Translation and Validation of the Amsterdam Preoperative Anxiety and Information Score for evaluation of preoperative anxiety in adult surgical patients in Black Lion Hospital, Addis Ababa, Ethiopia.

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Addis Abeba University


Background: Perioperative anxiety is described as a vague, uneasy feeling, the source of which is often nonspecific and unknown to the individual. It has the potential to affect all aspects of anesthesia such as preoperative visit, induction, perioperative and recovery periods. Although the magnitude and consequences of preoperative anxiety is well documented in developed world, there are limited studies conducted in Ethiopia. The use of anxiety screening instruments that take too much time to be filled will not be applicable clinically in our set up where enough time may not be given to conduct preoperative assessments. Objective: The primary aim of this study is to translate the APAIS into Ethiopian national language, Amharic and evaluate its validity in assessing the prevalence of preoperative anxiety in Black lion Hospital. Methods: A forward and backward translation of the items in APAIS was performed into Amharic by a legal bilingual expert. Three hundred sixty five sampled elective adult surgical patients scheduled for surgery at Black lion hospital were interviewed from July 01 to Aug 30, 2019 using the Amharic version of the APAIS. Then, the validity of the translated version was checked by evaluating its psychometric properties of internal validity and acceptability. The results were also compared with findings of other similar studies. Results: The reliability of the Amharic version of the APAIS was high ( Cronbach's alpha of 0.87) and the data collected was a good fit ( RMSEA of 0.04) In addition, the questionnaire was well accepted 100% with no missing values for each dimension of the APAIS. The mean APAIS scores for total anxiety and desire for information were 11.6 and 6.0 respectively and 58.9% of the study participants had anxiety and those patients, who had some form of formal education, came from urban areas, had previous anesthesia experience and complications and who had average or high information requirement were more likely to be anxious. Conclusion: The Amharic version of the APAIS is a reliable and acceptable tool for measuring patients’ preoperative anxiety and their need of information. It can be used routinely as a screening instrument at pre anesthesia clinics to assess patients’ level of anxiety.



Adult surgical patients,Anxiety ,Information Score