Regev Gilad J, Treister Roi, Brill Silviu, Ofir Dror, Salame Khalil, Lidar Zvi, Khashan Morsi, Litvin Rivka, Hochberg Uri
Spine Surgery Unit, Neurosurgical Department, Tel Aviv Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
J Pain Res. 2023 Mar 17;16:933-941. doi: 10.2147/JPR.S396844. eCollection 2023.
While advanced medical technology and unlimited access to medical information might benefit and empower patients, these same advantages may pose some risks, especially in the cases where patients have direct access to advanced imaging studies. The aim of this work was to evaluate three domains related to patients with lower back pain: the patients' perceptions, misconceptions and the experience of anxiety-related symptoms following direct access to their thoraco-lumbar spine radiology report. An additional aim was the assessment of possible associations with catastrophization.
Patients who were referred to the spine clinic, following the completion of a CT or MRI of their thoraco-lumbar spine were surveyed. Patient perceptions of the importance of having direct access to their imaging report and of the concern they attribute to the medical terms found in their report were evaluated using a set of questionnaires. The medical terms severity scores were then correlated to a reference clinical score created for the same medical terms by spine surgeons. Lastly, patients' anxiety-related symptoms and Pain Catastrophizing Scale (PCS) after reading their radiology report were evaluated.
Data from 162 participants (44.6% female), with mean age of 53.1 ± 15.6 years, were collected. Sixty-three percent of the patients stated that reading their report helped them gain better understanding of their medical condition and 84% agreed that having early access to the report helped improve communication with the physician. Patients' degree of concern associated with the medical terms in their imaging report ranged between 2.07 and 3.75, on a scale of 1-5. The patient's degree of concerns were significantly higher for six common medical terms and significantly lower in one, when compared to experts' opinions. A mean (± SD) of 2.86±2.79 anxiety-related symptoms was reported. The mean Pain Catastrophizing Scale (PSC) score was 29.18 ±11.86, ranging from 2 to 52. Both the degree of concerns and the number of symptoms reported were significantly associated with the PCS.
Direct access to radiology reports might provoke anxiety symptoms, especially in patients with a tendency for catastrophic thinking. Increasing awareness amongst spine clinicians and radiologist about possible risks associated with direct access to radiology reports could contribute to preventing patients' misconceptions and unnecessary anxiety-related symptoms.
先进的医疗技术和对医疗信息的无限制获取可能会使患者受益并增强其能力,但这些优势也可能带来一些风险,尤其是在患者能够直接获取先进影像学检查结果的情况下。这项研究的目的是评估与下背痛患者相关的三个方面:患者在直接获取胸腰椎脊柱放射学报告后的认知、误解以及焦虑相关症状的体验。另一个目的是评估与灾难化思维的可能关联。
对在完成胸腰椎脊柱CT或MRI检查后被转诊至脊柱诊所的患者进行调查。使用一组问卷评估患者对直接获取其影像报告重要性的认知以及他们对报告中医学术语的担忧程度。然后将医学术语严重程度评分与脊柱外科医生针对相同医学术语创建的参考临床评分进行关联。最后,评估患者在阅读放射学报告后的焦虑相关症状和疼痛灾难化量表(PCS)。
收集了162名参与者的数据(女性占44.6%),平均年龄为53.1±15.6岁。63%的患者表示阅读报告有助于他们更好地了解自己的病情,84%的患者同意尽早获取报告有助于改善与医生的沟通。患者对影像报告中医学术语的担忧程度在1至5分的量表上介于2.07至3.75之间。与专家意见相比,患者对六个常见医学术语的担忧程度显著更高,对一个术语的担忧程度显著更低。报告的焦虑相关症状平均(±标准差)为2.86±2.79。疼痛灾难化量表(PSC)的平均得分为29.18±11.86,范围为2至52。担忧程度和报告的症状数量均与PCS显著相关。
直接获取放射学报告可能会引发焦虑症状,尤其是在有灾难化思维倾向的患者中。提高脊柱临床医生和放射科医生对直接获取放射学报告可能存在风险的认识,有助于防止患者的误解和不必要的焦虑相关症状。