Assessing the Relationship Between Preoperative Anxiety and Postoperative Recovery

Assessing the Relationship Between Preoperative Anxiety and Postoperative Recovery | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessing the Relationship Between Preoperative Anxiety and Postoperative Recovery Nagehan EVKAYA TURAN, Yelda CANDAN This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8038706/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 06 Mar, 2026 Read the published version in BMC Surgery → Version 1 posted 13 You are reading this latest preprint version Abstract Background: The potential for preoperative anxiety to negatively affect postoperative recovery remains a current, increasingly important issue that warrants further investigation. The primary objective of this study was to assess the relationship between preoperative anxiety and postoperative Recovery in patients. Methods: Designed as a cross-sectional study, this research included patients who had surgeries in the general surgery department at a university hospital from September 15, 2020, to January 31, 2021. The study gathered data through the use of the Patient Information Form, the Anxiety Specific to Surgery Questionnaire, and the Postoperative Recovery Index. The analysis of the data was carried out using the SPSS (version25.0) software package. Results: The study found that the average age of the patients was 54.28±15.4 years, and 60.0% of them were women. The average score on the Anxiety Specific to Surgery Questionnaire was 27.9±10.9. The average score on the Postoperative Recovery Index was 2.84±0.86 for measurements taken on days 0-3 and 1.82±0.64 for measurements taken on days 10-15. Upon examining each sub-dimension and the total scale scores, it was found that most patients experienced positive recovery. In conclusion, it was determined that patients exhibited moderate levels of anxiety specific to surgery. Conclusion: Postoperatively, they generally experienced significant difficulties in recovery during days 0-3, and moderate difficulties during days 10-15. It was also found that preoperative anxiety adversely affected postoperative recovery. Anxiety Recovery Surgery Preoperative Postoperative Figures Figure 1 Introduction Anxiety is characterized by varying degrees of tension, worry, irritability, discomfort, and increased autonomic activity, arising from an anticipation of danger (1). Anxiety is a natural response developed by individuals in situations where they do not feel safe, and it is considered a universal emotion that plays a critical role in the perioperative period, influencing surgical outcomes and recovery processes (2, 3). Recent studies indicate that various levels of anxiety and fear are observed in a significant proportion of patients during the preoperative process (4, 5, 6), with prevalence rates ranging from approximately 60% to 80% among surgical patients (7). It is known that anxiety should exist up to a certain level and its positive features when it is functionally adequate (8). However, disproportionate reactions in response to anxiety, leading to the formation of symptoms at pathological levels, negatively impact the patient (9). As a result, it is anticipated that anxiety may have a negative impact on the surgical process (10, 11). All surgical procedures are followed by postoperative recovery (12). While the concept of recovery after surgery is widely utilized, defining it consistently has been challenging due to its multidimensional nature and the absence of a universally accepted definition (13). The process of Recovery after surgery starts immediately and can span several months, continuing beyond discharge and involving various milestones (14). It is noted that the recovery period may be lengthy, impacting both the physical and psychological well-being of the patient (14). From a comprehensive standpoint, postoperative recovery encompasses a gradual enhancement in functional abilities and the individual's subjective sense of recovery (15, 16). The concern regarding the postoperative recovery process can create anxiety in patients, and the possibility of pre-existing anxiety adversely affecting postoperative recovery (11) remains a timely, increasingly important, and research-worthy issue. In line with this, this study was conducted to assess the relationship between preoperative anxiety and postoperative recovery in patients. Materials and Methods The study was a cross-sectional descriptive study planned to examine the relationship between preoperative anxiety and postoperative recovery in patients. The study was conducted in the General Surgery Clinic of a university hospital in Turkey between September 15, 2020 and January 31, 2021. This clinic consists of 45 patient rooms and can accommodate 1-6 patients. The age of inpatients ranged from 18-99 years. Major procedures such as gastrointestinal tract surgery, hepatopancreatobiliary surgery, hernia surgery, breast surgery, thyroid-parathyroid surgery, and many minor procedures such as lipoma excision are performed here. The study population consisted of those scheduled for surgery at the general surgery clinic between the specified dates. The sample size was calculated using the “G. Power-3.1.9.2” program with a 95% confidence level. According to Cohen (1988), taking α value as 0.05 and standardized effect size as 0.27 (medium), considering that no similar study has been conducted in this field before and targeting a theoretical power of 0.80 for comparing three or more independent groups, the minimum required sample size was calculated as 138. All patients reached according to the calculated sample size agreed to participate in the study. The sample of the study consisted of 145 patients aged 18 years and over who were admitted to the general surgery clinic, scheduled for surgery, and who volunteered to participate in the study. Patients read and signed the informed consent form at the time of inclusion. During each process of patient contact, the information was obtained by the researcher personally. There was no loss of participants during the first, second and third interviews. The data were collected through face-to-face and telephone interviews using the "Patient Information Form," the "Anxiety Specific to Surgery Questionnaire (ASSQ)," and the "Postoperative Recovery Index (PoRI)." On the morning of the surgery day, the "Patient Information Form" and the "Anxiety Specific to Surgery Questionnaire" were administered to the patients through face-to-face interviews. After the surgery, the "Postoperative Recovery Index" was administered twice. The first administration (1st measurement) was conducted within the first three days after the surgery (17, 18). The second administration (2nd measurement) took place on days 10-15 after the surgery (17, 18), during the patients' first clinical follow-up either face-to-face or via telephone interview. The data collection time for each interview was approximately 10-15 minutes. The "Patient Information Form" consists of a total of 15 questions, was developed specifically for this study by the researchers based on a review of the relevant literature to collect sociodemographic and clinical data (10, 19, 20). The questionnaire has not been previously published elsewhere (Supplementary File 1). The Anxiety Specific to Surgery Questionnaire (ASSQ), evaluates specific fears and concerns related to surgery. Developed by Karanci and Dirik (2003), the scale consists of 10 questions rated on a 5-point Likert scale (21). Each question is rated on a scale from "5=Strongly Agree" to "1=Strongly Disagree." Only item 8 is reverse-scored. The possible score range from the scale is between 10 and 50, where higher scores reflect greater anxiety about pain, death during surgery, complications, and limitations. In Karanci and Dirik's study, the Cronbach’s Alpha value was found to be 0.79 (20), while in this study, it was determined to be 0.897. The Postoperative Recovery Index (PoRI), developed by Butler and colleagues in 2012, is used to assess the quality of recovery in patients undergoing major surgical procedures shortly after surgery (17). In a study conducted by Cengiz and Aygin (2019) in Turkey to establish its validity and reliability, the overall Cronbach’s Alpha value was found to be 0.967 (22). In this study, the overall Cronbach’s Alpha value was determined to be 0.926 for the first measurement and 0.925 for the second measurement. The Cronbach’s Alpha values for the subscales range from 0.77 to 0.94. The PoRI has been introduced into Turkish literature as a 25-item self-assessment scale. It includes three different 5-point Likert-type scales. For the first four questions, the options range from "none" to "extremely." For items 5-12, the options range from "not at all limited" to "extremely limited," and for the remaining items, from "not at all bothered" to "extremely bothered." To score the PoRI, the item scores within each subscale are summed and averaged to determine the subscale score. For the total score, the sum of all 25 items is averaged. Higher scores indicate greater difficulty in postoperative recovery, while lower scores indicate easier recovery. As specified in the study by Cengiz and Aygin, the PoRI assessment was conducted in two stages: the first measurement within the first three days post-surgery, and the second measurement between days 15-30. The scoring system for the total and subscale scores of the PoRI is explained in Figure 1. (17, 22). The IBM Statistical Package for the Social Sciences (SPSS) version 25.0 was employed for data analysis. Descriptive statistics and the Chi-square test were used to evaluate the data. Reliability analyses of the scales used and the normality assumption of statistical analysis were conducted using the Independent Samples T-test, Mann-Whitney U test, ANOVA test, Kruskal-Wallis test, Post Hoc Bonferroni test, and Spearman correlation. Ethics approval and consent to participate: Our study adhered to the Declaration of Helsinki. Human ethics and participation approval statements have been received. To conduct the study, approval was obtained from the medical research ethics committee of Ege University Medical Research Ethics Committee (Date: 15.09.2020, Decision No: 20-9T/12), as well as written permission from the general surgery clinic of the university hospital where the study was conducted. Additionally, permission to use the scales was obtained via email from the authors. All participants were informed about the purpose and procedures of the study and voluntarily provided written informed consent prior to participation. Results The average age of the patients included in the study was 54.28 ± 15.4 years, with 35.9% falling between the ages of 50-64. Among them, 60.0% were female, and 79.3% were parents, with 69.0% of the parents having children aged 19 and older. Furthermore, 58.6% of the patients had a chronic illness, with 40.3% of them being hypertensive, and 43.5% having multiple chronic conditions. 