What can help relieve anxiety before surgery?

Surveys have shown that most people don’t feel they have enough information before surgery. As a result, many don’t feel confident about the decision they have made, and they may have doubts.

The amount and type of information people want varies a lot from person to person: Some people want to know exactly what is going to happen during and after a procedure or operation. Others would prefer to be told about what they will see and feel. Many would like advice about how to cope with these situations. So it may be a good idea to do the following things ahead of time:

• Get information: Knowing what will happen during the operation can reduce uncertainty.
• Plan: You might want to talk with your doctors and nurses about the type of pain therapy and follow-up care you will have.

Having enough information can help you feel safer. Knowing what other treatments are available and how they compare with the planned procedure may also be helpful.

Last, but not least, every patient has the right to get a second opinion from a different doctor – in other words, to ask them for advice and perhaps be examined again.

Information and decision aids

One of doctors’ responsibilities is to inform patients about what will happen during a procedure and explain the risks. When preparing for doctor’s appointments, it’s a good idea to make a list of questions you may have about the surgery. You may find our list of questions helpful.

Because it isn’t always possible for the doctor to answer all of the questions, many people end up looking for more information afterwards. There are many different sources of medical information – including leaflets, books, films, websites or Internet forums – but the information is often contradictory, confusing or simply wrong. Some of it may even end up scaring you or making you feel even more anxious.

There are also decision aids for people with certain illnesses – on paper or online. These usually contain information and questions that can help you find out what is important for you, personally. Decision aids concerning surgery may, for instance, present the advantages and disadvantages of an operation and help you realize how important they are to you.

Once you have a clear idea of your own wishes, values and expectations, it can be easier to make the right decision – or to reassure yourself that you have made the correct decision. Structured decision aids are only available for a few illnesses. They were often developed in studies, and are rarely given to patients on a routine basis. Studies in which decision aids were used in preparation for decisions about treatments and surgery suggest that reliable, good-quality informationen and the active involvement of patients can increase their satisfaction with the decision while reducing their fears. So it can be helpful to use decision aids where they are available.

Other things that may be important before surgery

Having a talk with the doctor before surgery can also give you the opportunity to discuss and make arrangements concerning things that may be on your mind, such as:

• which medications you should stop taking before the operation, such as medication for chronic diseases,
• how long before having the anesthetic and after surgery you shouldn’t eat, drink or smoke,
• how surgical wounds and pain are treated after the surgery,
• what should happen if the operation leads to the discovery of a certain illness, such as cancer,
• whether medical or personal requests will be noted in your medical file,
• whether and how much medical information is allowed to be shared with family members and friends,
• whether you have, or have to make, arrangements for written documents like an advance health care directive or power of attorney,
• how soon after surgery you can return home, and how you will get there,
• when you can return to work,
• whether you will need help at home after the surgery, for instance with household chores or looking after children.

It can be helpful to write down any questions you have before you talk with the doctor, and take the list along to the appointment.

Sources

• Berth H, Petrowski K, Balck F. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) - the first trial of a German version. Psychosoc Med 2007; 4: Doc01. [PMC free article: PMC2736533] [PubMed: 19742298]
• Brandes K, Linn AJ, Butow PN et al. The characteristics and effectiveness of Question Prompt List interventions in oncology: a systematic review of the literature. Psychooncology 2015; 24(3): 245-252. [PubMed: 25082386]
• Kinnersley P, Edwards A, Hood K et al. Interventions before consultations to help patients address their information needs by encouraging question asking: systematic review. BMJ 2008; 337: a485. [PMC free article: PMC2500196] [PubMed: 18632672]
• Kinnersley P, Phillips K, Savage K et al. Interventions to promote informed consent for patients undergoing surgical and other invasive healthcare procedures. Cochrane Database Syst Rev 2013; (7): CD009445. [PubMed: 23832767]
• Niburski K, Guadagno E, Mohtashami S et al. Shared decision making in surgery: A scoping review of the literature. Health Expect 2020; 23(5): 1241-1249. [PMC free article: PMC7696205] [PubMed: 32700367]
• Sansoni JE, Grootemaat P, Duncan C. Question Prompt Lists in health consultations: A review. Patient Educ Couns 2015. [PubMed: 26104993]
• Sawicki PT. Qualität der Gesundheitsversorgung in Deutschland. Ein randomisierter simultaner Sechs-Länder-Vergleich aus Patientensicht. Med Klin 2005; 100(11): 755-768. [PubMed: 16328186]
• Stacey D, Légaré F, Lewis K et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2017; (4): CD001431. [PMC free article: PMC6478132] [PubMed: 28402085]

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.