背景與目的：接受人工關節置換的人口數漸增，關節置換術成為中老年常見的骨科手術，對於患者是否合併有焦慮的困擾較少被研究。本研究的目的在探討接受下肢關節置換術前後焦慮的情形並分析相關因素。研究方法：以接受下肢膝關節或髖關節置換手術為研究對象共有84人。以貝克焦慮量表(Beck Anxiety Inventary, BAI)中文版做為焦慮評估，視覺類比分數做為疼痛評估，自我健康狀態量表(Short Form-36, SF-36)中文版做為健康相關生活品質評估。結果：關節置換部位不同在焦慮的程度上並無顯著差異。術前有很少的焦慮者佔57.83%、輕微焦慮佔31.33%、中度及嚴重焦慮者佔10.84%。術後很少的焦慮者佔80.72%、輕微焦慮佔14.46%、中度焦慮者佔4.82%。術後比術前焦慮程度有顯著下降(t=4.09,p<0.001)。術前的焦慮男女有顯著的不同，而術後則未出現顯著的差異。術前焦慮相關因素以術前疼痛情形、教育程度的高低以及SF-36中五個面向均有顯著相關。術後焦慮相關因素以術後疼痛情形、及SF-36中四個面向有顯著相關。年齡、與住院日數長短在焦慮的程度上不論術前術後並無顯著相關。結論：疼痛嚴重情形與心理對生活幸福的感受仍是焦慮表現重要來源，性別差異與教育程度在焦慮及壓力的處理佔重要因素，女性與低教育程度在開刀前會顯得特別焦躁不安。如何降低疼痛以及術前提供相關訊息尤其在性別上及不同教育程度應有不同的考量都是後續研究如何降低焦慮重要的依據。(物理治療2003;28(6):317-323)

Purpose: The number of the elderly with lower extremity arthroplasty is increasing without sufficient information about their preoperative and postoperative anxiety. The purpose of this study was to investigate the anxiety and correlated factors in patients with lower extremity arthroplasty. Methods: Eighty-four patients with total hip replacement (THR: 31) and total knee replacement (TKR: 53) were assessed before and after operation. Anxiety, pain and health related quality of life were measured by Beck Anxiety Inventory (BAI), Visual Analog Scale and Taiwan Standard Version Medical Outcomes Study Short-Form 36 (SF-36) respectively. Results: Anxiety level was similar in both areas of arthroplasty. Before operation, 57.83% of the patients had only very slight anxiety, 31.33% mild, and 10.84% were moderate and severe. The postoperative anxiety decrease significantly (t=4.09, p < 0.001), most of patients (80.42%) were at very slight anxious level after surgery. Preoperative anxiety was significantly different between male and female but not in postoperative anxiety. Preoperative anxiety was correlated with preoperative pain (p <0.001), education level (p < 0.05) and 5 dimensions of SF-36 (p < 0.05). Postoperative anxiety was correlated with postoperative pain (p < 0.001) and 4 dimensions of SF-36 (p < 0.005). Anxiety was less likely to be affected by age and length of stay. Conclusions: Pain and sense of well being affect anxiety before and after operation. Gender and educational level nay affect anxiety and stress management before surgery.