35.9% of the patients had undergone gastrointestinal system surgery, 60.0% had previous surgical experience, 60.7% had been hospitalized before, and among those previously hospitalized, 67.6% had stayed in the hospital for less than 1 hour (Table I). Table I. Socio-Demographic Characteristics of Patients Characteristics X ± SD Min. - Max. Age 54.28 ± 15.4 18-89 Number (n) Percentage (% ) Age 18-29 11 7.6 30-49 35 24.1 50-64 52 35.9 65 and over 47 32.4 Gender Female 87 60.0 Male 58 40.0 Education Level Illiterate 19 13.1 Literate 12 8.3 Primary/Secondary School 43 29.7 High School 39 26.9 University 32 22.1 Employment Status Yes 50 34.5 No 95 65.5 Parenthood Status Yes 115 79.3 No 30 20.7 Presence of Chronic Disease Yes 85 58.6 No 60 41.4 If Yes; Diabetes Mellitus 33 24.6 Hypertension 54 40.3 Renal Insufficiency 6 4.5 Heart Diseases 13 9.7 Thyroid Diseases 10 7.5 Others (COPD, other cancers, psychiatric problems) 18 13.4 Number of Chronic Diseases 1 48 56.5 2 27 31.7 3 9 10.6 4 1 1.2 Type of Surgery Gastrointestinal System Surgery 52 35.9 Hepatopancreatobiliary Surgery 33 22.8 Hernia Surgery 11 7.6 Breast Surgery 21 14.5 Thyroid-Parathyroid Surgery 28 19.3 Previous Surgery Status Yes 87 60.0 No 58 40.0 Previous Hospitalization Status Yes 88 60.7 No 57 39.3 Length of Hospital Stay Less than 1 hour 98 67.6 1-24 hours 18 12.4 25-72 hours 12 8.3 73 hours and over 17 11.7 Total 145 100 Note: X: Mean, SD: Standard Deviation, Min: Minimum, Max: Maximum In Table II, the mean score of the patients on the ASSQ was found to be 27.9 ± 10.92 (min: 10.00 - max: 50.00). Table II. Mean Scores of Patients on the ASSQ Scale n Min. Max. Mean SD ASSQ Total Score 145 10,00 50,00 27,9034 10,92228 Min.:Minimum Max.:Maximum SD: Standard Deviation In this study, mean scores obtained from the PoRI measurements of the patients were examined. In the first measurement, the mean score for the Psychological Symptoms subscale was 2.2 ± 0.9, for the Physical Activities subscale was 3.2 ± 1.2, for the Appetite Symptoms subscale was 2.5 ± 1.3, for the Bowel Symptoms subscale was 2.8 ± 1.2, for the General Symptoms subscale was 2.9 ± 1.3, and the total mean score of the index was 2.8 ± 0.8. In the second measurement, the mean score for the Psychological Symptoms subscale was 1.4 ± 0.5, for the Physical Activities subscale was 2 ± 0.9, for the Desire-Symptoms subscale was 1.6 ± 0.9, for the Bowel Symptoms subscale was 1.6 ± 0.7, for the General Symptoms subscale was 2.1 ± 1.1, and the total mean score of the index was 1.8 ± 0.6 (Table III). Table III. Subscales and Total Score Means of the PoRI Scale and Subscales n Min. Max. Mean SD 1st Measurement (0-3 days) Psychological Symptoms Mean Score 145 1.00 5.00 2.2190 0.92650 Physical Activities Mean Score 145 1.00 5.00 3.2759 1.21540 Appetite Symptoms Mean Score 145 1.00 5.00 2.5052 1.31414 Bowel Symptoms Mean Score 145 1.00 5.00 2.8469 1.23018 General Symptoms Mean Score 145 1.00 5.00 2.9431 1.32607 Total Score Mean of PoRI 145 1.20 5.00 2.8444 0.86296 2nd Measurement (10-15 days) Psychological Symptoms Mean Score 145 1.00 3.50 1.4017 0.53546 Physical Activities Mean Score 145 1.00 5.00 2.0560 0.97738 Appetite Symptoms Mean Score 145 1.00 5.00 1.6310 0.95520 Bowel Symptoms Mean Score 145 1.00 4.00 1.6690 0.79351 General Symptoms Mean Score 145 1.00 5.00 2.1362 1.15957 Total Score Mean of PoRI 145 1.00 4.24 1.8188 0.64234 SD: Standard Deviation A statistically significant, positive, moderate correlation ( r = 0.222) was found between the total mean scores of the ASSQ and the first and second measurements of the PoRI ( p < 0.05) (Table IV). Table IV. The Relationship Between PoRI and ASSQ Scores Scale Correlation Psychological Symptoms Physical Activities Appetite Symptoms Bowel Symptoms General Symptoms PoRI Total Score ASSQ Total Score Psychological Symptoms r s 1.000 Physical Activities r s .385*** 1.000 Appetite Symptoms r s .431*** .347*** 1.000 Bowel Symptoms r s .217** .196* .269** 1.000 General Symptoms r s .276** .198* .299*** .300*** 1.000 PoRI Total Score r s .596*** .735*** .636*** .609*** .561*** 1.000 ASSQ Total Score r s .163 .152 .197* .102 .097 .222* 1.000 ***p<0.001, **p<0.01, *p<0.05 A statistically significant difference was found between the total scores of the ASSQ based on the educational status of the patients ( p <0.05). The Bonferroni test revealed statistically significant differences between the university group and the groups of illiterate, literate, and primary/middle school patients ( p =0.022, p =0.025, and p =0.005). It was observed that the total scores of the ASSQ for illiterate, literate, and primary/middle school patients were higher than those of university graduate patients. A statistically significant difference was found between the total scores of the ASSQ based on whether the patients had children ( p <0.05). It was determined that the total scores of the ASSQ for patients with children were higher than those for patients without children. Discussion It is known that preoperative anxiety not only affects the entire surgical process but also impacts postoperative recovery measures (10, 11). Postoperative recovery is an energy-demanding process that begins shortly after surgery and extends beyond discharge. The intended outcome is to return to preoperative levels of physical, psychological, customary, and social states, achieving optimal well-being and preoperative levels of independence/dependence in daily life activities (1, 15, 23). The mean score of the ASSQ in the preoperative period was found to be 27.9±10.9 for the patients. According to some similar studies in the literature, Bulut (2017) reported a mean score of 28.6±7.82 on the ASSQ (19), while Çevik Acar and Yıldız Fındık (2015) found a mean score of 28.5±7.06 in their study (24). Yıldız Fındık and Yıldızeli Topçu (2012) reported mean scores of 23.76±7.12 for planned surgical interventions, 28.55±7.15 for emergency surgical interventions, and 28.03±8.20 for day surgery interventions (25). In the study by Karancı and Dirik (2003), who developed the ASSQ, the mean score was reported to be 36.50±17.55 (21). Oflaz and Vural (2010) stated that the anxiety levels of patients in surgical clinics were higher than those in other clinics and that these levels increased even more when they focused on the surgery (25). The results show that the level of anxiety specific to surgery experienced by surgical patients is above average. Based on the literature, it is observed that preoperative anxiety still exists but shows a decrease in measured results and scores over time. Effective factors contributing to this decrease include preoperative information, education, and patient-centered approaches (20). Nurses are an essential part of the preoperative period. They need to monitor and identify risk factors for surgery, assess patients' needs, manage patients' expectations, and understand their sensitivities (26). In a study evaluating the quality of perioperative nursing care, Çevik Acar and Yıldız Fındık (2015) emphasized the importance of patient satisfaction and noted that the perceived quality of care by the patient would also affect their preoperative anxiety (20). Widiyawati et al. (2024) showed that hand relaxation and progressive muscle relaxation techniques applied before cesarean section reduce the preoperative anxiety levels of patients. The study stated that such interventions targeted during the preoperative period reduce the anxiety of patients and accelerate postoperative recovery (27). In addition, in a study conducted by İnce and Özlü (2024), it was found that preoperative anxiety directly affected the postoperative recovery process of patients and high anxiety levels prolonged the recovery period. This once again demonstrates the importance of nurses taking a more proactive role in the management of preoperative anxiety (28). A significant difference was found in the comparison of the mean scores of the ASSQ with socio-demographic data, particularly in terms of education level. It was observed that as the education level increased, the patients' scores on the ASSQ decreased. This finding is supported by Bulut (2017), who studied factors specific to preoperative anxiety; the scores of those who were illiterate or had only completed high school were statistically significantly higher than those of patients who had graduated from university (19). A statistically significant difference was found in the mean scores of the ASSQ based on whether patients had children ( p <0.05). The anxiety levels of patients with children were found to be higher than those without children. Another study examining preoperative anxiety also found that anxiety scores increased with the number of children (20). The recovery status and difficulties in recovery of the patients participating in the study were examined based on the total score and sub-dimensions of the PoRI. In the first measurement, moderate difficulties were identified in Psychological Symptoms, while significant difficulties were experienced in other areas and overall. In the second measurement, patients experienced mild difficulties in Psychological Symptoms