Approaches to Educating Patients and Their Families About General Anaesthesia and Their Impact on Reducing Perioperative Stress
DOI:
https://doi.org/10.12775/JEHS.2026.92.72366Keywords
general anesthesia, preoperative anxiety, educational interventions, perioperative stress, family-centered careAbstract
Introduction: Preoperative anxiety associated with general anesthesia is a frequent and clinically significant problem linked to a poorer perioperative experience, increased distress, and less favorable recovery outcomes. Limited knowledge about anesthesia and the anesthesiologist’s role may increase patient stress.
Aim: To examine the literature on educational strategies for patients receiving general anesthesia and, when applicable, their families, with emphasis on their effectiveness in decreasing anxiety and stress, improving knowledge, and enhancing satisfaction.
Methods: A narrative review of 28 full-text English-language articles published from 2020 to 2026 was performed using PubMed, Scopus, Web of Science, and Google Scholar. The review covered studies concerning preoperative education, family-oriented interventions, anxiety reduction, and perioperative experience in adult and pediatric populations.
Results: Educational interventions, especially multimodal, video-based, multimedia, and virtual reality methods, were linked to lower anxiety, greater preparedness, improved understanding of anesthesia, and increased satisfaction. In pediatric settings, family-oriented strategies were particularly relevant, as parental anxiety strongly affected children’s emotional responses. Verbal counseling remained essential, but combined and technology-assisted approaches seemed to be the most effective.
Conclusion: Preoperative education should be considered an integral part of perioperative care. Structured, accessible, and individualized educational strategies may decrease stress, improve cooperation, and strengthen the patient and family experience before general anesthesia.
References
1, Bello CM, Eisler P, Heidegger T. Perioperative anxiety: current status and future perspectives. J Clin Med. 2025;14(5):1422. https://doi.org/10.3390/jcm14051422
2. Skowrońska D, Garczyk A, Kluzik A, Grześkowiak M. What do patients know about anesthesia and anesthesiologists? J Clin Med. 2025;14(23):8459. https://doi.org/10.3390/jcm14238459
3. Abate SM, Chekol YA, Basu B. Global prevalence and determinants of preoperative anxiety among surgical patients: a systematic review and meta-analysis. Int J Surg Open. 2020;25:6-16. https://doi.org/10.1016/j.ijso.2020.05.010
4. Bedaso A, Mekonnen N, Duko B. Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open. 2022;12(3):e058187. https://doi.org/10.1136/bmjopen-2021-058187
5. Villa G, Lanini I, Amass T, Bocciero V, Scirè Calabrisotto C, Chelazzi C, et al. Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review. Perioper Med (Lond). 2020;9(1):38. https://doi.org/10.1186/s13741-020-00169-x
6. Agüero-Millan B, Abajas-Bustillo R, Ortego-Maté C. Efficacy of nonpharmacologic interventions in preoperative anxiety: a systematic review of systematic reviews. J Clin Nurs. 2023;32(17-18):6229-6242. https://doi.org/10.1111/jocn.16755
7. Getahun AB, Endalew NS, Mersha AT, Admass BA. Magnitude and factors associated with preoperative anxiety among pediatric patients: cross-sectional study. Pediatr Health Med Ther. 2020;11:485-494. https://doi.org/10.2147/PHMT.S288077
8. Gu X, Zhang Y, Wei W, Zhu J. Effects of preoperative anxiety on postoperative outcomes and sleep quality in patients undergoing laparoscopic gynecological surgery. J Clin Med. 2023;12(5):1835. https://doi.org/10.3390/jcm12051835
9. Santapuram P, Stone AL, Walden RL, Alexander L. Interventions for parental anxiety in preparation for pediatric surgery: a narrative review. Children (Basel). 2021;8(11):1069. https://doi.org/10.3390/children8111069
10. Oktaviani JR, Widjaja V, Singgih NA, Secodiningrat RHPS. Audiovisual technology intervention for reducing preoperative anxiety in children undergoing general anesthesia: a systematic review and meta-analysis. J Educ Health Promot. 2024;13:222. https://doi.org/10.4103/jehp.jehp_1344_23
11. Ruenhunsa T, Klinhom P, Sangsungnern P, Wittayapairoch P, Sripadungkul D, Maneewan N, et al. Comparison of preanesthesia visits using video animation with verbal communication versus verbal communication alone on preoperative anxiety in pediatric patients: a randomized controlled trial. Transl Pediatr. 2026;15(1):15. https://doi.org/10.21037/tp-2025-aw-772
12. Hou H, Li X, Song Y, Ji Y, Sun M, Wang D, et al. Effect of interactive, multimedia-based home-initiated education on preoperative anxiety in children and their parents: a single-center randomized controlled trial. BMC Anesthesiol. 2023;23:95. https://doi.org/10.1186/s12871-023-02055-7
