Patient distress increase due to diagnostic uncertainty
Most of us might have experienced the apprehensions of sitting in a hospital waiting area waiting for the test results to arrive and be discussed. The feeling of uneasiness can actually be more stressful than learning that you have an illness. This is according to a study conducted recently and presented today at the Radiological Society of North America (RSNA) annual meeting.
Quoting Elvira V. Lang, M.D., an associate professor of radiology at Harvard Medical School in Boston Massachusetts, she said that “not knowing your diagnosis is a very serious stressor.” She added that this uneasiness can actually be as severe as knowing that you are inflicted with a terminal disease or may have to undergo a dangerous treatment.
Dr. Lang, together with her collaborator Nicole Flory, Ph.D. made a study of the stress levels of 214 women who were scheduled to undergo different treatment procedures and diagnosis. Just before the procedures were undertaken, these women were asked to complete four standardized tests that measure stress and anxiety levels. The tests were the following: State Trait Anxiety Inventory (STAI), Center for Epidemiologic Studies Depression Scale (CES-D), Impact of Events Scale (IES) and Perceived Stress Scale (PSS).
Among the 214 women who underwent the tests, 112 were waiting for breast biopsy, which is a test done to examine if there are lumps in the breast. 42 other women were there for a hepatic chemoembolization which is a liver cancer treatment. The remaining 60 women were awaiting for a uterine fibroid embolization, a curing procedure for uterine myoma or benign fibroids.
The 112 women who had to undergo breast biopsy were reported to be in remarkably higher levels of anxiety, with an average score of 48 in STAI. This is comparatively lower than the anxiety levels of chemoembolization patients who had 26 STAI score in average. Laslty, fibroid embolization patients got an average of 24 STAI score.The scores for IES were not that different from the previous where breast biopsy patients got average score of 26. Other patients from the two remaining groups had 23 average score. The average test results for the CES-D test are as follows: 15 for breast biopsy patients; 14 for chemoembolization patients; and 12 for fibroid embolization patients. PSS ratings also show high average among the breast biopsy patients with 18 as compared to fibroid embolization patients who got 16 and chemoembolization patients with 15.
According to Dr. Lang, the results justify that there is certainly distress upon waiting for diagnosis results and this setup is serious. Dr. Lang believes that the patients, as well as the healthcare workers, are not entirely aware of just how emotionally stressful it is for having a diagnostic test.Dr. Lang further adds that many simple steps can be done to lessen the stress that patients feel before a certain procedure. She believes that trainings for medical team should be done so that they would know how to talk to the patients in a more caring way.