and moderate difficulties in other areas and overall. Furthermore, when examining the measurements of the PoRI, it was observed that patients had the highest mean scores in the Physical Activities sub-dimension and the lowest mean scores in the General Symptoms sub-dimension (29). These results suggest that surgical intervention impacts physical activities more significantly and that general symptoms are less pronounced. In this study, no differences were found between the PoRI and sociodemographic data. The discrepancy between these results and those of Dığın and Kızılcık Özkan's study may be attributed to the entirely elderly population in their study (29). Research on the recovery experiences of patients after colorectal surgery reveals severe physical weakness and a high need for caregiver support in the postoperative period (30, 31). These findings emphasise that the recovery process involves not only physical but also psychological and social dimensions. Similarly, in this study, we found the negative effects of preoperative anxiety on postoperative recovery. In particular, it was observed that patients experienced serious difficulties in the first 3 days of the postoperative period and needed psychological support in this process. It is frequently reported in the literature that preoperative anxiety may negatively affect surgical outcomes and the recovery rate of patients (32). The difficulties experienced by patients after colorectal surgery show that this process includes not only physical recovery but also psychological and social needs of patients. In this context, it is thought that nurses should adopt a more holistic approach in the postoperative support process, taking into account the psychological status of patients. Xiangting et al. (2023) stated that nurses' providing more support for the psychological status of patients may accelerate the healing process (31). These findings reveal that not only physical but also psychological and social needs of patients should be taken into consideration in the postoperative period. In this context, developing intervention strategies for patients with anxiety in the preoperative period may be an important factor in accelerating the recovery process. A study evaluating postoperative recovery via a mobile application on the 7th and 14th days revealed that the recovery criteria in the experimental group (sleep difficulties, general discomfort, feeling unwell, dizziness, headache, difficulty in eating, pain, or edema at the surgical incision site) were better compared to the control group, which did not receive nurse intervention (33). Similarly, in this study, recovery was assessed using similar criteria postoperatively, and all patients were followed up by a nurse on days 10-15. Based on these findings, it can be said that interaction with a nurse during the post-discharge period positively influences recovery. Postoperative recovery is a subjective, multidimensional, long-term, and complex process; therefore, using only objective findings to explain it is not an appropriate approach (34). This highlights the importance of understanding the impact of psychological factors before and after surgery. In a study on the Enhanced Recovery After Surgery (ERAS) approach in laparoscopic urology surgery, better recovery outcomes were observed in the experimental group where nursing interventions were conducted. The study results suggest that the concept of rapid rehabilitation surgery, combined with psychological nursing stress interventions and nursing guidance, can regulate patients' anxiety and depression, reduce postoperative stress response, improve immune function, and thus accelerate the recovery process (35). In a study investigating the sleep quality, anxiety, and perceived stress levels of patients scheduled for open-heart surgery showed that longer preoperative hospital stays contributed to increased stress levels after surgery, it was shown that the length of preoperative hospital stay increased postoperative stress levels (36). The results of a study examining the anxiety caused by preoperative waiting periods and its impact on sleep quality indicated that as patients' preoperative anxiety increased, their sleep quality simultaneously deteriorated (37). Similarly, another study reported that preoperative anxiety measurements in patients led to postoperative pain and sleep problems (37, 38). In another study examining the postoperative outcomes of preoperative anxiety, it was found that anxiety not only caused pain but also that an increase in the degree of pain exacerbated respiratory distress, nausea, and vomiting (39). This study found that preoperative anxiety negatively affected postoperative recovery. Implementing appropriate psychological support and stress management strategies in the preoperative period can positively impact patients' postoperative recovery process. Postoperative psychological support and stress intervention can mitigate the negative effects of preoperative anxiety and improve the recovery process. These findings highlight the importance of preoperative anxiety management and the critical role of psychological support strategies on postoperative recovery. Therefore, providing psychological evaluation and appropriate interventions during the preoperative period can help patients experience a more positive recovery. However, more research and individualized nursing interventions are needed to meet patients' personal needs and reduce anxiety levels (40). Strengths and limitations Despite the strengths of the study, there were several limitations. Collecting data during the pandemic period resulted in a longer data collection phase. In the early times of the pandemic, elective surgeries were stopped for a long time. After the onset, patients were usually referred to day surgery. This reduced the chance of preoperative counselling in patients, and therefore the sample group size could not be larger. Major surgeries were also postponed as much as possible. Conclusion Postoperative recovery is more difficult for patients who have high levels of preoperative anxiety. Therefore, it is recommended to adopt a multidisciplinary and multimodal approach, comprehensively evaluate patients' anxieties, provide expert support to patients experiencing anxiety, reduce the preoperative hospital stay, routinely assess postoperative recovery, and tailor nursing care accordingly. Additionally, it is suggested to conduct prospective studies with larger samples in different surgical fields. Psychological Care and Targeted Interventions in Nursing: This study highlights the psychological dimension of nursing by emphasizing nurses’ responsibility to assess preoperative anxiety levels and to develop tailored patient education and psychosocial support programs based on patients’ educational background and parental status. Timely, Evidence‑Based Recovery Monitoring: By systematically evaluating postoperative recovery at early (days 0–3) and late (days 10–15) intervals using the PoRI, this research provides novel, evidence‑based insights into care planning and the optimal timing of interventions. Holistic Surgical Nursing Approach: Through the concurrent examination of preoperative anxiety and postoperative recovery across a diverse surgical cohort, the study offers a comprehensive perspective to the general surgery literature and integrates nursing practice within multidisciplinary care pathways. Declarations Acknowledgements We would like to thank the participations who participated in this study. Authors' contributions All authors of this paper meet the authorship criteria according to the International Committee of Medical Journal Editors guidelines. Study design: NET, YCD. Data collection: NET. Data analysis: NET, YCD. Study supervision: NET, YCD. Manuscript writing: NET, YCD. Both authors read and approved the final version of the manuscript. Funding During this study, no financial or spiritual support was received neither from any pharmaceutical company that has a direct connection with the research subject, nor from a company that provides or produces medical instruments and materials which may negatively affect the evaluation process of this study . Data availability The datasets produced and investigated during this study are available from the relevant author upon reasonable request. Ethics approval and consent to participate Our study adhered to the Declaration of Helsinki. Ethical approval for this research was received from Ege University Medical Research Ethics Committee (Date: 15.09.2020, Decision No: 20-9T/12). All participants were informed about the purpose and procedures of the study and voluntarily provided written informed consent prior to participation. Consent for publication Not applicable. 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Widiyawati W, Wardani LK, Rinawati F, Widyastuti B, Hidajaturrokhmah NY, Saputro H. Effectiveness of finger hand relaxation and progressive muscle relaxation techniques on anxiety in pre-operative sectio caesarea patients. J Nurs Pract. 2024;8(1):229-236. doi:10.30994/jnp.v8i1.657. İnce M, Özlü ZK. The effect of virtual reality on pain, anxiety, physiological parameters, and postspinal headache in patients undergoing spinal anesthesia: a randomized controlled trial. J Perianesth Nurs. 2024;[Epub ahead of print]. doi:10.1016/j.jopan.2024.07.012. Dığın F, Özkan ZK. Determination of postoperative recovery status of elderly patients. Online Turk J Health Sci. 2021;6(3):413-418. doi:10.26453/otjhs.907564. Jakobsson J, Idvall E, Kumlien C. The lived experience of recovery during the first 6 months after colorectal cancer surgery. J Clin Nurs. 2017;26(23-24):4498-4505. doi:10.1111/jocn.13780. Xiangting Y, Meichun Z, Huiying Q. Supportive care needs and related factors among colorectal cancer patients with stoma in the postoperative rehabilitation period from a bio-psycho-social perspective: a cross-sectional study. Support Care Cancer. 