexperienced elderly patients had higher levels of surgical fear (P < 0.05). The spiritual well-being levels of elderly patients (transcendence, 59.65 ± 12.20; harmony with nature, 29.10 ± 4.65; anomy, 26.34 ± 5.28; total score, 115.10 ± 17.83) were high. The spiritual well-being levels of elderly individuals whose income matched their expenses were higher (P < 0.05). There was a statistically significant negative relationship between the level of anomy in elderly patients with gonarthrosis and surgical fear (P < 0.05).

CONCLUSIONS

In elderly patients with planned surgical interventions for gonarthrosis. It was determined that the levels of surgical fear were low, and the levels of spiritual well-being were high. The study identified that the level of anomy had an impact on surgical fear. It is recommended that healthcare professionals be aware of the influence of spiritual well-being on surgical fear and provide spiritual support to elderly patients.

The Effect of Preoperative Education Regarding Intraoperative Care on a Patient's Level of Fear of Surgery: A Randomized Controlled Study

This randomized controlled study aimed to investigate the effect that preoperative education provided by the perioperative nurse about the OR environment and intraoperative care has on surgical fear in patients who come to the OR for surgical intervention. The study involved 92 patients undergoing elective abdominal surgery who were randomly assigned to the intervention or routine care group. Preoperatively, patients in the intervention group received education via a form that described the OR environment, the surgical process, and intraoperative care. The patients' surgical fear levels were assessed in the patients' rooms, in the clinic before education, and on arrival to the OR after education. The results showed that preoperative education about the OR environment and intraoperative processes significantly reduced patients' surgical fears.

The Effect of Preoperative Pain, Fear, and Anxiety on Postoperative Pain in Urological Surgery Patients: A Descriptive and Correlational Study

PURPOSE

The study was conducted to determine the effect of preoperative pain, fear, and anxiety on postoperative pain and analgesia use in urology patients.

DESIGN

A descriptive and correlational design was used.

METHODS

The population of the study consisted of patients who were hospitalized in the Urology clinic of a university hospital and were planning surgery. The sample consisted of 106 patients who met the inclusion criteria and agreed to participate in the study. The study's data was collected using the Personal Information Form, Analgesia Follow-up Form, Surgical Fear Questionnaire, Surgical Anxiety Questionnaire, and Visual Analog Scale prepared in line with the literature. Descriptive statistics, Pearson correlation coefficient, and linear regression analysis were used to evaluate the data.

FINDINGS

A positive linear relationship was found between postoperative pain and surgical anxiety, surgical fear, and preoperative pain (P < .05). Regression analysis revealed that preoperative pain (P = .006) affected the level of postoperative pain. In addition, fear of surgery (P = .035) and postoperative pain (P = .000) were found to affect the use of postoperative 24-hour analgesia.

CONCLUSIONS

The study revealed a relationship between the postoperative pain experienced by the patients and preoperative pain, fear, and anxiety.

Effect of Emotional Freedom Technique Applied to Patients Before Laparoscopic Cholecystectomy on Surgical Fear and Anxiety: A Randomized Controlled Trial

PURPOSE

No studies have investigated the effect of the Emotional Freedom Technique (EFT) on the surgical fears and anxieties of patients before laparoscopic cholecystectomy. This study aimed to determine the effect of EFT on patients' surgical fears and anxieties before laparoscopic cholecystectomy.

DESIGN

The research was conducted using a pretest, post-test, and randomized controlled experimental research design.

METHODS

A total of 112 patients (56 in the intervention group and 56 in the control group) were included in the study. While routine care and treatment practices were applied to the control group, EFT was applied to the intervention group. A Patient Information Form, an Anxiety Specific to Surgery Questionnaire, a Surgical Fear Questionnaire, and Subjective Units of Disturbance (SUD) were used to collect the research data.

FINDINGS

There was no significant difference between the groups in terms of descriptive and clinical features (P > .05). The post-test score averages of EFT group in the Surgical Fear Questionnaire, Anxiety Specific to Surgery Questionnaire, and SUD were significantly lower than in the control group (P < .001). The EFT significantly reduced the SUD scores of the patients by 54.4% (η2 = 0.544, P < .001).

