The Effect of Health Literacy on Preoperative Anxiety Levels in Patients Undergoing Elective Surgery

Figures & data

Table 1 Patient Distribution Based on Social-Demographic Characteristics

	Mean ± SD	Min-Max
Age (year)	45.78 ± 15.18	18.00–87.00
	N	%
Gender
Female	207	44.4
Male	259	55.6
Educational Background
Primary School	173	37.3
Secondary School	98	21.1
High School	106	22.6
University	89	19.0
Marital Status
Married	335	71.9
Single	84	18.0
Divorced	47	10.1
Occupation
Worker	241	51.7
Civil Servant	34	7.3
Homemaker	112	24.0
Retired	79	17.0
Region (Current Location)
Province	387	83.0
District	31	6.7
Village - Town	48	10.3
Personal Monthly Income
0–5999 TL	207	44.4
6000–11.999 TL	198	42.5
>12.000 TL	61	13.1
Currently Living With
Family	406	87.1
Alone	32	6.9
With children	28	6.0

Abbreviations: N, number of patients; SD, Standard deviation; Min, Minimum value; Max, Maximum value; TL, Turkish Lira.

Table 2 Patient Distribution Based on Basic Health Parameters

Basic Health Parameters	N	%
Current Smoking Status
Yes	196	42.1
No	270	57.9
Comorbidities
Yes	352	75.5
No	114	24.5
Chronic Medication Use
Yes	182	39.1
No	284	60.9
Prior Surgery Status
Yes	327	70.2
No	139	29.8
Adverse Events in Previous Anaesthesia
Yes	7	2.1
No	320	97.9
ASA
I	167	35.8
II	299	64.2
Surgery Types
Group A surgery	91	19.5
Group B surgery	198	42.5
Other (Group C, D, E surgeries)	177	38.0
Department
General Surgery	141	30.3
Neurosurgery	91	19.5
Urologic Surgery	74	15.9
Orthopedic Surgery	67	14.4
Ear, Nose and Throat Surgery	34	7.2
Ophthalmic Surgery	37	7.9
Plastic Surgery	18	3.9
Thoracic Surgery	4	0.9
Type of Anaesthesia
General anaesthesia	271	58.2
Regional anaesthesia (Spinal, Epidural Block)	167	36.1
Sedation + Local anaesthesia	28	5.7

Notes: Group A surgeries (intracranial mass, intracranial aneurysm, total gastrectomy, rectal and colon surgery, Whipple operation, total nephrectomy, percutaneous nephrolithotomy, long segment vertebral stabilization surgery, etc.); Group B surgeries (thyroidectomy, parathyroidectomy, retinal detachment, vitrectomy, partial nephrectomy, lumbar and cervical vertebra stabilization, tympanoplasty, rhinoplasty, total hip-knee surgery, meniscus arthroscopy, ureteroscopy, etc.) Groups C, D, and E surgeries are inguinal hernia, laparoscopic cholecystectomy, septoplasty, refractory surgery, D-J catheter insertion and removal, pilonidal sinus, anal fistulectomy, and hemorrhoidectomy, etc).

Abbreviations: N, number of patients; ASA, American Society of Anaesthesiologists.

Table 3 A Comparative Analysis of Demographic Data, Basic Health Parameters, and the Health Literacy Scale

	Mean ± SD			Min-Max
Health Literacy Scale	105.89±24.42			25–125
Access to information	20.85±5.27			5–25
Understanding information	29.24±7.34			7–35
Value Assessment/Evaluation	34.24±8.17			8–40
Implementation/Use	21.55±5.39			5–25
Parameters (n=466)	Sub-dimensions
	Health Literacy Scale	Access to information	Understanding information	Value Assessment/Evaluation	Implementation/Use
Gender
Male	106.29±25.46	20.90±5.42	29.33±7.71	34.39±8.46	21.66±5.57
Female	105.39±23.15	20.81±5.10	29.14±6.88	34.05±7.82	21.38±5.17
P	0.692	0.851	0.777	0.660	0.579
Marital Status
Married^a	106.60±23.25	20.83±5.07	29.46±7.11	34.49±7.79	21.80±5.07
Single^b	108.65±23.14	21.90±4.82	30.16±6.95	34.71±7.63	21.83±5.37
Divorced^c	96.00±31.93	19.08±6.88	26.06±8.84	31.59±10.98	19.25±6.95
P	0.011*	0.013*	0.005*	0.063	0.008*
Post-Hoc	b>c^‡, a>c^‡	b>c^‡, a>c^‡	b>c^‡, a>c^‡		b>c^‡, 1>c^‡
Educational Background
Primary School^d	89.09±29.21	18.92±6.17	26.59±8.64	32.07±9.85	20.49±6.37
Secondary School^e	104.74±22.87	20.59±4.86	29.16±6.64	37.04±7.70	20.94±5.64
High school^f	113.57±17.14	22.35±4.01	31.66±5.13	36.50±5.96	23.03±3.83
University^g	113.17±17.61	23.10±3.42	31.61±5.67	35.96±6.06	22.49±3.91
P	<0.001**	<0.001**	<0.001**	<0.001**	<0.001
Post-Hoc	g>f^‡, g>d^‡	g>e^‡, g>d^‡	g>d^‡	g>d^‡	g>d*
Occupation
Worker^h	108.18±23.46	21.42±4.96	30.03±6.99	34.92±7.91	21.80±5.83
Civil Servant^i	114.44±17.02	22.88±3.53	32.44±8.89	36.29±5.88	22.82±3.95
Homemakers^j	103.42±23.15	20.38±5.06	28.44±6.90	33.43±7.83	21.16±5.06
Retired^k	98.72±29.43	18.91±6.43	26.62±8.89	32.41±9.77	20.77±6.26
P	0.002*	<0.001**	<0.001**	0.031*	0.197
Post-Hoc	i>k^‡; i>j^‡	i>j,k^‡; h>k^‡	i>j,k^‡; h>k^‡	i>j,k^‡