2023;31(10):599. doi:10.1007/s00520-023-08067-w. Andersson V, Bergstrand J, Engström Å, Gustafsson S. The impact of preoperative patient anxiety on postoperative anxiety and quality of recovery after orthopaedic surgery. J Perianesth Nurs. 2020;35(3):260-264. doi:10.1016/j.jopan.2019.11.008. Jaensson M, Dahlberg K, Eriksson M, Nilsson U. Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial. Br J Anaesth. 2017;119(5):1030-1038. doi:10.1093/bja/aex331. Liu Y, Qiu Y, Fu Y, Liu J. Evaluation of postoperative recovery: past, present and future. Postgrad Med J. 2023;99(1174):808-814. doi:10.1136/postgradmedj-2022-141652. Luo L, Jiang X, Kang X, Zeng F, Lin Y, Wu D. Application of ERAS concept and psychological guidance in nursing of patients with laparoscopic urology. Health. 2022;14(5):576-585. doi:10.4236/health.2022.145042. Bal E. Investigation of sleep quality, anxiety and perceived stress the levels of patients who will have open heart surgery [master’s thesis]. İstanbul: İstanbul Okan University, Institute of Health Sciences; 2020. Turkish. Duran B. The effect of patients' surgery waiting time on anxiety and sleep quality [master’s thesis]. İzmir: Ege University, Institute of Health Sciences; 2020. Turkish. Çalışkan E, Aksoy N. The relationship between preoperative anxiety level and postoperative pain outcomes in total hip and knee replacement surgery: a cross-sectional study. J Perianesth Nurs. 2025;40(1):76-82. doi:10.1016/j.jopan.2024.03.010. Yaman Ö. Evaluation of effect of anxiety levels of patients before open heart surgery on postoperative pain, dyspnea, nausea-vomiting and compliance to treatment [master’s thesis]. Sakarya: Sakarya University, Institute of Health Sciences; 2018. Turkish. Ruiz Hernandez C, Gómez-Urquiza JL, Pradas-Hernández L, Vargas Roman K, Suleiman-Martos N, Albendín-García L, et al. Effectiveness of nursing interventions for preoperative anxiety in adults: a systematic review with meta-analysis. J Adv Nurs. 2021;77(8):3274-3285. doi:10.1111/jan.14827. Additional Declarations No competing interests reported. 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09:00:07","extension":"html","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":135356,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8038706/v1/2c0a6dc6b804df56552bd186.html"},{"id":98777638,"identity":"70257740-3427-4574-a2be-bd9caf346dc6","added_by":"auto","created_at":"2025-12-22 12:28:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":5713,"visible":true,"origin":"","legend":"\u003cp\u003eLegend not included with this version.\u003c/p\u003e","description":"","filename":"placeholderimage.png","url":"https://assets-eu.researchsquare.com/files/rs-8038706/v1/6f215ebeae86be4af93575a0.png"},{"id":104250849,"identity":"9b0b1086-b4d0-4916-8a59-2d09ea9463a5","added_by":"auto","created_at":"2026-03-09 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tension, worry, irritability, discomfort, and increased autonomic activity, arising from an anticipation of danger (1). Anxiety is a natural response developed by individuals in situations where they do not feel safe, and it is considered a universal emotion that plays a critical role in the perioperative period, influencing surgical outcomes and recovery processes (2, 3). \u0026nbsp; Recent studies indicate that various levels of anxiety and fear are observed in a significant proportion of patients during the preoperative process (4, 5, 6), with prevalence rates ranging from approximately 60% to 80% among surgical patients (7). It is known that anxiety should exist up to a certain level and its positive features when it is functionally adequate (8). However, disproportionate reactions in response to anxiety, leading to the formation of symptoms at pathological levels, negatively impact the patient (9). As a result, it is anticipated that anxiety may have a negative impact on the surgical process (10, 11).\u003c/p\u003e\n\u003cp\u003eAll surgical procedures are followed by postoperative recovery (12). While the concept of recovery after surgery is widely utilized, defining it consistently has been challenging due to its multidimensional nature and the absence of a universally accepted definition (13). The process of Recovery after surgery starts immediately and can span several months, continuing beyond discharge and involving various milestones (14). It is noted that the recovery period may be lengthy, impacting both the physical and psychological well-being of the patient (14). From a comprehensive standpoint, postoperative recovery encompasses a gradual enhancement in functional abilities and the individual\u0026apos;s subjective sense of recovery (15, 16).\u003c/p\u003e\n\u003cp\u003eThe concern regarding the postoperative recovery process can create anxiety in patients, and the possibility of pre-existing anxiety adversely affecting postoperative recovery (11) remains a timely, increasingly important, and research-worthy issue. In line with this, this study was conducted to assess the relationship between preoperative anxiety and postoperative recovery in patients.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThe study was a cross-sectional descriptive study planned to examine the relationship between preoperative anxiety and postoperative recovery in patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study was conducted in the General Surgery Clinic of a university hospital in Turkey between September 15, 2020 and January 31, 2021. This clinic consists of 45 patient rooms and can accommodate 1-6 patients. The age of inpatients ranged from 18-99 years. \u0026nbsp;Major procedures such as gastrointestinal tract surgery, hepatopancreatobiliary surgery, hernia surgery, breast surgery, thyroid-parathyroid surgery, and many minor procedures such as lipoma excision are performed here.\u003c/p\u003e\n\u003cp\u003eThe study population consisted of those scheduled for surgery at the general surgery clinic between the specified dates. The sample size was calculated using the \u0026ldquo;G. Power-3.1.9.2\u0026rdquo; program with a 95% confidence level. According to Cohen (1988), taking \u0026alpha; value as 0.05 and standardized effect size as 0.27 (medium), considering that no similar study has been conducted in this field before and targeting a theoretical power of 0.80 for comparing three or more independent groups, the minimum required sample size was calculated as 138. All patients reached according to the calculated sample size agreed to participate in the study. The sample of the study consisted of 145 patients aged 18 years and over who were admitted to the general surgery clinic, scheduled for surgery, and who volunteered to participate in the study. Patients read and signed the informed consent form at the time of inclusion. During each process of patient contact, the information was obtained by the researcher personally. There was no loss of participants during the first, second and third interviews.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe data were collected through face-to-face and telephone interviews using the \u0026quot;Patient Information Form,\u0026quot; the \u0026quot;Anxiety Specific to Surgery Questionnaire (ASSQ),\u0026quot; and the \u0026quot;Postoperative Recovery Index (PoRI).\u0026quot; On the morning of the surgery day, the \u0026quot;Patient Information Form\u0026quot; and the \u0026quot;Anxiety Specific to Surgery Questionnaire\u0026quot; were administered to the patients through face-to-face interviews. After the surgery, the \u0026quot;Postoperative Recovery Index\u0026quot; was administered twice. The first administration (1st measurement) was conducted within the first three days after the surgery (17, 18). The second administration (2nd measurement) took place on days 10-15 after the surgery (17, 18), during the patients\u0026apos; first clinical follow-up either face-to-face or via telephone interview. The data collection time for each interview was approximately 10-15 minutes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe \u0026quot;Patient Information Form\u0026quot; consists of a total of 15 questions, was developed specifically for this study by the researchers based on a review of the relevant literature to collect sociodemographic and clinical data (10, 19, 20). The questionnaire has not been previously published elsewhere (Supplementary File 1).\u003c/p\u003e\n\u003cp\u003eThe Anxiety Specific to Surgery Questionnaire (ASSQ), evaluates specific fears and concerns related to surgery. Developed by Karanci and Dirik (2003), the scale consists of 10 questions rated on a 5-point Likert scale (21). Each question is rated on a scale from \u0026quot;5=Strongly Agree\u0026quot; to \u0026quot;1=Strongly Disagree.\u0026quot; Only item 8 is reverse-scored. The possible score range from the scale is between 10 and 50, where higher scores reflect greater anxiety about pain, death during surgery, complications, and limitations. In Karanci and Dirik\u0026apos;s study, the Cronbach\u0026rsquo;s Alpha value was found to be 0.79 (20), while in this study, it was determined to be 0.897.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Postoperative Recovery Index (PoRI), developed by Butler and colleagues in 2012, is used to assess the quality of recovery in patients undergoing major surgical procedures shortly after surgery (17). In a study conducted by Cengiz and Aygin (2019) in Turkey to establish its validity and reliability, the overall Cronbach\u0026rsquo;s Alpha value was found to be 0.967 (22). In this study, the overall Cronbach\u0026rsquo;s Alpha value was determined to be 0.926 for the first measurement and 0.925 for the second measurement. The Cronbach\u0026rsquo;s Alpha values for the subscales range from 0.77 to 0.94.\u003c/p\u003e\n\u003cp\u003eThe PoRI has been introduced into Turkish literature as a 25-item self-assessment scale. It includes three different 5-point Likert-type scales. For the first four questions, the options range from \u0026quot;none\u0026quot; to \u0026quot;extremely.\u0026quot; For items 5-12, the options range from \u0026quot;not at all limited\u0026quot; to \u0026quot;extremely limited,\u0026quot; and for the remaining items, from \u0026quot;not at all bothered\u0026quot; to \u0026quot;extremely bothered.