Preoperative anxiety may be huge problem among Latinos, new research suggests

Latinos may be more anxious than Caucasian patients about having surgery and also want more detailed information before having a procedure, suggests research being presented at the ANESTHESIOLOGY® 2016 annual meeting.

Preoperative anxiety, which affects about 80 percent of adult patients, can negatively affect recovery and pain. The new research suggests anxiety may be an even bigger problem among Latinos, especially those who are Spanish-speaking. Until now, no studies have evaluated self-reported changes in anxiety among Latino patients in the preoperative setting.

"Often due to cultural reasons, we've found that some Latino patients do not question their health care providers and may be left with unanswered concerns, which can lead to increased levels of anxiety," said Zeev Kain, M.D., senior author of the study and Chancellor's Professor of Anesthesiology, Pediatrics and Medicine, University of California, Irvine. "Latinos are the largest minority population in this country and increasing numbers of Latino patients are undergoing surgery each year. Studies that help us understand the needs of our patients and the impact ethnicity, culture, gender and other factors might have on perioperative care are important."

Reducing preoperative anxiety improves outcomes after surgery and decreases costs by helping to prevent emergency room visits and hospital readmissions, researchers say. Understanding why anxiety may be a particular problem among Latinos will help surgeons and physician anesthesiologists address the issue and achieve the Institute for Healthcare Improvement's Triple Aim of improved patient care experience, improved health among specific patient populations and reduced costs, they note.

In the study, researchers examined 243 patients - 64 Spanish-speaking Latinos, 45 English-speaking Latinos and 84 English-speaking Caucasians. Prior to having elective surgery, 193 patients completed two questionnaires: one evaluating their level of anxiety and another assessing their desire for information. Spanish-speaking Latinos reported significantly higher preoperative anxiety than English-speaking Caucasian or Latino patients, while English-speaking Latinos reported more anxiety than Caucasians. Although all patients desired more information prior to surgery, Latinos said they wanted to know more details, such as what needles were being used, the length of time they would receive anesthesia and when they could get out of bed after surgery. They also expressed they would like to meet with their physician anesthesiologist prior to surgery.

"There likely are a number of factors that lead to these disparities, including language and cultural barriers, health literacy and socioeconomic gaps," said Dr. Kain. "Previous research suggests there may be a gap in knowledge about surgery and the various providers' roles among Latino patients. For example, there is a general lack of knowledge among this population about the physician anesthesiologist's role during surgery as well as a misunderstanding about the likelihood of complications. More research is needed to help health care providers understand the impact ethnicity and culture might have on perioperative care."