Evaluation of effect of anxiety levels of patients before open heart surgery on postoperative pain, dispnea, nausea-vomiting and compliance to treatment

INTRODUCTION and OBJECTIVE: To assess the effect of preoperative anxiety levels of patients on post-operative pain, dyspnea, nausea-vomiting and compliance to treatment. MATERIALS and METHOD: The study was conducted with 77 patients who underwent open heart surgery between the dates of September 2017 and April 2018 after obtaining the approval of the ethics committee. Anxiety Specific to Surgery Questionnaire (ASSQ) and a patient information form were used in the pre-operative period. The Visual Analog Scale (VAS), the Modified Borg Scale (MBS), the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) and the Morisky 8-item Medication Adherence Scale (MMAS-8) were used in the post-operative period. The data were analyzed by mean, standard deviation, frequency distribution, Mann-Whitney U Test, Spearman Correlation Analysis and Kruskal-Wallis Test. FINDINGS: The mean age of the participants was found to be 58,63±11,85; 72.7% of them were male; 46.8% of them were overweight, 58.4% of them underwent coronary artery bypass graft surgery. According to the mean scores of the scales, pain level was 1.94; dyspnea severity was 0.91; anxiety level was 22.69; RINVR score was 0.51; mean MMAS score was 5.39. The median of RINVR and ASSQ total distress scores of the female participants compared to the male participants; the median of ASSQ scores of the non-drug using participants compared to the drug using participants; the median of total RINVR scores of the particants having previous surgery was significantly higher compared to the participants having no previous surgery (p<0.05). There was a statistically significant positive correlation between the pain level and the MBS and between the pain level and the RINVR (p <0,05). CONCLUSION: Patients were found to have moderate anxiety prior to open heart surgery, and as postoperative pain increased, dyspnea complaints and nausea and vomiting increased. However, there was no relationship between anxiety and pain, dyspnea, nausea-vomiting and compliance to treatment. Keywords: anxiety, compliance to treatment, dyspnea, nausea, pain