Impact of Preoperative Surgical Fear and Anxiety on Sleep Quality and Recovery Outcomes After Arthroplasty

Background: Surgical interventions affect patients not only physiologically but also psychologically. Perioperative anxiety and surgical fear are common and may impact postoperative recovery and sleep quality.

Aim: This study aimed to examine the relationship between preoperative surgical fear and anxiety levels and postoperative sleep quality and recovery one month after hip and knee arthroplasty.

Methods: This cross-sectional study was conducted between 2022 and 2023 with 83 patients who underwent hip or knee arthroplasty at a training and research hospital in Türkiye. Data were collected using the Surgical Fear Question-naire, State-Trait Anxiety Inventory – State subscale, Postoperative Recovery Index, and Pittsburgh Sleep Quality Index. The Pearson correlation test, chi-squared test, Student's t-test, Mann-Whitney U test, and Kolmogorov-Smirnov test were used for data analysis.

Results: The mean age and Body Mass Index (BMI) of the patients were 65.66±7.74 and 31.42±4.99, respectively. Of the patients, 75.9% were female and 85.5% were married. The mean Surgical Fear Questionnaire score was 27.80±20.82, and the mean State Anxiety Inventory score was 40.78±10.00. The mean Postoperative Recovery Index score was 1.76±0.73. According to the Pittsburgh Sleep Quality Index, 66.1% of patients had poor sleep quality. A moderate positive correlation was found between surgical fear and anxiety levels, while a low positive correlation was observed between surgical fear and postoperative recovery (p<0.05).

Conclusion: Preoperative surgical fear and anxiety are associated with poorer postoperative recovery and sleep quality among hip and knee arthroplasty patients. These findings emphasize the importance of evaluating and addressing psychological factors before surgery to improve postoperative outcomes.