CONCLUSIONS

EFT was found to be useful in clinical practice in the preoperative period, reducing surgery-specific anxiety and surgical fear. EFT can be recommended for application during the preoperative period in clinics.

The relationship between the perception of surgical fear and nursing satisfaction

Since patient satisfaction is considered a criterion in the evaluation of nursing care, it is important and necessary to know the factors associated with satisfaction. The aim of this study is to determine the relationship between surgical fear and satisfaction with nursing care in surgical patients. This descriptive correlational study was conducted with 110 patients who underwent planned major surgical intervention in a university hospital in Turkey. A patient introduction form, the Surgical Fear Questionnaire and Newcastle Satisfaction with Nursing Care Scale were used to collect data, as well as a face to face interview with patients during the pre and postoperative periods. The results showed that the surgical fear levels of the patients were low, their satisfaction with nursing care was high, and a weak correlation existed between the fear and satisfaction levels. We recommend nursing care interventions aimed at keeping the surgical fear levels of patients low and their satisfaction high.

The Effect of Preoperative Pain Fear on Postoperative Pain, Analgesic Use, and Comfort Level

BACKGROUND

Preoperative assessment of pain fear could provide essential information for improving perioperative care and could be the first step toward targeted pain management.

AIMS

The aim of this study is to determine the effect of preoperative pain fear on postoperative pain, analgesic use, and comfort level.

METHOD

This cross-sectional study was conducted with 201 patients in the general surgery service between January 2022 and March 2022. A sociodemographic questionnaire, Visual Analog Scale (VAS), pain fear, and general comfort scales were used for data collection. Correlation analysis was performed to examine the relationship between scales, and p < .05 was considered statistically significant.

RESULTS

The mean age of the individuals participating in the study was 51.22±15.89 and 69.2% of them were women. The average score of pain fear was 63.77±21.47, and the average score of the VAS was 7.63±1.82 after the surgery before analgesics and 5.06±1.58 six hours after surgery. The mean comfort level was 132.88±9.26. A significant and positive correlation was detected between the total pain fear and the VAS score, analgesic use, and comfort level (p < .05).

CONCLUSIONS

In this research, findings demonstrated that as the patients' pain fear increased, postoperative pain severity and amount of analgesia increased. Providing pain management with analgesics increases comfort in patients, but it may cause secondary problems in patients who use high-dose analgesics. Therefore, reducing pain fear, which is one of the main factors in pain, is essential in pain management.

Does surgery cause anxiety, stress and fear in geriatric patients?

BACKGROUND

Because of physiological changes in geriatric patients, their surgical process differs from that of young adults. In this regard, the perioperative period is an extremely risky time for geriatric patients. The present study examined preoperative fear, anxiety, and perceived stress levels as well as the factors affecting them in elderly patients prior to surgical intervention.

METHODS

This study adopted a cross-sectional descriptive design. The study sample consisted of geriatric patients (n = 407) scheduled for elective laparoscopic cholecystectomy in a research and training hospital in northeast Turkey. Data were collected by the researchers using the personal information form, Perceived Stress Scale (PSS-10), Surgical Fear Questionnaire (SFQ) and Anxiety Specific to Surgery Questionnaire (ASSQ). In the data analysis, descriptive statistics, the t-test in independent groups, one-way analysis of variance (ANOVA), correlation analysis and Bonferroni tests for post hoc analyses were used.

RESULTS

On the PSS-10, the mean score was higher for the 75-and-older age group, single patients, patients with a disease requiring medication, and those who had previously undergone surgery (P < 0.05). On the ASSQ, the mean score was lower for patients aged 65-69, university graduates, patients without children, and those without a disease requiring medication (P < 0.05). On the SFQ, the mean score was higher for the 75-and-older age group, primary school graduates, and single patients (P < 0.05).

