Department of Vascular Surgery, Sahlgrenska University Hospital, SE-416 85 Gothenburg, Sweden.
Department of Vascular Surgery and Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, SE-416 85 Gothenburg, Sweden.
J Vasc Nurs. 2023 Sep;41(3):95-102. doi: 10.1016/j.jvn.2023.05.004. Epub 2023 May 23.
In order to reduce the incidence of abdominal aortic aneurysm rupture and mortality, the Swedish Medical Council has introduced a national abdominal aortic aneurysm (AAA) screening program that offers ultrasound examination of 65-year-old men. Screening programmes of AAA may confer both benefits and harms. The study aim was to investigate the psychosocial consequences of AAA screening among men with screening-detected AAA as compared to men identified as AAA-negative at screening, using an AAA-specific questionnaire.
This cross-sectional study investigated the psychosocial consequences of AAA screening measured with a condition-specific questionnaire. This study focused on the Experience of the Diagnosis and the Screening Procedure in terms of Anxiety, Sense of Dejection and Existential Values. One hundred and fifty-eight men with AAA (63%) and 275 with normal aorta size (55%) completed the diagnosis-specific questionnaire.
Ninety-six percent of men with screening detected AAA did not regret the screening examination, the corresponding figure for controls being 99.6%. Seventy percent of AAA patients were surprised that something was wrong in their body. Some (85%) of men with AAA were current or previous smokers, about half of them (45%) felt guilty about it and 78% of the current smokers in the AAA group had considered stopping smoking. Both groups considered changing lifestyle, although at a higher rate (32%) among AAA cases than controls (20%), with differences both in intention to change their ways to exercise (p = 0.019) and food intake (p = 0.001). Intergroup differences were identified for the majority of items as captured by the questionnaire where men identified with AAA reported more negative psycho-social consequences for all evaluated items except for the items: Regret of the screening examination (p = 0.069) and feeling terrified (p = 0.10). Fifty-one percent of AAA cases stated that they feared rupture, and 12% were anxious about rupture during sexual activity whereas 57% were worried about rupture during intense physical activity.
Men who were diagnosed with AAA reported more psychosocial consequences compared to controls; still only a minority of AAA cases reported psychosocial consequences in greater occurrence. To some degree, men with AAA also feared rupture during various types of activities. There appears to be a need for improved patient information and easy access to caregivers for men with screening-detected AAA, which might help to reduce psychosocial consequences associated with the diagnosis.
为了降低腹主动脉瘤破裂和死亡率的发生率，瑞典医学委员会推出了一项全国性的腹主动脉瘤（AAA）筛查计划，为 65 岁男性提供超声检查。AAA 筛查计划可能带来益处和危害。本研究旨在使用特定于 AAA 的问卷，调查与筛查阴性的男性相比，筛查发现的 AAA 男性的 AAA 筛查的心理社会后果。
这项横断面研究使用特定于条件的问卷调查了 AAA 筛查的心理社会后果。本研究重点关注诊断和筛查程序的心理社会后果，包括焦虑、沮丧感和存在价值。158 名 AAA 患者（63%）和 275 名主动脉正常大小的男性（55%）完成了诊断特异性问卷。
96%的筛查发现 AAA 的男性并不后悔接受筛查检查，对照组的相应比例为 99.6%。70%的 AAA 患者对他们身体的某些问题感到惊讶。一些（85%）AAA 患者是当前或以前的吸烟者，其中约一半（45%）对此感到内疚，78%的 AAA 组当前吸烟者曾考虑戒烟。两组都考虑改变生活方式，尽管 AAA 组的比例更高（32%），而对照组为 20%，并且在改变锻炼方式的意图（p=0.019）和饮食摄入（p=0.001）方面存在差异。通过问卷发现，大多数项目的组间差异明显，被诊断为 AAA 的男性报告了更多的负面心理社会后果，除了以下项目：对筛查检查的后悔（p=0.069）和感到恐惧（p=0.10）。51%的 AAA 患者表示他们担心破裂，12%的患者在性行为期间担心破裂，而 57%的患者担心在剧烈体力活动期间破裂。
与对照组相比，被诊断为 AAA 的男性报告了更多的心理社会后果；但只有少数 AAA 患者报告了更频繁的心理社会后果。在某种程度上，AAA 患者也担心在各种类型的活动中破裂。对于筛查发现的 AAA 患者，似乎需要改善患者信息和方便获得护理人员的途径，这可能有助于减少与诊断相关的心理社会后果。
