Validity and Reliability of the Amsterdam Preoperative Anxiety and Information Scale (APAIS); Thai version in adult Thai pre-operative patients

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Apinya Kunthonluxamee
Siriporn Pitimana-aree
Puchong Laurujisawat


Background: Preoperative anxiety has significant effect on anesthesia in both physiological and psychological outcome. There is no specific tools to evaluate in preoperative anxiety in Thai, recently.
Amsterdam preoperative anxiety and information scale (APAIS) is an effective worldwidely used tool which is interested to be study in evaluating pre operative anxiety in Thai patients.
Objective: To translate APAIS into Thai and validate the reliability of questionnaires in Thai patients. Material and Method: APAIS comprised of 6 questions, two in anesthesia related anxiety, two
in surgical related anxiety and two in information desire component. The translation validation was done in forward and backward translation. The sample size was calculated and 34 patients who were scheduled for surgery answered the Thai APAIS on the day before operation. The validity was determined by
correlation between the Spielbergerûs State Trait Anxiety Inventory (STAI form Y-1) and APAIS (r > 0.6, P < 0.01). The internal consistency was evaluated by Cronbachûs α > 0.70.
Results: Thirty four patients (15 male and 19 female) enrolled in the study. The moderate correlation between STAI-state score and APAIS was shown, anesthesia-related anxiety (sum A),r= 0.57;
surgery-related anxiety (sum S), r= 0.48; total anxiety score (sum C), r= 0.57; and information desire component (IDC), r= 0.42. High reliability with Cronbachûs alpha of 0.88 was found in overall
component, 0.87 in the anxiety component and in the information requirement component. The information desire component showed well correlation with APAIS (SUM A) but less in STAI-state
(IDC vs. STAI-state, SUM C= 0.42, 0.62, relatively).
Conclusion: APAIS Thai version, has consistently reliable correlation with the gold standard STAI-state. The application of APAIS can be use for screening and further studies.


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Kunthonluxamee, A., Pitimana-aree, S., & Laurujisawat, P. (2013). Validity and Reliability of the Amsterdam Preoperative Anxiety and Information Scale (APAIS); Thai version in adult Thai pre-operative patients. Journal of the Psychiatric Association of Thailand, 54(1), 83–92. Retrieved from
Original Articles
Author Biographies

Apinya Kunthonluxamee, Department of Anesthesia, Pranangklao Hospital, Nonthaburi

Siriporn Pitimana-aree, Department of Anesthesia, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

Puchong Laurujisawat, Department of Psychiatry. Faculty of Medicine, Chulalongkorn University, Bangkok