In a contemporary world, it is becoming increasingly clear that we can improve medical care by paying more attention to psychological aspects of medical assessment and treatment(1). Admission in hospitals for medical evaluation and treatment results in different psychological reactions such as anxiety. Anxiety is a diffuse, unpleasant, vague sense of apprehension accompanied by autonomic and somatic symptoms. Despite anxiety has lifesaving qualities and warns of threats of bodily damage, it can affect social, occupational and other important areas of functioning if it is prolonged, irrational, disproportionate and/or severe; occur in the absence of stressful events; interfere with everyday activities. The 12-month prevalence rate of anxiety disorder was 17.7% (2, 3). Anxiety is a common problem in hospitalized patients, particularly in those waiting for surgical procedures and patients with surgical intervention was more than four times more likely to develop anxiety(4), and with chronic conditions which are treatment refractory(5, 6). Anxiety disorders are among the most common mental health problems that share features of excessive fear, anxiety and related behavioral disturbances(7). In a survey of lifetime prevalence and age-of-onset distributions of mental disorders in the recently completed National Comorbidity Survey Replication, the lifetime prevalence estimates of anxiety disorders were 28.8% (8). Worldwide, the estimated number of people living with anxiety disorders in 2015 was 264 million (3.6%), and females were more affected than males (4.6–2.6% ratio)(9). Fifteen point three (15.3%) of anxiety was reported among inpatients in the general hospital in China(10). A 12 year case-control study on inpatient medical-surgical suicidal behavior reported that the prevalence of anxiety disorder was 25% and inadequately controlled anxiety was one of the identified stressor of the suicide attempters(11) and increases length of hospital stay(12).
It was found that the prevalence of anxiety was reported to be 64.9% among adult hospitalized patients in Internal and Surgical Wards of Shiraz Hospitals, Iran(13). In a study conducted among patients with chronic heart, kidney and respiratory disorders, the prevalence of anxiety was 52.2% in Turkey (66%, 46.6% and 44.3% of patients with respiratory disease, heart disease and renal disease respectively(14). In a cross sectional study performed in patients admitted to a university hospital in southern Brazil, the prevalence of anxiety was 33.7%(15). In the assessment of anxiety symptoms among surgical hospitalized patients in Ghulam Mohammad Mahar Medical College and Hospital, Sukkur, Pakistan, 64% of them were severely anxious(16). According to a hospital-based cross-sectional study among 510 cancer patients in Vietnam, the prevalence rate of anxiety was reported to be 43.1%(17). At the third week of admission, anxiety was found in 32 and 29.87% of patients undergoing emergency and elective surgery in Allama Iqbal Memorial Teaching Hospital, Sialkot, Pakistan respectively(18). In a study carried out to assess the prevalence and associated factors of anxiety and depression among cancer patients at a Rwandan referral hospital, it was reported that 52.1% of patients had anxiety(19). A study on mental distress and associated factors among medical surgical adult in patients in public hospitals in Addis Ababa Ethiopia and found that the prevalence of mental disorder was 53.1% (20).
Anxiety disorders are the sixth leading cause of disability in both high and low- and middle-income countries(21). Anxiety amplify physical symptoms; increases impairment in functioning; decreases quality of life; decreases adherence to prescribed regimens; increases use of health service resources; Affects good health behaviors (diet, exercise, and smoking), increases suicidal tendencies(22) and mortality(23) in the medical and surgical patients. Anxiety is affecting the quality of life patients with chronic medical illness like cancer(24–27).
There were several factors that could play a role in the development of anxiety in patients with medical and surgical illnesses. Of these, socioeconomic and educational status (10, 23, 28, 29), employment status and stages of cancer(19), age, gender, and residence(15, 20, 29–31), hospital stay(16, 30), social support(22, 32, 33), fear of death, family concern, fear of dependency and fear of disability(23), high blood pressure, diabetes mellitus and obesity(15), and cigarette and alcohol(34).
Studies revealed that anxiety is the commonest psychological problem among medical and surgical patients posed greater consequences including the quality of life, use of health service resources, increase suicidal behaviors and mortality, yet frequently it is under diagnosed and untreated. The investigators, observed a high number of medical and surgical inpatients through their liaison consultation. Despite its burden, the prevalence of anxiety and predictors among these groups of people has not been well explored in Ethiopia. Therefore, the results of this study will provide essential data for future interventions.