Translation of the Amsterdam Preoperative Anxiety and Information Score (APAIS) into the Amharic Version and Its Validation for Evaluation of Preoperative Anxiety

BACKGROUND: Peri-operative anxiety is a vague, unpleasant feeling, the source of which is often nonspecific and unknown to the individual. It affects all aspects of anesthesia. Although the magnitude and consequences of preoperative anxiety are well documented in the developed world, there are limited studies conducted in Ethiopia. The primary aim of this study is to produce the Amharic version of APAIS and evaluate its validity in assessing the prevalence of preoperative anxiety in surgical patients. METHODS: A cross-cultural adaptation process using a forward/backward translation of the APAIS scale was performed. The Amharic version was then tested in 365 sampled elective adult surgical patients scheduled for surgery at Tikur Anbessa specialized Hospital. The validity of the translated version was also checked by evaluating its psychometric properties of internal validity and acceptability. RESULT: The results showed that the reliability of the APAIS-Amharic was high (Cronbach's alpha of 0.87) and the data collected was a good fit (RMSEA of 0.04). In addition, the questionnaire was well-accepted 100% with no missing values for each dimension of the APAIS. The mean APAIS scores for total anxiety and desire for information were 11.6 and 6.0 respectively and 58.9% of the study participants had anxiety and those patients, who had some form of formal education, came from urban areas, had previous anesthesia experience and complications and who had average or high information requirement was more likely to be anxious. CONCLUSION: APAIS-Amharic is a reliable and acceptable tool for measuring patients' preoperative anxiety and their need for information. It can be used routinely as a screening instrument at pre-anesthesia clinics to assess patients' level of anxiety.