Boston: Feeling high levels of distress, fear and hostility just before undergoing medical procedures such as angioplasty may lead to a poor outcome, a new study has found. “I was surprised by this result. Prior to this study, I did not believe patient mood could have an effect on outcome,” said study author Nadja Kadom, currently at Emory University School of Medicine and Children’s Healthcare of Atlanta in US.
In the study, researchers analysed the results of 230 patients, including 120 women and 110 men (mean age 55 years) who underwent image-guided interventional radiology procedures including vascular and kidney interventions. The minimally invasive procedures involved the use of a catheter, which is inserted through a blood vessel and threaded to an area of the body, such as a blocked artery, for treatment.
Upon arriving for their procedure, patients were asked to complete a questionnaire called the Positive Affect Negative Affect Schedule (PANAS) to assess their mood. Using a five-point rating scale, the patients reported to what extent they felt strong, alert, determined and other positive feeling states and to what degree they were experiencing negative feelings, such as guilt, nervousness or irritability.
Researchers grouped the patients based on high and low scores for positive affect and high and low scores for negative affect. Those groups were then correlated with the occurrence of adverse events during the procedures, such as a prolonged lack of oxygen, low or high blood pressure, post-operative bleeding or an abnormally slow heart rate. A statistical analysis of the data showed that patients with a high negative affect experienced significantly more adverse events than patients with low negative affect. Of the 104 patients with high negative affect, 23 (22 per cent) had an adverse event, compared to 15 (12 per cent) of the 126 patients with low negative affect.
The degree of positive affect did not make a significant difference in the incidence of adverse events. “Our study shows that mood matters,” said Elvira V Lang, an interventional radiologist in Boston. “You don’t need to have a chipper, cheery attitude prior to your procedure. You just have to overcome negative emotions and get to a neutral level,” Lang said.
Unlike surgical procedures in which patients are not conscious, interventional radiology procedures are often performed on patients who are sedated but awake and able to talk with the physician and healthcare team.
“The procedure room is a two-way street in which the patient can affect the healthcare professional and vice versa. Any time the team must manage an adverse event, it takes attention away from the procedure,” Lang said.