\u0026quot; To score the PoRI, the item scores within each subscale are summed and averaged to determine the subscale score. For the total score, the sum of all 25 items is averaged. Higher scores indicate greater difficulty in postoperative recovery, while lower scores indicate easier recovery. As specified in the study by Cengiz and Aygin, the PoRI assessment was conducted in two stages: the first measurement within the first three days post-surgery, and the second measurement between days 15-30. The scoring system for the total and subscale scores of the PoRI is explained in Figure 1. (17, 22).\u003c/p\u003e\n\u003cp\u003eThe IBM Statistical Package for the Social Sciences (SPSS) version 25.0 was employed for data analysis. Descriptive statistics and the Chi-square test were used to evaluate the data. Reliability analyses of the scales used and the normality assumption of statistical analysis were conducted using the Independent Samples T-test, Mann-Whitney U test, ANOVA test, Kruskal-Wallis test, Post Hoc Bonferroni test, and Spearman correlation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e Our study adhered to the Declaration of Helsinki. Human ethics and participation approval statements have been received. To conduct the study, approval was obtained from the medical research ethics committee of Ege University Medical Research Ethics Committee (Date: 15.09.2020, Decision No: 20-9T/12), as well as written permission from the general surgery clinic of the university hospital where the study was conducted. Additionally, permission to use the scales was obtained via email from the authors. All participants were informed about the purpose and procedures of the study and voluntarily provided written informed consent prior to participation.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe average age of the patients included in the study was 54.28 \u0026plusmn; 15.4 years, with 35.9% falling between the ages of 50-64. Among them, 60.0% were female, and 79.3% were parents, with 69.0% of the parents having children aged 19 and older. Furthermore, 58.6% of the patients had a chronic illness, with 40.3% of them being hypertensive, and 43.5% having multiple chronic conditions. 35.9% of the patients had undergone gastrointestinal system surgery, 60.0% had previous surgical experience, 60.7% had been hospitalized before, and among those previously hospitalized, 67.6% had stayed in the hospital for less than 1 hour (Table I).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable I.\u003c/strong\u003e Socio-Demographic Characteristics of Patients\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003eX \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0796%;\"\u003e\n \u003cp\u003eMin. - Max.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e54.28 \u0026plusmn; 15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e18-89\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003eNumber (n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003ePercentage (% )\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e18-29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e30-49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e50-64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e35.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e65 and over\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e32.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eEducation Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Illiterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e13.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Literate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Primary/Secondary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e22.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eEmployment Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e34.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e65.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eParenthood Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e79.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e20.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003ePresence of Chronic Disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e58.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e41.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eIf Yes;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Diabetes Mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e24.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hypertension\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e40.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Renal Insufficiency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Heart Diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Thyroid Diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Others (COPD, other cancers, psychiatric problems)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e13.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eNumber of Chronic Diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e56.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eType of Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Gastrointestinal System Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e35.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hepatopancreatobiliary Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Hernia Surgery \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Breast Surgery \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Thyroid-Parathyroid Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e19.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003ePrevious Surgery Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003ePrevious Hospitalization Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e60.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e39.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003eLength of Hospital Stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Less than 1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e67.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;1-24 hours \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;25-72 hours \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;73 hours and over \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27.8124%;\"\u003e\n \u003cp\u003e11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31.6932%;\"\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 12.5479%;\"\u003e145\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 55.6894%;\"\u003e100\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003eNote: X: Mean, SD: Standard Deviation, Min: Minimum, Max: Maximum\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eIn Table II, the mean score of the patients on the ASSQ was found to be 27.9 \u0026plusmn; 10.92 (min: 10.00 - max: 50.00).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable II.\u003c/strong\u003e Mean Scores of Patients on the ASSQ\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"72%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.21649%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35.0515%;\"\u003e\n \u003cp\u003eScale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.24742%;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3093%;\"\u003e\n \u003cp\u003eMin.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3093%;\"\u003e\n \u003cp\u003eMax.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.433%;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.433%;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.21649%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35.0515%;\"\u003e\n \u003cp\u003eASSQ Total Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.24742%;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3093%;\"\u003e\n \u003cp\u003e10,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.3093%;\"\u003e\n \u003cp\u003e50,00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.433%;\"\u003e\n \u003cp\u003e27,9034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.433%;\"\u003e\n \u003cp\u003e10,92228\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eMin.:Minimum Max.:Maximum SD:\u003c/em\u003e\u003cem\u003e\u0026nbsp;Standard Deviation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, mean scores obtained from the PoRI measurements of the patients were examined. In the first measurement, the mean score for the Psychological Symptoms subscale was 2.2 \u0026plusmn; 0.9, for the Physical Activities subscale was 3.2 \u0026plusmn; 1.2, for the Appetite Symptoms subscale was 2.5 \u0026plusmn; 1.3, for the Bowel Symptoms subscale was 2.8 \u0026plusmn; 1.2, for the General Symptoms subscale was 2.9 \u0026plusmn; 1.3, and the total mean score of the index was 2.8 \u0026plusmn; 0.8. In the second measurement, the mean score for the Psychological Symptoms subscale was 1.4 \u0026plusmn; 0.5, for the Physical Activities subscale was 2 \u0026plusmn; 0.9, for the Desire-Symptoms subscale was 1.6 \u0026plusmn; 0.9, for the Bowel Symptoms subscale was 1.6 \u0026plusmn; 0.7, for the General Symptoms subscale was 2.1 \u0026plusmn; 1.1, and the total mean score of the index was 1.8 \u0026plusmn; 0.6 (Table III).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable III.\u003c/strong\u003e Subscales and Total Score Means of the PoRI\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eScale and Subscales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003eMin.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eMax.