Abstract
BACKGROUND: Preoperative anxiety is a common psychological condition, and many patients express a desire for more information before surgery. Understanding the prevalence and associated factors of both preoperative anxiety and the desire for information can improve patient care. OBJECTIVE: This study aimed to assess the prevalence of preoperative anxiety and desire for information, as well as their associated sociodemographic, medical, and surgical factors, among patients undergoing elective surgery in Northern State, Sudan. METHODS: A hospital-based, multicenter, cross-sectional study was conducted from November 2024 to February 2025 in Northern State, Sudan, involving patients undergoing elective surgery. Data were collected through face-to-face interviews using a structured questionnaire and the validated Arabic version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Chi-square tests and univariate and multivariate logistic regression were performed to identify the associated factors and the magnitude, with statistical significance set at P<.05. RESULTS: Of the 380 patients approached, 305 participated in the study (response rate=80.3%): 173 of the 305 participants (56.7%) were male, and the median age was 43 (IQR 30-64) years. Most participants were married (n=207, 67.9%), educated (n=248, 81.3%), and had family support (n=253, 83.0%). Regarding surgical characteristics, the majority underwent either intermediate (n=136, 44.6%) or major (n=142, 46.6%) procedures. General anesthesia was the most common type used (n=159, 52.2%), and most participants (n=169, 55.4%) underwent surgery in public hospitals. Most participants reported that their surgeries were not covered by insurance (n=264, 86.6%) and described good sleep quality the night before surgery (n=221, 72.5%). Of the 305 participants, 75 (24.6%) experienced preoperative anxiety, whereas 92 (30.1%) expressed a moderate to high desire for information. Preoperative anxiety was significantly associated with family support (adjusted odds ratio [aOR] 7.12, 95% CI 2.64-19.23; P<.001), surgery in public hospitals (aOR 4.31, 95% CI 2.30-8.07; P<.001), poor sleep quality the night before surgery (aOR 2.85, 95% CI 1.51-5.38; P=.001), and American Society of Anesthesiologists (ASA) classification III/IV (aOR 2.36, 95% CI 1.00-5.54; P=.049). Similarly, a higher desire for information was significantly associated with being educated (aOR 2.48, 95% CI 1.00-6.11; P=.049), having family support (aOR 4.10, 95% CI 1.81-9.30; P=.001), undergoing surgery in a public hospital (aOR 3.57, 95% CI 1.93-6.61; P<.001), and being classified as ASA III/IV (aOR 3.26, 95% CI 1.39-7.64; P=.001). CONCLUSIONS: Preoperative anxiety and desire for information are common among Sudanese patients. Family involvement may paradoxically increase anxiety and the desire for more information due to shared concerns and cultural factors. Other significant predictors of anxiety include poor sleep quality and higher ASA classification. Additionally, education, family support, and chronic diseases were associated with a higher desire for information. Addressing these factors may alleviate preoperative anxiety, satisfy communication needs, and improve preoperative care.