Notes: ^‡Post-Hoc = Scheffe, our post-hoc analysis test was Scheffe. Marital Status: Married^a, Single^b, Divorced^c: Upper numerical values^a,b,c are written to indicate the ranking of the subgroups in order to number them during post-hoc analysis. Educational Background: Primary School^d, Secondary School^e, High school^f, University^g: Upper numeric values^d,e,f,g are written to indicate the ranking of the subgroups in order to number them during post-hoc analysis. Occupation: Worker^h, Civil Servantⁱ, Homemakers^j, Retired^k: Upper numeric values^h,i,j,k are written to indicate the the ranking of the subgroups in order to number them during post-hoc analysis. *p<0.05. **p<0.001.

Abbreviations: N, number of patients; SD, Standart Deviation; Min, Minimum; Max, Maximum; ASA, American Society of Anaesthesiologists.

Table 4 Distribution of Beck Anxiety Inventory Scale Total Mean Scores According to Socio-Demographic Characteristics and Basic Health Variables (n=466)

Beck Anxiety Inventory		Mean ± SD	Min-Max
		9.28±10.85	0–58
Parameters	n	BAI	BAI
		Mean ± SD	p
Gender
Male	259	7.31±9.64	<0.001**
Female	207	11.71±11.77
Marital Status
Married	335	9.52±11.10	0.537
Single	84	8.08±10.42
Divorced	47	9.70±9.78
Educational Background
Primary School	173	10.46±11.32	0.103
Secondary School	98	8.10±9.57
High School	106	8.98±12.81
University	89	7.44±8.13
Occupation
Worker	241	8.69±11.10	<0.001**
Civil Servant	34	8.20±8.90
Homemaker	112	12.21±11.56
Retired	79	7.36±8.98
Region (Current location)
City	387	9.96±11.36	0.007
Country	31	7.45±9.14
Village-Town	48	4.97±5.01
Living With
Family	406	9.25±10.85	0.034*
Children	28	12.78±11.48
Alone	32	6.56±9.56
Personal Monthly Income
0–5999 TL	241	10.05±11.01	0.029*
6000–11.999 TL	214	8.24±10.65
>12.000 TL	11	12.36±9.88
Current Smoking Status
Yes	196	9.59±10.87	0.593
No	270	9.05±10.84
ASA
I	167	8.40±10.66	0.188
II	299	9.77±10.94
Comorbid Disease
Yes	352	10.11±11.23	0.008*
No	114	6.70±9.12
Previous Surgery History
Yes	327	9.37±10.53	0.786
No	139	9.07±11.59
Surgery Type
Group A (major)	91	11.60±12.49	0.055
Group B (moderate)	198	8.30±9.90
Group C, D, E (minor)	177	9.17±10.83
Type of Anesthesia
General anaesthesia	271	7.71±10.12	0.056
Regional anaesthesia	168	10.26±11.21
Sedation + Local anaesthesia	27	9.11±10.79

Notes: Group A surgeries (intracranial mass, intracranial aneurysm, total gastrectomy, rectal and colon surgery, Whipple operation, total nephrectomy, percutaneous nephrolithotomy, long segment vertebral stabilization surgery, etc.); Group B surgeries (thyroidectomy, parathyroidectomy, retinal detachment, vitrectomy, partial nephrectomy, lumbar and cervical vertebra stabilisation, tympanoplasty, rhinoplasty, total hip-knee surgery, meniscus arthroscopy, ureteroscopy, etc.) Groups C, D, and E surgeries are inguinal hernia, laparoscopic cholecystectomy, septoplasty, refractory surgery, D-J catheter insertion and removal, pilonidal sinus, anal fistulectomy, and hemorrhoidectomy, etc). Bold values: *p<0.05, **p<0.001.

Abbreviations: N, number of patients; Sd, Standart deviation; Min, Minimum value; Max, Maximum value; BAI, Beck Anxiety Inventory; ASA, American Society of Anaeshesiologists, TL, Turkish Lira.

Table 5 Analysis of the Correlation Between Health Literacy Scale and Other Parameters

		1	2	3	4	5	6	7	8
1. Age	r p	1	0.328** <0.001	0.057 0.219	−0.188** <0.001	−0.193** <0.001	−0.205** <0.001	−0.161** <0.001	−1.133** 0.003
2. BMI (Body Mass Index)	r p		1	0.026 0.570	−0.044 0.342	−0.028 0.552	−0.068 0.144	−0.041 0.377	−0.018 0.697
3. Beck Anxiety Inventory	r p			1	−0.076 0.102	−0.094* 0.043	−0.075 0.108	−0.058 0.210	−0.061 0.187
4. Health Literacy Scale	r p				1	0.873** <0.001	0.957** <0.001	0.966** <0.001	0.915** <0.001
5. Access to information	r p					1	0.801** <0.001	0.773** <0.001	0.812** <0.001
6. Understanding the information	r p						1	0.893** <0.001	0.812** <0.001
7. Value Assessment/Evaluation	r p							1	0.885** <0.001
8. Implementation/Use	r p								1

Notes: 1: Age, 2: BMI (Body Mass Index), 3: Beck Anxiety Inventory, 4: Health Literacy Scale, 5: Access to information, 6: Understanding the information, 7: Value Assessment/ Evaluation, 8: Implementation/Use. Bold values: *p<0.05, **p<0.001.