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e1st Measurement (0-3 days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003ePsychological Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.2190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.92650\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003ePhysical Activities Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e3.2759\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1.21540\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eAppetite Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.5052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1.31414\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eBowel Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.8469\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1.23018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eGeneral Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.9431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1.32607\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eTotal Score Mean of PoRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.8444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.86296\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e2nd Measurement (10-15 days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003ePsychological Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.4017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.53546\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003ePhysical Activities Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.0560\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.97738\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eAppetite Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.6310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.95520\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eBowel Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.6690\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.79351\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eGeneral Symptoms Mean Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e2.1362\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1.15957\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 40px;\"\u003e\n \u003cp\u003eTotal Score Mean of PoRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.8188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e0.64234\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eSD: Standard Deviation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA statistically significant, positive, moderate correlation (\u003cem\u003er\u003c/em\u003e = 0.222) was found between the total mean scores of the ASSQ and the first and second measurements of the PoRI (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05) (Table IV).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable IV.\u003c/strong\u003e The Relationship Between PoRI and ASSQ Scores\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"665\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 169px;\"\u003e\n \u003cp\u003eScale\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCorrelation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003ePsychological Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003ePhysical Activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eAppetite Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eBowel Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eGeneral Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003ePoRI Total Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003eASSQ Total Score\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 140px;\"\u003e\n \u003cp\u003ePsychological Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003er\u003csub\u003es\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 140px;\"\u003e\n \u003cp\u003ePhysical Activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003er\u003csub\u003es\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e.385***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 140px;\"\u003e\n \u003cp\u003eAppetite Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003er\u003csub\u003es\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e.431***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.347***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 140px;\"\u003e\n \u003cp\u003eBowel Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003er\u003csub\u003es\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e.217**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.196*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.269**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 140px;\"\u003e\n \u003cp\u003eGeneral Symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003er\u003csub\u003es\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e.276**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.198*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.299***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.300***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 140px;\"\u003e\n \u003cp\u003ePoRI Total Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003er\u003csub\u003es\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;.596***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.735***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.636***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.609***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.561***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 140px;\"\u003e\n \u003cp\u003eASSQ Total Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003er\u003csub\u003es\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.197*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e.222*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e***p\u0026lt;0.001, **p\u0026lt;0.01, *p\u0026lt;0.05\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eA statistically significant difference was found between the total scores of the ASSQ based on the educational status of the patients (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). The Bonferroni test revealed statistically significant differences between the university group and the groups of illiterate, literate, and primary/middle school patients (\u003cem\u003ep\u003c/em\u003e=0.022, \u003cem\u003ep\u003c/em\u003e=0.025, and \u003cem\u003ep\u003c/em\u003e=0.005). It was observed that the total scores of the ASSQ for illiterate, literate, and primary/middle school patients were higher than those of university graduate patients.\u003c/p\u003e\n\u003cp\u003eA statistically significant difference was found between the total scores of the ASSQ based on whether the patients had children (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). It was determined that the total scores of the ASSQ for patients with children were higher than those for patients without children.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIt is known that preoperative anxiety not only affects the entire surgical process but also impacts postoperative recovery measures (10, 11). Postoperative recovery is an energy-demanding process that begins shortly after surgery and extends beyond discharge. The intended outcome is to return to preoperative levels of physical, psychological, customary, and social states, achieving optimal well-being and preoperative levels of independence/dependence in daily life activities (1, 15, 23).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe mean score of the ASSQ in the preoperative period was found to be 27.9\u0026plusmn;10.9 for the patients. According to some similar studies in the literature, Bulut (2017) reported a mean score of 28.6\u0026plusmn;7.82 on the ASSQ (19), while \u0026Ccedil;evik Acar and Yıldız Fındık (2015) found a mean score of 28.5\u0026plusmn;7.06 in their study (24). Yıldız Fındık and Yıldızeli Top\u0026ccedil;u (2012) reported mean scores of 23.76\u0026plusmn;7.12 for planned surgical interventions, 28.55\u0026plusmn;7.15 for emergency surgical interventions, and 28.03\u0026plusmn;8.20 for day surgery interventions (25). In the study by Karancı and Dirik (2003), who developed the ASSQ, the mean score was reported to be 36.50\u0026plusmn;17.55 (21). Oflaz and Vural (2010) stated that the anxiety levels of patients in surgical clinics were higher than those in other clinics and that these levels increased even more when they focused on the surgery (25). The results show that the level of anxiety specific to surgery experienced by surgical patients is above average. Based on the literature, it is observed that preoperative anxiety still exists but shows a decrease in measured results and scores over time. Effective factors contributing to this decrease include preoperative information, education, and patient-centered approaches (20).\u003c/p\u003e\n\u003cp\u003eNurses are an essential part of the preoperative period. They need to monitor and identify risk factors for surgery, assess patients\u0026apos; needs, manage patients\u0026apos; expectations, and understand their sensitivities (26). In a study evaluating the quality of perioperative nursing care, \u0026Ccedil;evik Acar and Yıldız Fındık (2015) emphasized the importance of patient satisfaction and noted that the perceived quality of care by the patient would also affect their preoperative anxiety (20). Widiyawati et al. (2024) showed that hand relaxation and progressive muscle relaxation techniques applied before cesarean section reduce the preoperative anxiety levels of patients. The study stated that such interventions targeted during the preoperative period reduce the anxiety of patients and accelerate postoperative recovery (27). In addition, in a study conducted by İnce and \u0026Ouml;zl\u0026uuml; (2024), it was found that preoperative anxiety directly affected the postoperative recovery process of patients and high anxiety levels prolonged the recovery period. This once again demonstrates the importance of nurses taking a more proactive role in the management of preoperative anxiety (28).\u003c/p\u003e\n\u003cp\u003eA significant difference was found in the comparison of the mean scores of the ASSQ with socio-demographic data, particularly in terms of education level. It was observed that as the education level increased, the patients\u0026apos; scores on the ASSQ decreased. This finding is supported by Bulut (2017), who studied factors specific to preoperative anxiety; the scores of those who were illiterate or had only completed high school were statistically significantly higher than those of patients who had graduated from university (19).