Diagnosis uncertainty a huge source of patient stress

CHICAGO, (Reuters Life!) – Uncertainty about a  possible diagnosis causes more anxiety and can be more  stressful than knowing you actually have a serious illness, a  study said.
In fact, patients can sometimes be so anxious they won’t  complete testing procedures such as MRIs, said study leader  Elvira Lang, at Harvard Medical School in Boston.

“Once people have the diagnosis, they gain some  understanding and control. But without it, all they have is  anxiety, and they do not know how to handle it,” Lang told  Reuters Health about the study, reported at the annual meeting  of the Radiological Society of North America.

Lang and a colleague studied 214 women waiting to undergo  either a breast biopsy, hepatic chemoembolization — a  treatment for cancer such as liver cancer — or treatment for  uterine fibroid tumours.

Immediately prior to the procedures the women completed  tests to measure their stress and anxiety levels. The breast  biopsy patients scored significantly higher on tests for  anxiety and slightly higher on all other tests.

“We were very surprised to see that the women having breast  biopsy were significantly more anxious than the women who came  for treatment for malignant cancer and those who came for  fibroids,” Lang said in an interview. “People in health care  and also family members may judge what is minor or major by how  much risk is involved. But that is not what the patient is  experiencing.”

Lang noted that with lost revenue from tests that patients  are too anxious to complete having an impact on insurance  premiums, dealing with patient anxiety is a plus for health  care institutions as well.

“People want to make patients feel better but they use  language that is not helpful,” Lang said.
“For instance, they will say ‘oh, it’s not going to be that  bad’ or ‘it’s just going to be a little sting,’ but using such  vocabulary only increases anxiety and pain.”
Lang recommended that medical personnel involved with  diagnostic tests avoid negative suggestions and words such as  ‘hurt’ in explanations, and that they use comforting language  that at the same time helped patients recognize their own  strength.