The effects of a long and uncertain surgical appointment on the pre-operative psychological status of patients awaiting arthroscopic knee surgery

Abstract

Introduction: Postponements of surgery present a constant challenge for both the healthcare system and patients, which can have many adverse effects on patients’ health. Due to the COVID-19 pandemic, the number of postponed surgeries has multiplied, which has not been seen in recent decades. Patients’ preoperative anxiety can be traced back to a wide range of reasons, to which the pandemic also contributed. The resulting postponements presumably meant additional psychological strain for the patients.
Methodology: We included 83 patients between the ages of 18 and 60 waiting for arthroscopic knee surgery registered at the Traumatology Department of the Szent-Györgyi Albert Clinical Center of the University of Szeged in the study on an anonymous, voluntary basis. The mean age of the patients was 37.7 (standard deviation: 13.1) years. The study group included 54 patients whose surgery was postponed one or more times during the second or third wave of the pandemic, or whose surgical appointment was postponed. The control group consisted of 29 patients whose complaints appeared after the end of the third wave of the pandemic, and whose doctor booked them for surgery after the examinations. The patients filled out the abbreviated Hungarian version of the World Health Organization Well-Being Index, the abbreviated version
of Spielberger’s State-Trait Anxiety Inventory, the Perceived Stress Scale and the Hopelessness Questionnaire. The obtained data were processed and compared in groups, for which the IBM SPSS Statistics 21 program was used.
Results: According to the results, patients whose surgery was postponed several times are characterized by worse well-being and higher anxiety. The duration of the surgical postponement does not affect the psychological state of the patients. In terms of trait and state anxiety, the highest score was shown when the notification of the surgical postponement was provided by assistants, followed by doctors, while the lowest level of anxiety was shown when postponement was reported by e-mail notification.
Conclusions: The patients do not primarily have a problem with the long appointment time interval, but with the new postponement over and over again, which means that patients have to mentally prepare for the surgery every time, and then process the disappointment caused by the postponement. Based on the results of the present study, it is most suitable in terms of the patients’ anxiety if they receive the information about the postponement of the surgery by email, but at the same time, the operating doctor can provide the comprehensive information.