Preoperative anxiety among patients and its correlation with their personality type and pain: A cross-sectional study

Table 1 Cronbach alpha of scales

Scale	NRPS	Anxiety	Need for information	Consciousness	Agreeableness	Emotional stability	Openness	Extraversion
Cronbach alpha	0.911	0.834	0.902	0.74	0.769	0.687	0.762	0.638

NRPS: Numerical Pain Rating Scale.

Table 2 Sociodemographic characteristics of participants

Characteristic		Frequency	Distribution (%)
Gender	Female	247	63.0
	Male	145	37.0
Nationality	Lebanese	289	73.7
	Palestinian	37	9.4
	Syrian	62	15.8
	Other	4	1.0
Place of residency	Akkar	2	0.5
	Baalbek	4	1.0
	Beirut	96	24.5
	Beqaa	68	17.3
	Keserwan	3	0.8
	Mount Lebanon	57	14.5
	Nabatiyeh	12	3.1
	North Lebanon	3	0.8
	South Lebanon	147	37.5
Marital status	Single	77	19.6
	Married	277	70.7
	Widowed	31	7.9
	Divorced	6	1.5
	Separated	1	0.3
Smoking	No	205	52.3
	Yes	187	47.7
Education	None	154	39.3
	High school	110	28.1
	University	128	32.7
Working	No	249	63.5
	Yes	143	36.5
Health care work	No	375	95.7
	Yes	17	4.3

Table 3 Participants’ clinical and surgery-related information

Characteristic		Frequency	Distribution (%)
Chronic diseases	No	217	55.4
	Yes	175	44.6
Cardiovascular	No	46	26.3
	Yes	129	73.7
Pulmonary	No	168	96.0
	Yes	7	4.0
Nervous	No	169	96.6
	Yes	6	3.4
Diabetes	No	110	62.9
	Yes	65	37.1
Cancer	No	163	93.1
	Yes	12	6.9
Others	No	152	86.9
	Yes	23	13.1
Diagnosed with depression	No	368	93.9
	Yes	24	6.1
If diagnosed with depression, does the patient take medication for it?	No	12	50.0
	Yes	12	50.0
Does the patient take any medication (analgesics or other treatments)?	No	195	49.7
	Yes	197	50.3
Company	No	24	6.1
	Yes	368	93.9
Previous surgeries	No	104	26.5
	Yes	288	73.5
Post-operative complications	No	255	88.5
	Yes	33	11.5
Type of surgery	Minor	208	53.1
	Major	184	46.9
Knowledge about types of anesthesia	No	246	62.8
	Yes	146	37.2
Knowledge about type of anesthesia for this surgery	No	200	51.0
	Yes	192	49.0
Type of anesthesia used	General	194	49.5
	Regional	92	23.5
	Local	106	27.0
Fees	Personal	151	38.5
	Insurance	111	28.3
	Other	130	33.2
Income	Low	142	36.2
	Middle	229	58.4
	High	21	5.4

Table 4 Pain levels assessed by Numerical Pain Rating Scale

Characteristic		Frequency	Distribution (%)
NPRS	Nothing	89	22.7
	Mild	130	33.2
	Moderate	134	34.2
	Severe	39	9.9

NPRS: Numerical Pain Rating Scale.

Table 5 Anxiety and Need for information frequencies assessed by Amsterdam Preoperative Anxiety and Information Scale

Characteristic		Frequency	Distribution (%)
Anxiety	Anxious	98	25
	Not anxious	294	75
Need for information	No	192	49
	Yes	200	51

Table 6 Personality traits assessed by Ten-Item Personality Inventory

Characteristic		Frequency	Distribution (%)
Conscientiousness	Low	10	2.6
	Moderate	142	36.2
	High	240	61.2
Agreeableness	Low	43	11.0
	Moderate	137	34.9
	High	212	54.1
Emotional stability	Low	41	10.5
	Moderate	255	65.1
	High	96	24.5
Openness	Low	164	41.8
	Moderate	193	49.2
	High	35	8.9
Extraversion	Low	30	7.7
	Moderate	332	84.7
	High	30	7.7

Table 7 Association between sociodemographic and patient clinical and surgical variables with scales

