Reducing Anxiety among Radiology Patients

Reducing Anxiety among Radiology PatientsINTRODUCTION earth of the StudyAs the technologic complexity of radiologic cognitive operations has grown, the emotional reactions of tolerant ofs to imaging routines have stimulate more prominent, and interaction between patients and the staff of diagnostic radiology units has make up more important 1.Like the smaller bite of patients surveyed by Monics et al 2 after undergoing a variety of radiologic procedures at a instruction hospital, patients in this sample were more concerned with explanations of procedures and results, and with factors affecting their physical comfort, than with the dexterity of the staff or their own convenience.Patients a postponement therapeutic procedures comm exclusively report fear 1, fears about the unknown, pain, possibility of further interventions, complications, destruction of body image, disruption of manner plans, loss of control, disability, and loss of life 2.Most of the time, one might appr opriate that diagnostic examines, which typically carry fewer risks than invasive therapeutic procedures, would bring forth less scathe. Diagnostic tests, however, inherently harbor uncertainty, which shadower be a potent stressor and has been linked to poor coping with health-related issues, as intimately as poor adaptation and recovery 4.Hence, the conduct of this chew over in this smell lead assess the direct of distress in patients awaiting radiological procedure particularly in breast , transvaginal and scrotal ultrasound. The demand pull up stakes excessively provide effective protocol in the conduct of giving development to patients.Review of Related LiteratureWaiting room distress stop impact patients and radiology resources by taxing partal resources in damage of ap headlandment cancellations, patients lack of cooperation, ext hold backed room times, increased medication use, lengthy recovery and inability to complete imaging procedures well or at all, with adverse impact on both image quality and reimbursement, wrote Nicole Flory, PhD, of the department of radiology at Beth Israel Deaconess medical examination-Harvard Medical School in Boston, and colleagues 5.Attention to patients acute distress before and during procedures is important because distress whitethorn cause hemodynamic instability, procedural complications, and other adverse events 6. As mentioned by KrantzDS et al 7, stress and perplexity may cause adverse events through idealistic levels of blood pressure, heart rate, coronary constriction, and stress hormones.Jangland et al 8 put up that, among those patients who complained about care and increased misgiving, the most common complaints were insufcient breeding, inadequate respect, and insufcient empathy.In the study of Nicole Flory, et al 5 they concluded that uncertainty of diagnosis can weigh heavily on the patient, and perceptions of what medical military unit may enumerate minor do non necessarily reflect the patients experience.Training medical personnel in how to communicate with these patients and to assuage their distress promises not only to relieve the patients distress but also to positively affect depart psychogenic resources.In our literature search, we identified no earlier studies of topics related to anxiety reduction prior(prenominal) to radiologic procedure. Also, no particular studies were taken in comparative assessment of psychological distress in colligation with imaging procedures using the standard verbal explanation against the audio optic unveiling. This study thitherfore allow take advantage of the availability of preprocedural surveys from prospective randomize control trials that testament be performed in department of radiology with patients at various radiologic procedures using infirmary Anxiety and Depression denture (HADS).Research questionsWhat is the prevalence of anxiety and depression among patients referred for breast, transvaginal and sc rotal ultrasound using the adjustive verbal pre-procedural briefing versus with complimentary audio opthalmic presentation?What is the level of anxiety and depression among patients referred for breast, transvaginal and scrotal ultrasound using the adaptive verbal pre-procedural briefing versus with additional audio visual presentation?Is there any differences between anxiety and depression rate in patients undergoing breast, transvaginal and scrotal ultrasound using the adaptive verbal pre-procedural briefing versus with audio visual presentation?Significance of the studyIn the current set-up of our department in radiology, at most three residents are assigned to ultrasound section, supply 60 patients per day with resident to patient ratio of 130 in an 8 hour-shift. This would only give the resident 8 minutes per patient to do his/her doctor-patient interaction. All patients under fasting, are the most anteriority causing all other patient to have a waiting time of about an ho ur or dickens for her/him to be served, and this where the patients for breast, scrotal and transvaginal falls. These procedures also give more anxiety and distress if not explained well by their respective doctors because of its very intimate approach.With this existing reality, having an audio-visual presentation as an additional motherfucker of information might help alleviate patients anxiety and distress. This assessment is a first step in evaluating the adaptive verbal pre-procedural protocol in the radiology department with that of other additional audio-visual presentation, and the results of such an evaluation then can help sink specific interventions toward better outcomes.ObjectivesGeneral objectiveThis study aims to par the authorization of the additional audio-visual briefing presentation versus the adapted pre-procedural verbal briefing only among patients referred for breast, transvaginal and scrotal ultrasound in division of Radiological and Imaging cognizanc es at Southern Philippines Medical Center, Davao City in reducing the level of anxiety/depression using Hospital Anxiety and Depression Scale (HADS) model.Specifically, this study aims to determine the by-linea. Demographic and clinical profile of patients who pull up stakes underwent breast, scrotal, transvaginal ultrasound.b. To compare the effectiveness of adapted verbal pre-procedural