CONCLUSION

It was determined that being single, having a chronic disability, and advancing age had an effect on the patients' surgery-specific anxiety, perceived stress, and fear of surgery. Long-standing chronic diseases can negatively affect both stress and anxiety levels of individuals.

Are religious patients less afraid of surgery? A cross-sectional study on the relationship between dimensions of religiousness and surgical fear

INTRODUCTION

Surgical fear is common and has a negative impact on surgery and its outcome. Recent research has identified individual religiousness as an important factor among patients with associations to mental health, particularly anxiety.

OBJECTIVE

This study aimed to examine associations between religiousness and surgical fear in a representative sample of adult surgical patients in Croatia.

DESIGN

Cross-sectional study among elective surgery patients at different departments of a single hospital.

SETTING

University Hospital Sveti Duh, a tertiary health care facility in Croatia.

MEASUREMENTS

Religiousness and surgical fear were the variables of interest and assessed through self-report instruments. The Croatian version of the Duke Religiosity Index questionnaire (DUREL) assessed organizational religious activity (ORA), non-organizational religious activity (NORA), and intrinsic religiousness (IR). The Croatian version of the Surgical Fear Questionnaire (SFQ) measured surgical fear and its subscales the fear of the short-term and long-term consequences of surgery. Additionally, sociodemographic characteristics and medical history were assessed. Analyses were carried out using descriptive and linear regression analyses.

RESULTS

178 subjects were included for data analysis. Univariate linear regression found two dimensions of religiousness (non-organizational religious activity, intrinsic religiousness) to be weak, but significant predictors of greater surgical fear (adj. R2 = 0.02 and 0.03 respectively). In the multiple linear regression model together with age, gender, education and type of surgery, all three dimensions of religiousness were found to be significant independent predictors of greater surgical fear.

LIMITATIONS

The study was single-center and cross-sectional and did not assess patients' specific religious identity.

CONCLUSIONS

This study demonstrated significant positive associations between dimensions of religiousness and surgical fear, potentially suggesting that surgical patients experience increased religiousness to cope with heightened anxiety. Assessment and intervention to address patient religiousness is warranted in the context of surgical fear among religious patients, and the importance of religiousness in the context of surgical fear needs to be further addressed in research.

A cross-sectional study of fear of surgery in female breast cancer patients: Prevalence, severity, and sources, as well as relevant differences among patients experiencing high, moderate, and low fear of surgery

BACKGROUND

Fear of surgery has been associated with more postoperative pain, disability, and a lower quality of life among patients undergoing various surgical procedures. While qualitative studies indicate breast cancer patients to be afraid of surgery, detailed quantitative analyses are lacking. The present research aimed at investigating the prevalence, severity, and sources of fear of surgery in this patient group and to compare patients reporting different degrees of such fear.

METHODS

This cross-sectional study included 204 breast cancer patients, 18-70 years old, and scheduled for surgery at Oslo University Hospital, Norway. Following their preoperative visit participants completed validated psychological questionnaires online. Among these, the primary outcome measure, the Surgical Fear Questionnaire (SFQ; scores: 0-10 per item, 0-80 overall). Patients were grouped based on SFQ-percentiles (<25th = little, 25th-75th = moderate and >75th percentile = high fear) and compared on psychological (anxiety, depression, experienced injustice, optimism and expected postsurgical pain), sociodemographic, and medical outcomes.

RESULTS

195 patients completed the SFQ. On average fear of surgery was low (M = 26.41, SD = 16.0, median = 26, min-max = 0-80), but omnipresent. Only 1.5% (n = 3) indicated no fear at all. Overall, patients feared surgery itself the most (M = 3.64, SD = 2.8). Groups differed significantly (p < .001) in their experience of anxiety, depression, and injustice, as well as their disposition to be optimistic, and expectance of postsurgical pain. Differences between groups concerning demographic and medical information were largely insignificant.

DISCUSSION

This study was the first to demonstrate fear of surgery to be prevalent and relevant among female breast cancer patients. The higher a patients' fear group, the poorer their preoperative psychological constitution. This, largely irrespective of their current diagnoses or treatments, medical history, and demographics. Fear of surgery might thus cater as a prognostic marker and treatment target in this patient group. However, given the cross-sectional character of the present data, prognostic studies are needed to evaluate such claims.