Characteristic		VAS		APAIS (P value)		TIPI (P value)
		Mean rank	P value	Need of information	Anxiety	Conscientiousness	Agreeableness	Emotional stability	Openness	Extraversion
Gender	Male	202.31	0.423	0.037a	0.003a	0.73	0.009a	0.261	0.608	0.172
	Female	193.09
Age	Numerical value	-	0.147	0.269	0.474	0.885	0.145	0.058	0.029a	0.230
Place of residence	Akkar	252.75	0.004a	0.270	0.698	0.214	0.133	0.900	0.048a	0.015a
	Baalbek-Hermel	305.38
	Beirut	196.45
	Beqaa	235.86
	Keserwan-Jbeil	205.00
	Mount Lebanon	202.47
	Nabatiyeh	179.71
	North	280.17
	South	171.77
Marital status	Single	197.20	0.028a	0.417	0.130	0.620	0.102	0.206	0.556	0.811
	Married	201.49
	Widowed	138.39
	Divorced	252.75
	Separated	225.50
Smoking	Yes	206.00	0.102	0.134	0.861	0.116	0.179	0.236	0.918	0.374
	No	187.84
Employment status	Yes	210.39	0.058	0.298	0.102	0.047a	0.298	0.014a	0.005a	0.717
	No	188.52
Chronic illness	Yes	193.77	0.659	0.172	0.319	0.594	0.029a	0.461	0.117	0.734
	No	198.70
Diagnosed with depression	Yes	210.54	0.518	0.246	0.001a	0.849	0.752	0.026a	0.283	0.800
	No	195.58
Previous surgeries	Yes	191.93	0.170	0.830	0.187	0.049a	0.253	0.992	0.178	0.421
	No	209.16
Type of surgery	Minor	183.52	0.013a	0.704	0.161	0.299	0.466	0.462	0.417	0.258
	Major	211.17
Knowledge about anesthesia for this surgery	Yes	215.66	0.001a	0.680	0.816	0.403	0.010a	0.319	0.001a	0.194
	No	178.11
Type of anesthesia	General	217.50	0.001a	0.415	0.045a	0.271	0.525	0.732	0.144	0.168
	Regional	168.52
	Local	182.35

^aP < 0.05, association is significant.

Mean rank values in non-parametric tests represent the relative ranking of groups when all observations are pooled; they are not equivalent to raw scale scores. Higher mean ranks indicate relatively greater values of the measured variable compared. Bonferroni correction applied within sets of related comparisons. For associations between the five personality traits and pain or anxiety, the adjusted significance threshold was α = 0.01. For categorical variables with multiple levels (e.g., type of anesthesia), adjusted thresholds were based on the number of groups. After correction, only the associations between emotional stability and anxiety (P = 0.010), need for information and anxiety (P < 0.001), knowledge about anesthesia and pain (P = 0.001), and type of anesthesia and pain (P = 0.001) remained statistically significant. VAS: Visual Analog Scale; APAIS: Amsterdam Preoperative Anxiety and Information Scale; TIPI: Ten-Item Personality Inventory.

Table 8 Logistics regression predicting preoperative anxiety based on pain and personality traits

Predictor variable	B	SE	Wald	P value	OR [Exp(B)]
VAS (continuous)	-0.004	0.004	1.262	0.261	0.996
Conscientiousness	-	-	1.442	0.486	-
Moderate vs low	-1.176	1.089	1.165	0.280	0.309
High vs low	-1.279	1.089	1.377	0.241	0.278
Agreeableness	-	-	1.301	0.522	-
Moderate vs low	0.118	0.403	0.085	0.770	1.125
High vs low	0.374	0.409	0.835	0.361	1.454
Emotional stability	-	-	7.212	0.027a
Moderate vs low	0.220	0.402	0.298	0.585	1.246
High vs low	1.083	0.500	4.698	0.030a	2.953
Openness	-	-	0.809	0.667	-
Moderate vs low	-0.196	0.259	0.575	0.448	0.822
High vs low	0.106	0.478	0.049	0.825	1.111
Extraversion	-	-	1.674	0.433	-
Moderate vs low	0.535	0.441	1.474	0.225	1.708
High vs low	0.320	0.606	0.279	0.597	1.377
Constant	1.444	1.188	1.476	0.224	4.236

^aP < 0.05, association is significant.

VAS: Visual Analog Scale; OR: Odds ratio; SE: Standard error; Exp: Exponentiated coefficient; B: Unstandardized regression coefficient.