Preoperative Anxiety and One-year Patient-reported Outcomes in Orthopedic Surgery Patients Receiving Enhanced Recovery After Surgery or Conventional Care

Inclusion Criteria: * Inclusion Criteria: 1. Age \>= 20 years. 2. Hospitalized patients scheduled for elective major orthopedic surgery (such as total knee arthroplasty, total hip arthroplasty, or spinal surgery). 3. Possess sufficient language comprehension and expression skills to complete interviews and questionnaires in Mandarin, Taiwanese, Hakka, or English. 4. Agree to participate in the study and provide written informed consent. Exclusion Criteria: 1. Patients requiring immediate management due to emergency or traumatic urgent surgery. 2. Diagnosed by a physician with significant cognitive impairment, delirium, or severe mental illness resulting in the inability to complete evaluation and follow-up. 3. Severe and unstable medical conditions (such as ASA-V, shock, or requiring long-term intensive care treatment). 4. Anticipated requirement for intensive care unit (ICU) admission postoperatively. 5. Concurrent participation in other clinical trials or intervention studies that would affect anxiety or functional outcomes. 6. Patients for whom follow-up up to 12 months is inconvenient or difficult during the study period.