\u003c/p\u003e\n\u003cp\u003eA statistically significant difference was found in the mean scores of the ASSQ based on whether patients had children (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). The anxiety levels of patients with children were found to be higher than those without children. Another study examining preoperative anxiety also found that anxiety scores increased with the number of children (20).\u003c/p\u003e\n\u003cp\u003eThe recovery status and difficulties in recovery of the patients participating in the study were examined based on the total score and sub-dimensions of the PoRI. In the first measurement, moderate difficulties were identified in Psychological Symptoms, while significant difficulties were experienced in other areas and overall. In the second measurement, patients experienced mild difficulties in Psychological Symptoms and moderate difficulties in other areas and overall.\u003c/p\u003e\n\u003cp\u003eFurthermore, when examining the measurements of the PoRI, it was observed that patients had the highest mean scores in the Physical Activities sub-dimension and the lowest mean scores in the General Symptoms sub-dimension (29). These results suggest that surgical intervention impacts physical activities more significantly and that general symptoms are less pronounced. In this study, no differences were found between the PoRI and sociodemographic data. The discrepancy between these results and those of Dığın and Kızılcık \u0026Ouml;zkan\u0026apos;s study may be attributed to the entirely elderly population in their study (29).\u003c/p\u003e\n\u003cp\u003eResearch on the recovery experiences of patients after colorectal surgery reveals severe physical weakness and a high need for caregiver support in the postoperative period (30, 31). These findings emphasise that the recovery process involves not only physical but also psychological and social dimensions. Similarly, in this study, we found the negative effects of preoperative anxiety on postoperative recovery. In particular, it was observed that patients experienced serious difficulties in the first 3 days of the postoperative period and needed psychological support in this process. It is frequently reported in the literature that preoperative anxiety may negatively affect surgical outcomes and the recovery rate of patients (32). The difficulties experienced by patients after colorectal surgery show that this process includes not only physical recovery but also psychological and social needs of patients. In this context, it is thought that nurses should adopt a more holistic approach in the postoperative support process, taking into account the psychological status of patients. Xiangting et al. (2023) stated that nurses\u0026apos; providing more support for the psychological status of patients may accelerate the healing process (31). \u0026nbsp;These findings reveal that not only physical but also psychological and social needs of patients should be taken into consideration in the postoperative period. In this context, developing intervention strategies for patients with anxiety in the preoperative period may be an important factor in accelerating the recovery process.\u003c/p\u003e\n\u003cp\u003eA study evaluating postoperative recovery via a mobile application on the 7th and 14th days revealed that the recovery criteria in the experimental group (sleep difficulties, general discomfort, feeling unwell, dizziness, headache, difficulty in eating, pain, or edema at the surgical incision site) were better compared to the control group, which did not receive nurse intervention (33). Similarly, in this study, recovery was assessed using similar criteria postoperatively, and all patients were followed up by a nurse on days 10-15. Based on these findings, it can be said that interaction with a nurse during the post-discharge period positively influences recovery.\u003c/p\u003e\n\u003cp\u003ePostoperative recovery is a subjective, multidimensional, long-term, and complex process; therefore, using only objective findings to explain it is not an appropriate approach (34). This highlights the importance of understanding the impact of psychological factors before and after surgery. In a study on the Enhanced Recovery After Surgery (ERAS) approach in laparoscopic urology surgery, better recovery outcomes were observed in the experimental group where nursing interventions were conducted. The study results suggest that the concept of rapid rehabilitation surgery, combined with psychological nursing stress interventions and nursing guidance, can regulate patients\u0026apos; anxiety and depression, reduce postoperative stress response, improve immune function, and thus accelerate the recovery process (35).\u003c/p\u003e\n\u003cp\u003eIn a study investigating the sleep quality, anxiety, and perceived stress levels of patients scheduled for open-heart surgery showed that longer preoperative hospital stays contributed to increased stress levels after surgery, it was shown that the length of preoperative hospital stay increased postoperative stress levels (36). The results of a study examining the anxiety caused by preoperative waiting periods and its impact on sleep quality indicated that as patients\u0026apos; preoperative anxiety increased, their sleep quality simultaneously deteriorated (37). Similarly, another study reported that preoperative anxiety measurements in patients led to postoperative pain and sleep problems (37, 38). In another study examining the postoperative outcomes of preoperative anxiety, it was found that anxiety not only caused pain but also that an increase in the degree of pain exacerbated respiratory distress, nausea, and vomiting (39). This study found that preoperative anxiety negatively affected postoperative recovery. Implementing appropriate psychological support and stress management strategies in the preoperative period can positively impact patients\u0026apos; postoperative recovery process. Postoperative psychological support and stress intervention can mitigate the negative effects of preoperative anxiety and improve the recovery process. These findings highlight the importance of preoperative anxiety management and the critical role of psychological support strategies on postoperative recovery. Therefore, providing psychological evaluation and appropriate interventions during the preoperative period can help patients experience a more positive recovery. However, more research and individualized nursing interventions are needed to meet patients\u0026apos; personal needs and reduce anxiety levels (40).\u003c/p\u003e"},{"header":"Strengths and limitations","content":"\u003cp\u003eDespite the strengths of the study, there were several limitations. Collecting data during the pandemic period resulted in a longer data collection phase. In the early times of the pandemic, elective surgeries were stopped for a long time. After the onset, patients were usually referred to day surgery. This reduced the chance of preoperative counselling in patients, and therefore the sample group size could not be larger. \u0026nbsp;Major surgeries were also postponed as much as possible. \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePostoperative recovery is more difficult for patients who have high levels of preoperative anxiety. Therefore, it is recommended to adopt a multidisciplinary and multimodal approach, comprehensively evaluate patients\u0026apos; anxieties, provide expert support to patients experiencing anxiety, reduce the preoperative hospital stay, routinely assess postoperative recovery, and tailor nursing care accordingly. Additionally, it is suggested to conduct prospective studies with larger samples in different surgical fields.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003ePsychological Care and Targeted Interventions in Nursing:\u0026nbsp;\u003c/strong\u003eThis study highlights the psychological dimension of nursing by emphasizing nurses\u0026rsquo; responsibility to assess preoperative anxiety levels and to develop tailored patient education and psychosocial support programs based on patients\u0026rsquo; educational background and parental status.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eTimely, Evidence‑Based Recovery Monitoring:\u0026nbsp;\u003c/strong\u003eBy systematically evaluating postoperative recovery at early (days 0\u0026ndash;3) and late (days 10\u0026ndash;15) intervals using the PoRI, this research provides novel, evidence‑based insights into care planning and the optimal timing of interventions.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eHolistic Surgical Nursing Approach:\u0026nbsp;\u003c/strong\u003eThrough the concurrent examination of preoperative anxiety and postoperative recovery across a diverse surgical cohort, the study offers a comprehensive perspective to the general surgery literature and integrates nursing practice within multidisciplinary care pathways.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank the participations who participated in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors of this paper meet the authorship criteria according to the International Committee of Medical Journal Editors guidelines. Study design: NET, YCD. \u0026nbsp;Data collection: NET. Data analysis: NET, YCD. Study supervision: NET, YCD. Manuscript writing: NET, YCD. Both authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring this study, no financial or spiritual support was received neither from any pharmaceutical company that has a direct connection with the research subject, nor from a company that provides or produces medical instruments and materials which may negatively affect the evaluation process of this study\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets produced and investigated during this study are available from the relevant author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study adhered to the Declaration of Helsinki. Ethical approval for this research was received from Ege University Medical Research Ethics Committee\u0026nbsp;(Date: 15.09.2020, Decision No: 20-9T/12). All participants were informed about the purpose and procedures of the study and voluntarily provided written informed consent prior to participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo conflicts of interest between the authors and/or family members of the scientific and medical committee members or members of the potential conflicts of interest, counseling, expertise, working conditions, shareholding and similar situations in any firm.