[2026-01-26] Intraoperative Anxiety and Its Associated Factors Among Patients Undergoing Conscious Surgery for Closed-Leg Fracture

Xue  Zhang; Niphawan Samartkit; Khemaradee Masingboon

doi:10.33165/rmj.2026.e276243

Authors

Xue Zhang Nursing Science Program, Faculty of Nursing, Burapha University, Chon Buri, Thailand / Department of Operating Room, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
Niphawan Samartkit Department of Adult Nursing, Faculty of Nursing, Burapha University, Chon Buri, Thailand https://orcid.org/0000-0002-8193-3042
Khemaradee Masingboon Department of Adult Nursing, Faculty of Nursing, Burapha University, Chon Buri, Thailand https://orcid.org/0000-0002-6278-7860

DOI:

https://doi.org/10.33165/rmj.2026.e276243

Keywords:

Age, Conscious surgery, Gender, Intraoperative anxiety, Surgical time, Waiting time

Abstract

Background: Patients undergoing open reduction and internal fixation surgery frequently opt for spinal anesthesia, which preserves intraoperative consciousness. This conscious state may trigger significant anxiety during surgical procedures. Despite the clinical relevance of this phenomenon, intraoperative anxiety among conscious patients remains under-recognized in Chinese surgical populations. Many scholars have conducted extensive research on preoperative and postoperative anxiety levels. However, a study on the level of intraoperative anxiety and its’ related factors is still lacking. This knowledge gap motivated the current investigation.

Objectives: To examine the level of intraoperative anxiety and the relationship between gender, age, waiting time, surgical time and intraoperative anxiety among patients with closed-leg fracture undergoing conscious surgery.

Methods: A total of 112 participants were recruited during February 2025 to April 2025 by selecting samples as per the inclusion criteria and using random sampling. Research instruments include the demographic questionnaire and the Visual Analog Scale for Anxiety (VAS-A). Data were analyzed using descriptive statistics, the independent t test, and the Pearson correlation coefficient.

Results: The mean (SD) intraoperative anxiety was 6.3 (2.2), which indicates a clinically-relevant level of anxiety. There was a significant difference in the experience of intraoperative anxiety between female and male patients (t = -3.92, P < .001). Age, waiting time, and surgical time had a positive correlation with intraoperative anxiety among the patients undergoing conscious surgery (r = 0.221, P < .05; r = 0.307, r = 0.346, P < .001, respectively).

Conclusions: The findings provide a reference for healthcare providers to better understand the factors contributing to intraoperative anxiety of patients with closed-leg fracture undergoing conscious surgery, allowing for early identification of high-risk individuals, and targeted interventions, thereby preventing and alleviating intraoperative anxiety, reducing anxiety-related physiological response, minimizing complication risk, and promoting postoperative recovery.

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