The Amsterdam Preoperative Anxiety and Information Scale (APAIS) - the first trial of a German version

Objective: Preoperative anxiety influences the result of the treatment in patients. To assess preoperative anxiety the Amsterdam Preoperative Anxiety and Information Scale (APAIS) [1] was developed. The APAIS measures anxiety and the need-for-information with 6 items, with good reliability and validity. This article presents the first test of the German version of this screening instrument. Methods: The German version of the APAIS was tested on 68 patients questioned before surgery on the lower extremities in the Orthopaedic Department of a University Hospital. From 68 patients, 47 (69%) were female and the average age was 55 years. Besides the APAIS, several additional questionnaires with similar or divergent content were administered for testing the convergent and discriminant validity of the APAIS (HADS, SCL-9-K, KASA, COSS, STOA). Results: The two scales anxiety and need-for-information could be replicated by a factor analysis and had high reliability (anxiety: Cronbachs Alpha = 0.92; need-for-information: Cronbachs Alpha = 0.86). As expected the scales of the APAIS correlated highly with different standard questionnaires which measure anxiety (KASA, STOA) and low with questionnaires of divergent contents (HADS depression, COSS). The APAIS-scales are independent of sex, age or previous surgeries. Patients with a higher need-for-information show higher anxiety (r=0.59) prior to surgery. Conclusions: During its first trial the German version of the APAIS proved to be a reliable and valid instrument. Furthermore, it is a good screening instrument to assess preoperative anxiety and need-for-information in clinical practice, especially due to its brevity. In further studies the predictive validity has to be examined in large heterogeneous samples.