Understanding Women’s Anxiety and Uncertainty attending a Rapid Diagnostic Clinic for Suspicious Breast Abnormality: A Mixed Methods Study

Abstract

Background: Rapid diagnostic centres (RDC) for breast abnormality offer a speedier process from the discovery of a suspicious breast lump to same-day investigation and confirmation of a breast cancer diagnosis. Study purpose: This proof of concept study aimed to assess the anxiety and uncertainty levels of women going through an RDC and explore women's need for support during the diagnostic period. Methods: Thirteen women who attended an RDC in 2013 took part in a sequential mixed-method study to assess anxiety and uncertainty levels. Measures were taken pre-and post-testing, at three weeks following receipt of results, and were followed by a semi-structured telephone interview. Results: The mixed data results show congruency between women scoring above clinical values for anxiety and above normative values for uncertainty and detailing their RDC experience as stressful. At pre-diagnosis, uncertainty and anxiety levels were above clinical and normative values for the majority of the thirteen women. Among the women who received a cancer diagnosis (7/13), five had high anxiety, and two scored above normative values for uncertainty. Among the women with a benign diagnosis (6/13), all had anxiety scores below clinical levels, and three had scores above normative values for uncertainty. Anxiety and uncertainty levels remained relatively the same from the three days to three weeks post-testing. The women suggested the need to receive details of the day's unfolding, especially what medical procedures will take place, how, and why, and in advance of the day of testing. Conclusion: While RDCs offer women with a suspicious breast lump the opportunity for quicker diagnostic testing, preliminary results suggest that the period leading up to the day of testing and three days and three weeks post-testing is marked with anxiety and uncertainty levels above clinical and normative values. The results illustrate the need for further inquiry into the psychological impact of obtaining testing at RDCs for a breast abnormality. Results suggest a potential role for nurses to support the waiting period with psycho-educational guidance and resources.

Keywords

• Rapid diagnosis centre
• Oncology
• Breast cancer
• Anxiety
• Psycho-educational support
• Uncertainty