Riverside Radiology and Interventional Associates, Columbus, Ohio, USA.
J Am Coll Radiol. 2013 Jun;10(6):423-31. doi: 10.1016/j.jacr.2012.11.005. Epub 2013 Mar 15.
The aim of this study was to evaluate patient anxiety and its association with perceived radiologist-patient communication in the setting of imaging-guided breast biopsy.
After informed consent was obtained, 138 women recommended for imaging-guided breast procedures completed questionnaires immediately before and after biopsies, measuring state anxiety using the State-Trait Anxiety Inventory (range, 20-80). Before biopsies, women also completed questionnaires regarding their perceived communication with the radiologists recommending the procedures (modified Questionnaire on the Quality of Physician-Patient Interaction), demographic characteristics, and medical history; immediately after the biopsies, they completed a measure of perceived communication with the radiologists performing the biopsies. Experience levels (eg, attending radiologist, fellow) of the radiologists recommending and performing the biopsies were recorded. Data were analyzed using paired and independent t tests, one-way analysis of variance, Pearson's correlations, and multiple linear regression analyses.
Average prebiopsy anxiety was 44.5 ± 12.4 (range, 20-77) on a scale ranging from 20 to 80 points. Perceived communication with radiologists recommending biopsies averaged 52.4 ± 11.5 (range, 18-65). Better communication with radiologists recommending biopsies was significantly associated with lower levels of prebiopsy anxiety (r = -0.22, P = .01). After the biopsies, women's anxiety significantly decreased (paired t = -7.32, P < .001). Better communication with radiologists performing biopsies (mean, 57.8 ± 8.4; range, 32-65) was associated with lower postbiopsy anxiety after accounting for patients' baseline anxiety levels (β = -0.17, P = .04). White women reported higher prebiopsy and postbiopsy anxiety; nonwhite women reported poorer communication with recommending radiologists.
Patients' perceptions of better communication with radiologists were associated with lower levels of anxiety before and after biopsies. These results have implications for radiologist training and adherence to mammographic screening.
本研究旨在评估影像学引导下乳腺活检患者的焦虑状况及其与患者感知的放射科医生与患者交流之间的关系。
在获得知情同意后，138 名推荐进行影像学引导下乳腺操作的女性在活检前后立即完成问卷调查，使用状态-特质焦虑量表（范围为 20-80）测量状态焦虑。在进行活检之前，女性还完成了关于其与推荐进行这些操作的放射科医生之间感知交流的问卷（修改后的医患互动质量问卷）、人口统计学特征和病史；在活检后，她们立即完成了一项关于与进行活检的放射科医生之间感知交流的测量。记录推荐和进行活检的放射科医生的经验水平（如，主治放射科医生、研究员）。使用配对和独立 t 检验、单因素方差分析、皮尔逊相关分析和多元线性回归分析来分析数据。
平均术前焦虑水平为 44.5 ± 12.4（范围为 20-77），分值范围为 20-80 分。与放射科医生推荐活检的感知交流平均为 52.4 ± 11.5（范围为 18-65）。与放射科医生推荐活检的沟通更好与术前焦虑水平较低显著相关（r = -0.22，P =.01）。在活检后，女性的焦虑明显下降（配对 t = -7.32，P <.001）。在考虑到患者的基线焦虑水平后，与放射科医生进行活检的沟通更好（平均 57.8 ± 8.4；范围为 32-65）与术后焦虑较低相关（β = -0.17，P =.04）。白人女性报告的术前和术后焦虑水平更高；非白人女性报告与推荐放射科医生的沟通较差。
患者对放射科医生的沟通更好的感知与活检前后的焦虑水平较低有关。这些结果对放射科医生的培训和对乳腺筛查的依从性有影响。