13. Tang X, Zhang M, Yang L, Tao X, Li Y, Wang Y, et al. Individual cartoon video for alleviating perioperative anxiety and reducing emergence delirium in children: a prospective randomised trial. BMJ Paediatr Open. 2023;7(1):e001854. https://doi.org/10.1136/bmjpo-2023-001854
14. Zhang K, Rashid-Kolvear M, Waseem R, Englesakis M, Chung F. Virtual preoperative assessment in surgical patients: a systematic review and meta-analysis. J Clin Anesth. 2021;75:110540. https://doi.org/10.1016/j.jclinane.2021.110540
15. Kristoffersen EW, Opsal A, Tveit TO, Berg RC, Fossum M. Effectiveness of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies. BMJ Open. 2022;12(5):e054206. https://doi.org/10.1136/bmjopen-2021-054206
16. Brodersen F, Wagner J, Uzunoglu FG, Petersen-Ewert C. Impact of preoperative patient education on postoperative recovery in abdominal surgery: a systematic review. World J Surg. 2023;47(4):937-947. https://doi.org/10.1007/s00268-022-06884-4
17. Osman T, Lew E, Lum EPM, van Galen L, Dabas R, Sng BL, et al. PreAnaesThesia computerized health (PATCH) assessment: development and validation. BMC Anesthesiol. 2020;20(1):286. https://doi.org/10.1186/s12871-020-01202-8
18. Osman T, Lew E, Lum E, Chew J, Dabas R, Sng BL, et al. Effect of PreAnaesThesia computerized health (PATCH) assessment on duration of nurse-patient consultation and patient experience: a pilot trial. Int J Environ Res Public Health. 2020;17(14):4972. https://doi.org/10.3390/ijerph17144972
19. van den Heuvel SF, Jonker P, Hoeks SE, Ismail SY, Stolker RJ, Korstanje JWH. The effect of stand-alone and additional preoperative video education on patients’ knowledge of anaesthesia: a randomised controlled trial. Eur J Anaesthesiol. 2025;42(4):313-323. https://doi.org/10.1097/EJA.0000000000002109
20. Turkdogan S, Roy CF, Chartier G, Payne R, Mlynarek A, Forest VI, et al. Effect of perioperative patient education via animated videos in patients undergoing head and neck surgery. JAMA Otolaryngol Head Neck Surg. 2022;148(2):173-180. https://doi.org/10.1001/jamaoto.2021.3765
21. Xing J, Gong C, Wu B, Li Y, Liu L, Yang P, et al. Effect of an educational video about ERAS on reducing preoperative anxiety and promoting recovery. Heliyon. 2023;9(10):e20536. https://doi.org/10.1016/j.heliyon.2023.e20536
22. Park H, Ko E, Lim CH, Lee J, Kim D, Yeom G, et al. Effects of video-assisted preanesthetic patient education on preanesthetic interview time: a prospective, single-blinded, randomized controlled trial. Medicine (Baltimore). 2024;103(25):e38577. https://doi.org/10.1097/MD.0000000000038577
23. Akemoto K, Kamata K, Kaiho Y, Onishi E, Yabuki S, Shiga T, et al. Effectiveness of a preoperative explanatory video system on patient acceptance and anesthesiologists’ workload: a questionnaire survey. JA Clin Rep. 2025;11(1):40. https://doi.org/10.1186/s40981-025-00805-9
24. Karalar M, Demirbas A, Gercek O, Topal K, Keles I. Impact of preoperative video-based education on anxiety levels in patients with renal stones scheduled for flexible ureteroscopic lithotripsy: a comparative study using APAIS and STAI. Med Sci Monit. 2023;29:e941351. https://doi.org/10.12659/MSM.941351
25. Chiu PL, Li H, Yap KYL, Lam KC, Yip PR, Wong CL. Virtual reality-based intervention to reduce preoperative anxiety in adults undergoing elective surgery: a randomized clinical trial. JAMA Netw Open. 2023;6(10):e2340588. https://doi.org/10.1001/jamanetworkopen.2023.40588
26. Li H, Chiu PL, Efendi D, Huang H, Ko KY, Wong CL. Effects of virtual reality-based interventions on preoperative anxiety in patients undergoing elective surgery with anesthesia: systematic review and meta-analysis. J Med Internet Res. 2025;27:e55291. https://doi.org/10.2196/55291
27. Rostami E, Khanjari S, Haghani H, Amirian H. Effect of video games on preoperative anxiety in 3- to 6-year-old children undergoing elective surgery. J Educ Health Promot. 2022;11:135. https://doi.org/10.4103/jehp.jehp_455_21
28. Nowak A, Dudziak P, Golińska M, Maj W, Łyko M, Kurasz J, et al. The Impact of Anesthetic Modality Selection on Surgical Outcomes in Trauma Management. Quality in Sport. 2025;38:58209. https://doi.org/10.12775/QS.2025.38.58209
29. Fussek-Styga U, Błaszczyk A, Trojan S, Kwieciński J, Miszuda S, Szwedkowicz A, et al. Virtual Reality as a method to reduce pain and anxiety in pediatric patients - a review. Journal of Education, Health and Sport. 2023;31(1):80-93. https://doi.org/10.12775/JEHS.2023.31.01.008
30. Małajewicz I, Nawrocka N, Bednarek F, Hojda A, Rodak H, Plinta O, et al. The Effect of Physical Activity on Anxiety Symptoms in Adults: A Literature Review. Pedagogy and Psychology of Sport. 2026;32:69922. https://doi.org/10.12775/PPS.2026.32.69922
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