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eTadesse M, Ahmed S, Regassa T, Girma T, Hailu S, Mohammed A, et al. 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Sakarya: Sakarya University, Institute of Health Sciences; 2018. Turkish.\u003c/li\u003e\n \u003cli\u003eBulut Ş. Investigation of surgery-related anxiety and related factors in patients who will have a surgery [master\u0026rsquo;s thesis]. İstanbul: Maltepe University, Institute of Health Sciences; 2017. Turkish.\u003c/li\u003e\n \u003cli\u003e\u0026Ccedil;evik Acar E, Yıldız Fındık \u0026Uuml;. Thoughts about the quality of nursing care of patients in the operating room and the assessment of anxiety levels. Anatol J Nurs Health Sci. 2015;18(4):268-273.\u003c/li\u003e\n \u003cli\u003eKarancı N, Dirik G. Predictors of pre- and postoperative anxiety in emergency surgery patients. J Psychosom Res. 2003;55(4):363-369. doi:10.1016/S0022-3999(02)00631-1.\u003c/li\u003e\n \u003cli\u003eCengiz H, Aygin D. Validity and reliability study of the Turkish version of the Postoperative Recovery Index of patients undergoing surgical intervention. Turk J Med Sci. 2019;49:566-573. doi:10.3906/sag-1806-33.\u003c/li\u003e\n \u003cli\u003eFriedrich S, Reis S, Meybohm P, Kranke P. Preoperative anxiety. Curr Opin Anaesthesiol. 2022;35(6):674-678. doi:10.1097/ACO.0000000000001186.\u003c/li\u003e\n \u003cli\u003eYıldız Fındık \u0026Uuml;, Yıldızeli Top\u0026ccedil;u S. Effect of the way of surgery on preoperative anxiety. Hacettepe Univ Fac Health Sci Nurs J. 2012;19(2):22-33.\u003c/li\u003e\n \u003cli\u003eOflaz F, Vural H. Evaluation of inpatients\u0026rsquo; depression and anxiety symptoms and related factors. Med J Suleyman Demirel Univ. 2010;17(1):1-7.\u003c/li\u003e\n \u003cli\u003eMalley A, Kenner C, Kim T, Blakeney B. The role of the nurse and the preoperative assessment in patient transitions. AORN J. 2015;102(2):181-e1. doi:10.1016/j.aorn.2015.06.004.\u003c/li\u003e\n \u003cli\u003eWidiyawati W, Wardani LK, Rinawati F, Widyastuti B, Hidajaturrokhmah NY, Saputro H. Effectiveness of finger hand relaxation and progressive muscle relaxation techniques on anxiety in pre-operative sectio caesarea patients. J Nurs Pract. 2024;8(1):229-236. doi:10.30994/jnp.v8i1.657.\u003c/li\u003e\n \u003cli\u003eİnce M, \u0026Ouml;zl\u0026uuml; ZK. The effect of virtual reality on pain, anxiety, physiological parameters, and postspinal headache in patients undergoing spinal anesthesia: a randomized controlled trial. J Perianesth Nurs. 2024;[Epub ahead of print]. doi:10.1016/j.jopan.2024.07.012.\u003c/li\u003e\n \u003cli\u003eDığın F, \u0026Ouml;zkan ZK. Determination of postoperative recovery status of elderly patients. Online Turk J Health Sci. 2021;6(3):413-418. doi:10.26453/otjhs.907564.\u003c/li\u003e\n \u003cli\u003eJakobsson J, Idvall E, Kumlien C. The lived experience of recovery during the first 6 months after colorectal cancer surgery. 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Br J Anaesth. 2017;119(5):1030-1038. doi:10.1093/bja/aex331.\u003c/li\u003e\n \u003cli\u003eLiu Y, Qiu Y, Fu Y, Liu J. Evaluation of postoperative recovery: past, present and future. Postgrad Med J. 2023;99(1174):808-814. doi:10.1136/postgradmedj-2022-141652.\u003c/li\u003e\n \u003cli\u003eLuo L, Jiang X, Kang X, Zeng F, Lin Y, Wu D. Application of ERAS concept and psychological guidance in nursing of patients with laparoscopic urology. Health. 2022;14(5):576-585. doi:10.4236/health.2022.145042.\u003c/li\u003e\n \u003cli\u003eBal E. Investigation of sleep quality, anxiety and perceived stress the levels of patients who will have open heart surgery [master\u0026rsquo;s thesis]. İstanbul: İstanbul Okan University, Institute of Health Sciences; 2020. Turkish.\u003c/li\u003e\n \u003cli\u003eDuran B. The effect of patients\u0026apos; surgery waiting time on anxiety and sleep quality [master\u0026rsquo;s thesis]. İzmir: Ege University, Institute of Health Sciences; 2020. Turkish.\u003c/li\u003e\n \u003cli\u003e\u0026Ccedil;alışkan E, Aksoy N. The relationship between preoperative anxiety level and postoperative pain outcomes in total hip and knee replacement surgery: a cross-sectional study. J Perianesth Nurs. 2025;40(1):76-82. doi:10.1016/j.jopan.2024.03.010.\u003c/li\u003e\n \u003cli\u003eYaman \u0026Ouml;. Evaluation of effect of anxiety levels of patients before open heart surgery on postoperative pain, dyspnea, nausea-vomiting and compliance to treatment [master\u0026rsquo;s thesis]. Sakarya: Sakarya University, Institute of Health Sciences; 2018. Turkish.\u003c/li\u003e\n \u003cli\u003eRuiz Hernandez C, G\u0026oacute;mez-Urquiza JL, Pradas-Hern\u0026aacute;ndez L, Vargas Roman K, Suleiman-Martos N, Albend\u0026iacute;n-Garc\u0026iacute;a L, et al. Effectiveness of nursing interventions for preoperative anxiety in adults: a systematic review with meta-analysis. J Adv Nurs. 2021;77(8):3274-3285. doi:10.1111/jan.14827.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bsur","sideBox":"Learn more about [BMC Surgery](http://bmcsurg.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bsur/default.aspx","title":"BMC Surgery","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Anxiety, Recovery, Surgery, Preoperative, Postoperative","lastPublishedDoi":"10.21203/rs.3.rs-8038706/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8038706/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eThe potential for preoperative anxiety to negatively affect postoperative recovery remains a current, increasingly important issue that warrants further investigation. The primary objective of this study was to assess the relationship between preoperative anxiety and postoperative Recovery in patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eDesigned as a cross-sectional study, this research included patients who had surgeries in the general surgery department at a university hospital from September 15, 2020, to January 31, 2021.\u003cstrong\u003e \u003c/strong\u003eThe study gathered data through the use of the Patient Information Form, the Anxiety Specific to Surgery Questionnaire, and the Postoperative Recovery Index. The analysis of the data was carried out using the SPSS (version25.0) software package.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe study found that the average age of the patients was 54.28±15.4 years, and 60.0% of them were women. The average score on the Anxiety Specific to Surgery Questionnaire was 27.9±10.9. The average score on the Postoperative Recovery Index was 2.84±0.86 for measurements taken on days 0-3 and 1.82±0.64 for measurements taken on days 10-15. Upon examining each sub-dimension and the total scale scores, it was found that most patients experienced positive recovery. In conclusion, it was determined that patients exhibited moderate levels of anxiety specific to surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003ePostoperatively, they generally experienced significant difficulties in recovery during days 0-3, and moderate difficulties during days 10-15. It was also found that preoperative anxiety adversely affected postoperative recovery.\u003c/p\u003e","manuscriptTitle":"Assessing the Relationship Between Preoperative Anxiety and Postoperative Recovery","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-22 09:00:02","doi":"10.21203/rs.3.rs-8038706/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-02T09:26:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-17T19:57:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-17T09:25:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-15T22:58:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"69043124400721683864074992326966597197","date":"2025-12-15T22:38:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"288035143834405435982665031480627220232","date":"2025-12-15T08:51:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"45583896387909183286451474202080371985","date":"2025-12-14T08:21:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"199293557284494924305153239613320974495","date":"2025-12-12T07:41:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-12T07:25:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-08T22:18:17+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-18T19:55:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-18T09:19:53+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Surgery","date":"2025-11-18T09:16:21+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bsur","sideBox":"Learn more about [BMC Surgery](http://bmcsurg.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bsur/default.aspx","title":"BMC Surgery","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7b657894-29c5-4163-ae98-d48cfe313101","owner":[],"postedDate":"December 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-09T16:06:44+00:00","versionOfRecord":{"articleIdentity":"rs-8038706","link":"https://doi.org/10.1186/s12893-026-03589-6","journal":{"identity":"bmc-surgery","isVorOnly":false,"title":"BMC Surgery"},"publishedOn":"2026-03-06 15:59:35","publishedOnDateReadable":"March 6th, 2026"},"versionCreatedAt":"2025-12-22 09:00:02","video":"","vorDoi":"10.1186/s12893-026-03589-6","vorDoiUrl":"https://doi.org/10.1186/s12893-026-03589-6","workflowStages":[]},"version":"v1","identity":"rs-8038706","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8038706","identity":"rs-8038706","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}