Materials and Methods: This Cross-sectional study was conducted at Alzahra hospital, Rasht, Iran. Firstly 1772 participants were interviewed for the State-Trait Anxiety Inventory to screen cases with more than or equal to 44 scores indicating at least moderate anxiety. Then eligible cases enrolled in the survey and demographic data and the causes of POA were documented.

Results: Among 1772 cases candidate for elective surgeries, the data from 530(29.6%) with at least moderate POA were analyzed. Fear of Anesthesia complications (22.45%), post-operation pain (21.16%), and surgery complications (12.5%) were the most common causes of POA. While fear of transfusion was the least important cause (0.64%). Two hundred forty-one participants suffered from one POA factor and 11 from 4 factors. A higher level of education, occupation, and the history of anesthesia and surgery were significantly associated with lower degrees of POA (P = 0.0001).

Conclusions: The prevalence of moderate to high degrees of POA was acceptable in this study; however, most were avoidable. Therefore individuals screening for detecting high-risk cases in the routine workup and assessing the need for psychiatrists" intervention would be helpful to improve the conditions.