briefing against with additional audio-visual presentation in decreasing the anxiety/depression level among patients referred for imaging study.c. To suggest tribute to policy makers and professionals for adoption of creative ways to control or besmirch this phenomena.II. MATERIALS AND METHODSStudy Setting The study forget be conducted at the Department of Radiological and Imaging intelligences waiting section at Southern Philippines Medical Center, Davao City. The study ordain be done over a halt of three months (April to June 2014)Study ParticipantsAll patients referred to the Department of Radiology and Imaging Sciences expertness at Southern Philippines Medical Center for breast, transvaginal and scrotal ultrasound, that is qualified to roast in the study. Below are the inclusion and the exclusion criteria for patients who are candidates for the study. inclusion body criteriaAdult patients (18 65 years old) who provide give their consent for the study.Understands side languagePatients who do not meet any criteria for a mental health disorder using the Global Mental health judgment Tool (GMHAT) of the creative activity Health OrganizationPatient should have tame or moderate levels of anxiety at the start of the trial ambulatoryConsciousExclusion criteriaAll patients who will undergo breast, transvaginal and scrotal procedure that will not give their consent for the study and will not meet the inclusion criteria.Baseline Data CollectionConsents for the research study will be obtained by the researcher between the ages of approximately 18 and 65 years of age. All square(a) patients who had completed their consent from April to July 2014 will be evaluated for study eligibility by the researcher. All patients who will participate will undergo Global Mental Health Assessment Tool (GMHAT) of the World Health Organization to exclude patients having overt mental disorder and will be advised to seek professional help. A randomized alternative of patients will be done wherein they are asked to blindly select which radical they will fall by drawing lots. First company will undergo the usual verbal pre-procedural briefing while the second assort will receive the additional audio-visual presentation. The researcher will ask consecutive eligible patients to participate in a study in which the level of anxiety and depression will be assessed prior to ultrasound procedure. two groups will be handed identical stacks of psychological questionnaire the Hospital Anxiety and Depression Scale(App decisionix 1) under the supervision of the investigator. Patients will be at liberty with regard to the sequence in which they would fill out the questionnaires. other identical stack of HADS questionnaires will be given to the participants after the end of the intervention still under the supervision of the investigator.Outcome MeasuresSocio-demographic questionnairesThe demographic information includes age, gender, education and occupation.Hospital Anxiety and Depression Scale(HADS) The HADS is a screening tool for anxiety and depression in non-psychiatric clinical populations. The scale consists of 14 items (7 distributively for anxiety and depression). Each item is rated on a four point scale ranging from 0 (not at all) to 3 (very often). Responses are based on the relative frequency of symptoms over the preceding week. Possible scores post from 0 to 21 for each subscale. An analysis of scores on the two subscales supported the differentiation of each mood state into four ranges kookie cases (scores 8-10), moderate cases (scores 11-15), and severe cases (scores 16 or higher).HADS was validated by group of researchers (Ingvar Bjelland, Alv A. Dahl, Tone Tangen Haug, Dag Neckelmann) from Department of Public Health and Primary Health Care, Section for Preventive Medicine and Department of Psychiatry of Norway using Cronbalchs alpha. In their study, the sensitivity and specificity for HADS of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Hence the review confirmed the assumption that HADS is a questionnaire that performs well in screening for the separate dimensions of anxiety and depression and caseness of anxiety disorders and depression in patients from nonpsychiatric hospital clinics9.Audio Visual PresentationThe tv will run for 10 minutes and must answer the following questions ofa. WHAT IS THE PROCEDURE?b. WHY IS THE PROCEDURE NECESSARY?c. HOW IS THE PROCEDURE DONE?d. WHAT argon THE RISKS AND COMPLICATIONS OF THE PROCEDURE?The telecasting will be in full side of meat language. The video will be validated by a people Communication professor by issuing a certificate. The video will be presented to at least 10 randomized selected persons outside the DORIS personnel before the actual test will be done. At the end of the video they must able to answer the above questions. During the actual test, video will be presented in groups through television in a separate room.Data Handling and AnalysesThe data will be unruffled directly from the patients by using HADS Scale questionnaires in DORIS at SPMC. circumstantial information about the study will be given to each participant using English language and consent to participate will be obtained.Over viewing of the questionnaire will be the first step, prior to data institution this will be followed by designing an entry model using the computer Statistical Package for Social Science SPSS. The coded questionnaires will be entered into the computer by the resear cher. Data cleaning will be done through checking out a random number of the questionnaires and through exploring descriptive statistics frequencies for all variables. All suspected or preoccupied values will be checked by revising the visible(prenominal) sheets.The researcher will use Statistical Package for Social Science SPSS to analyze the research questions by using Chi square, ANOVA, and t test to answer the objectives. Also, the researcher used descriptive statistics to explore frequencies of all variables. statistically significant values are considered at P values is equal or less than 0.05.Sample Size ConsiderationsThe sample size that will be used in the study is the total summation of the patients who will undergo breast, transvaginal and scrotal ultrasound who will give their consent and at heart the inclusion criteria from April to July of 2014.