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Observational Study
. 2018 Aug 9;13(8):e0201511.
doi: 10.1371/journal.pone.0201511. eCollection 2018.

Validity and time course of surgical fear as measured with the Surgical Fear Questionnaire in patients undergoing cataract surgery

Maurice Theunissen  1 , Soraya Jonker  2 , Jan Schepers  3 , Nancy A Nicolson  4 , Rudy Nuijts  2 , Hans-Fritz Gramke  1 , Marco A E Marcus  1   5 , Madelon L Peters  6
Affiliations
Observational Study

Validity and time course of surgical fear as measured with the Surgical Fear Questionnaire in patients undergoing cataract surgery

Maurice Theunissen et al. PLoS One. .

Abstract

Objectives: The primary aim of the study was to assess the convergent validity of the Surgical Fear Questionnaire (SFQ) with other self-report instruments and biological indices of stress. Secondary aims were the examination of predictors of the level and time course of fear and preferences for fear treatment.

Methods: In a prospective observational cohort study SFQ short-term (SFQ-s) and long-term (SFQ-l) scores were assessed one week, one day, and the morning before cataract surgery, together with salivary cortisol and alpha-amylase (sAA) levels, and numeric rating scale (NRS) fear score. SFQ-scores were also assessed before second eye surgery. Expected pain and recovery, and sociodemographic and medico-psychological predictors of fear were assessed at baseline.

Results: Data of 98 patients were analyzed. Scores of both SFQ-subscales (range 0-40) were generally low, all mean ≤ 9.0. SFQ-s and SFQ-l correlated significantly with the other self-report instruments: NRS fear .83 and .89, expected pain .49 and .54, expected recovery -.27 and -.44. No association was found between SFQ-scores and cortisol or sAA level. Predictors of the level of fear were baseline pain and stress. Additional effects of time were found for subgroups based on educational level, antidepressant use, and presurgical stress (SFQ-l). SFQ-scores were significantly lower before the second cataract surgery than before the first, and higher in patients who would have appreciated treatment of fear.

Discussion: Convergent validity of the SFQ with other self-report measures is shown. The sensitivity of the SFQ permits the detection of small variations in fear caused by time or other factors.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Schedule study measurements.
Fig 2
Fig 2. Patient flow.
Fig 3
Fig 3. Surgical fear short- and long-term subscales, at time point 1–4.
T1-3: all patients, T4: binocular patients only. T1: one week before surgery, T2: the evening before surgery, T3: the morning of the day of surgery, morning, at home, T4: binocular patients, the evening before their second surgery. ° indicates outlier.
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Grants and funding

This study was conducted with departmental funding and supported by a grant from the Netherlands Organization for Health Research and Development, http://www.zonmw.nl/en/ (grant #453-07-005), received by MP.