The relationship between fear of surgery and affecting factors in surgical patients

BACKGROUND

This study aimed to explain the fear of surgery in surgical patients, the affecting factors, and their relationship.

METHODS

This study was conducted as a descriptive and cross-sectional study. The study population consists of 300 patients undergoing surgical intervention. Data were collected using the "patient information form" and "Surgical Fear Questionnaire." Parametric and nonparametric tests were used to evaluate the data. The relationship between the fear questionnaire and age, number of previous surgeries, and pre-operative pain was evaluated using Spearman correlation analysis. The relationship with emotional stress was evaluated with multiple linear regression analysis.

RESULTS

In this study, it was determined that the predictors of the surgical fear level of the patients were age, gender, anesthesia type, and pre-operative pain experience. There was a negative correlation between the age of the patients and the fear of surgery score and a positive correlation between the pre-operative pain severity and the fear of surgery score. It was determined that the factors most associated with pre-operative fear levels were the patients' pre-operative sense of inadequacy (p < 0.001), feeling anxious and unhappy, and confusion about the surgery decision (p < 0.05).

CONCLUSION

According to the results of this study, it has been determined that the emotional states and fears of the patients before the surgery have significant effects on the fear of surgery. For this, it is recommended to determine the emotional states and fears of the patients before the surgery and to make appropriate interventions, as it will facilitate compliance with the surgical process.

Risk factors and protective factors of acute postoperative pain: an observational study at a German university hospital with cross-sectional and longitudinal inpatient data

OBJECTIVES

Surgical fear is one of the most important psychological risk factors for postoperative pain, but less is known about the contribution of protective factors. This study investigated somatic and psychological risk and resilience factors of postoperative pain and validated the German version of the Surgical Fear Questionnaire (SFQ).

SETTING

University Hospital of Marburg, Germany.

DESIGN

Single-centre observational study and cross-sectional validation study.

PARTICIPANTS

Data for validating the SFQ were obtained from a cross-sectional observational study (N=198, mean age 43.6 years, 58.8% female) with persons undergoing different kinds of elective surgery. A sample of N=196 (mean age 43.0 years, 45.4% female) undergoing elective (orthopaedic) surgery was analysed to investigate somatic and psychological predictors of relevant acute postsurgical pain (APSP).

OUTCOME MEASURES

Participants completed preoperative and postoperative assessments at postoperative days 1, 2 and 7. Presurgical pain, age, gender, pain expectation, surgical setting, physical status, anaesthesia, surgical fear, pain catastrophising, depression, optimism and self-efficacy were examined as predictors.

RESULTS

Confirmatory factor analysis confirmed the original two-factor structure of the SFQ. Correlation analyses indicated good convergent and divergent validity. Internal consistency (Cronbach's α) was between 0.85 and 0.89. Blockwise logistic regression analyses for the risk of APSP revealed outpatient setting, higher preoperative pain, younger age, more surgical fear and low dispositional optimism as significant predictors.

CONCLUSIONS

The German SFQ is a valid, reliable and economical instrument with which the important psychological predictor surgical fear can be assessed. Modifiable factors that increase the risk of postoperative pain were higher pain intensity before surgery and being fearful about negative consequences of the surgery whereas positive expectations seem to buffer against postsurgical pain.

TRIAL REGISTRATION NUMBERS

DRKS00021764 and DRKS00021766.

The Fear of Surgery and Coronavirus in Patients Who Will Undergo a Surgical Intervention

PURPOSE

The aim of this study was to determine the fear of surgery and Coronavirus in patients who will undergo a surgical intervention.

DESIGN

A descriptive cross-sectional study.

