EFFECT OF PREOPERATIVE COUNSELING ON ANXIETY LEVELS AND POSTOPERATIVE RECOVERY: A RANDOMIZED CONTROLLED TRIAL

Abstract

This randomized controlled trial demonstrated that structured preoperative counselling significantly reduced anxiety levels and positively influenced several important postoperative recovery outcomes among patients undergoing elective surgery. Anxiety before surgery is a well-recognized psychological response that can adversely affect perioperative experiences, increase postoperative pain perception, elevate analgesic requirements, and delay functional recovery. The findings of the present study indicate that patients who received structured counselling experienced a substantial reduction in preoperative anxiety, as evidenced by significantly lower STAI-S scores compared with those receiving routine care alone. The observed reduction in anxiety highlights the value of providing patients with clear, organized, and individualized information regarding the surgical procedure, anaesthetic management, expected postoperative course, pain control strategies, and recovery expectations. Such interventions may reduce uncertainty, enhance understanding, and improve patients’ sense of control over the surgical experience. Beyond the psychological benefits, the counselling intervention translated into meaningful clinical improvements in postoperative recovery. Patients in the counselling group achieved earlier ambulation, suggesting enhanced confidence, reduced fear, and greater readiness to participate in postoperative rehabilitation activities. Early mobilization is a critical component of enhanced recovery pathways because it contributes to improved circulation, reduced pulmonary complications, lower risk of thromboembolic events, and faster return to normal activities. Additionally, reduced opioid consumption observed in the intervention group suggests that lower anxiety levels may diminish pain perception and improve coping mechanisms, thereby decreasing reliance on opioid analgesics. This finding is clinically important given the growing emphasis on opioid-sparing approaches and the need to minimize opioid-related adverse effects such as nausea, vomiting, constipation, sedation, and delayed recovery. Patient satisfaction was also significantly higher among participants who received counselling, indicating that improved communication and psychological preparation contribute substantially to the overall quality of perioperative care. Satisfaction is increasingly recognized as a key indicator of healthcare quality and is closely linked to patient engagement, adherence to postoperative instructions, and positive healthcare experiences. Furthermore, improvements in recovery parameters may contribute to reduced healthcare utilization and more efficient hospital resource management. The findings support the integration of structured counselling programs into routine perioperative practice as a simple, low-cost, and non-pharmacological intervention capable of producing measurable benefits. The randomized design and intention-to-treat analysis strengthen the validity of the results and reduce the likelihood of selection and attrition bias. Nevertheless, certain limitations should be acknowledged. The study was conducted among elective surgical patients within a specific clinical setting, which may limit the generalizability of the findings to emergency surgeries or different healthcare environments. Anxiety assessment relied on self-reported measures, which may be influenced by individual perceptions and reporting tendencies. Future multicentre studies involving larger and more diverse patient populations are warranted to confirm these findings and explore the long-term effects of counselling on postoperative recovery, quality of life, and healthcare costs. Structured preoperative counselling significantly reduced preoperative anxiety and improved key recovery outcomes, including earlier ambulation, lower opioid consumption, and greater patient satisfaction. These findings support the routine incorporation of structured counselling into perioperative care pathways to enhance patient-centred outcomes, optimize recovery, and improve the overall surgical experience.