Lucock M P, Morley S, White C, Peake M D
Department of Clinical Psychology, Pontefract General Infirmary.
BMJ. 1997 Sep 6;315(7108):572-5. doi: 10.1136/bmj.315.7108.572.
To study the time course and prediction of responses to reassurance after gastroscopy showing no serious illness.
Selection of consecutive patients were assessed before gastroscopy, immediately after reassurance, and at follow up at 24 hours, 1 week, 1 month, and 1 year. Responses of subgroups of patients identified as high, medium, and low health anxiety by the health anxiety questionnaire were analysed.
Endoscopy clinic in a general hospital.
Oral reassurance that there was "nothing seriously wrong."
One consultant physician and 60 patients aged 18-74 referred for gastroscopy.
Physician's and patients' ratings of the extent of the reassurance and patients' ratings of their anxiety about their health and of their illness belief.
There was good agreement between the patients and the physician about whether reassurance had been given. Health anxiety and illness belief decreased markedly after reassurance. Patients with high health anxiety showed a significant resurgence in their worry and illness belief at 24 hours and 1 week, and these levels were maintained at 1 months and 1 year later. Patients with medium levels of health anxiety showed a reduction in worry and illness belief after reassurance, and this was generally maintained during follow up. Patients with low health anxiety maintained low levels of health worry and illness belief throughout the study. Partial correlation analyses showed that the levels of worry and illness belief after reassurance were predicted by the health anxiety questionnaire. This measure also had predictive value beyond that of a measure of general anxiety.
Medical reassurance results in a reduction of worry about health and of illness belief, but this may be very short term. Measurable individual differences in health anxiety can be used to predict the response to reassurance.
研究胃镜检查显示无严重疾病后给予安慰的时间过程及反应预测。
选取连续的患者，在胃镜检查前、给予安慰后即刻、以及在24小时、1周、1个月和1年的随访时进行评估。对通过健康焦虑问卷确定为高、中、低健康焦虑的患者亚组的反应进行分析。
一家综合医院的内镜诊所。
口头安慰称“没有严重问题”。
一名顾问医生和60名年龄在18 - 74岁之间因胃镜检查前来就诊的患者。
医生和患者对安慰程度的评分，以及患者对自身健康焦虑和疾病信念的评分。
患者和医生在是否给予安慰方面达成了良好的一致。安慰后健康焦虑和疾病信念显著降低。高健康焦虑患者在24小时和1周时担忧和疾病信念显著反弹，且在1个月和1年后维持在这些水平。中度健康焦虑患者在安慰后担忧和疾病信念有所降低，且在随访期间总体保持稳定。低健康焦虑患者在整个研究过程中健康担忧和疾病信念维持在低水平。偏相关分析表明，安慰后的担忧和疾病信念水平可由健康焦虑问卷预测。该指标的预测价值超出了一般焦虑测量指标。
医学安慰可减少对健康的担忧和疾病信念，但这可能只是短期的。健康焦虑中可测量的个体差异可用于预测对安慰的反应。