METHODS

This study was carried out with 103 patients who were hospitalized in the thoracic and cardiovascular surgery departments of a university hospital between July and December 2021 and underwent elective cardiac/thoracic surgery for various indications. The Patient Information Form, Surgical Fear Questionnaire, and Coronavirus (COVID-19) Fear Scale were used to collect data. One hundred three patients were reached within the scope of the study. Data were analyzed with the Mann Whitney U and Kruskal Wallis tests and Spearman's correlation analysis in IBM SPSS (V.22.0) program.

FINDINGS

The mean age of the participants was 57.8 ± 14.0 years (19-82), 68.0% (n = 70) were male, and 78.7% (n = 81) underwent thoracic surgery. The total mean score of the patients on the Surgical Fear Scale was 26.9 ± 20.5 while the total mean score on the Coronavirus Fear Scale was 18.2 ± 7.5. A weak positive correlation was identified between the patients' total score averages on the Surgical Fear Scale and the Coronavirus Fear Scale (COVID-19) (P < .001).

CONCLUSIONS

Patients undergoing cardiothoracic surgery had a low fear of surgery and a close to moderate fear of Coronavirus. Patients' fears of surgery and Coronavirus should be determined before surgery, and psychological support should be provided to patients with high levels of fear.

Preoperative Surgical Fear and Related Factors of Patients Undergoing Brain Tumor Surgery

PURPOSE

Patients with brain tumors may experience preoperative fear due to various reasons such as obscurity, pain, and loss of function. This study was carried out to reveal the pre-operative fear levels of patients undergoing brain tumor surgery.

DESIGN

This descriptive and cross-sectional study was completed with 144 patients.

METHODS

Data were obtained using patient identification forms and the Surgical Fear Questionnaire (SFQ). Descriptive statistics, independent t test, one-way Anova, Pearson correlation, and multiple regression analysis were used.

FINDINGS

The results revealed that the duration of preoperative hospital stay was 3.05 ± 2.26 days, the mean age of the patients was 51.44 ± 13.76 years, and more than half (54.1%) were male. The SFQ total and subscale mean scores of patients who are not working were higher (P < .05). The mean SFQ total and subscale mean scores of those aged 53 and over were lower. (P < .05). Duration of preoperative hospital stay, age, and female gender were statistically significant predictors of SFQ. Duration of preoperative hospital stay was responsible for 62.3% of the change in the SFQ, female gender was responsible for 17.6%, and age was responsible for 20.4%.

CONCLUSION

Understanding the risk factors for preoperative fear can help identify patients at risk. Factors that cause fear should be investigated and information deficiencies that increase the level of fear should be eliminated. It is recommended to use pharmacological and nonpharmacological methods in managing the fear of risk groups.

Evaluation of Fear of Pain Among Surgical Patients in the Preoperative Period

PURPOSE

To evaluate the fear of surgery-related pain of patients in the preoperative period.

DESIGN

A descriptive, cross-sectional study.

METHODS

A total of 419 patients who were scheduled for a variety of surgical procedures in a tertiary hospital were included. Data were collected using a Patient Identification Information Form and fear of pain was evaluated using the Fear of Pain Questionnaire-III.

FINDINGS

50.8% of the patients were males with a mean age of 49.2 ± 17.3 years. A total of 88.8% patients had a fear of pain after surgery, and 89.3% of them had a moderate to severe fear of pain. 84.5% of female patients, 82.5% of literate patients, and 86.1% of patients who had previously experienced severe pain had a fear of pain of moderate to severe intensity (P < .05). The mean Fear of Pain Questionnaire-III score was 75.1 ± 20.2, and the most commonly identified fears were severe pain (30.64 ± 9.5), and medical pain (24.17 ± 7.7). Patients who had a higher score of fear of severe pain and medical pain were those who had experienced severe pain previously and those who believed that they would experience postoperative pain (P < .05).

CONCLUSIONS

Almost all patients included in this study had a fear of moderate to severe postoperative pain while in the preoperative period. Nurses should question pain history with each patient, obtain a detailed pain history, and identify the degree of fear of pain in the preoperative period. Fear of pain should be reduced using necessary interventions and pain control should be maintained. Reduced fear of pain in the preoperative period may decrease postoperative pain and yield favorable patient outcomes.