¹ University Hospital Centre Osijek, Josip Huttler Street 4, Osijek, 31000, Osijek-Baranja County, Croatia, antun.kraljevic@kbco.hr; suzana.luketic@fdmz.hr

² Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Car Hadrijan Street 10e, Osijek, 31000, Osijek-Baranja County, Croatia, spacaric@fdmz.hr; jvujanic@fdmz.hr

³ Department of Nursing and Palliative Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena Street 21, Osijek, 31000, Osijek-Baranja County, Croatia, zmudri@fdmz.hr; mbarisic@fdmz.hr; ibarac@fdmz.hr; nfarcic@fdmz.hr

⁴ Department of Sociology, Croatian Catholic University, Ilica Street 242, Zagreb, 10 000, Croatia

⁵ Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josip Huttler Street 4, Osijek, 31000, Osijek-Baranja County, Croatia

Abstract

Introduction: Surgical fear refers to the emotional response experienced by patients while preparing for a surgical procedure. The aim of this study was to assess the level of preoperative fear among cardiac surgery patients and to explore its relationship with age, gender, risk factors for chronic diseases, and type of surgery.

Methods: This cross-sectional study was conducted between January and April 2025 at the Department of Cardiac Surgery, Osijek Clinical Hospital Center. A total of 87 patients aged 30 to 75 years, scheduled for elective cardiac surgery (coronary artery bypass grafting, valvuloplasty, or correction of heart defects), were included. Data were collected using the validated Croatian version of the Surgical Fear Questionnaire (CRO-SFQ), which measures short-term and long-term fear of surgery, as well as a questionnaire covering sociodemographic and clinical variables. Statistical analyses included descriptive methods and non-parametric tests (Mann–Whitney, Kruskal–Wallis, and Wilcoxon Signed-Rank tests), with the level of significance set at P<0.05.

Results: The median overall surgical fear score was 36 (IQR 23–42). Women reported significantly higher levels of fear compared with men (P=0.01). Higher fear scores were also observed among patients undergoing heart valve replacement or reconstruction compared with those undergoing coronary artery bypass grafting (P=0.04). No statistically significant differences in fear levels were found in relation to the presence of chronic disease risk factors.

Conclusion: Surgical fear is prevalent among most cardiac surgery patients, with higher levels observed in women and in those undergoing more complex procedures. Integrating systematic preoperative interventions, including patient education and psychological support, into clinical practice may help reduce the emotional burden associated with surgery.