Authors: Zech N et al.
Anesthesia & Analgesia, 142(5):869–878, May 2026
Summary:
This prospective, patient-blinded pre–post intervention study evaluated whether targeted communication training for anesthesiologists during preoperative consultations can reduce patient anxiety. The study is based on the understanding that risk disclosure and informed consent discussions can unintentionally increase anxiety through nocebo effects, negatively impacting perioperative outcomes.
Patient anxiety was assessed using validated tools including the State-Trait Anxiety Inventory (STAI-S), a numeric rating scale, and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The study compared a control group (standard consultation) with an intervention group in which anesthesiologists completed a one-hour structured communication training session focused on delivering risk information while emphasizing positive aspects such as safety measures, monitoring, and treatability of complications.
Overall, preoperative consultation reduced anxiety in the majority of patients (85%). However, the reduction was significantly greater in the intervention group (approximately 89.5%) compared to the control group (81.5%). Anxiety scores improved modestly overall, but more meaningful reductions were seen in anesthesia-specific anxiety. Patients with higher baseline anxiety derived the greatest benefit from the communication training, showing significantly larger reductions in anxiety scores.
The intervention focused on reframing communication strategies—balancing necessary risk disclosure with reassurance about preventive strategies and the ability to manage complications. This approach appears to mitigate the negative psychological impact of risk discussions while maintaining informed consent.
The findings demonstrate that even a brief, one-hour educational intervention can meaningfully improve patient experience by reducing preoperative anxiety, particularly in high-risk or highly anxious individuals.
What You Should Know:
Preoperative discussions can unintentionally increase anxiety due to nocebo effects. A simple, structured communication training session for anesthesia providers can significantly reduce patient anxiety, especially in those with high baseline anxiety. Emphasizing positive aspects of care while still providing accurate risk information improves patient experience without compromising informed consent.
Key Points:
- Prospective pre–post study evaluating communication training
- One-hour training significantly improved anxiety reduction
- 89.5% anxiety reduction in trained group vs 81.5% control
- Greatest benefit seen in patients with high baseline anxiety
- Focus on positive framing of risk information improves outcomes
- Supports integrating communication training into anesthesia practice
Thank you to Anesthesia & Analgesia for allowing us to summarize this article.