Effect of a pulmonary nodule fact sheet on patient anxiety and knowledge: a quality improvement initiative.

Autor:	Koroscil MT; San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Bowman MH; San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Morris MJ; San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Skabelund AJ; San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Hersh AM; San Antonio Military Medical Center, Fort Sam Houston, Texas, USA.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2018 Sep 14; Vol. 7 (3), pp. e000437. Date of Electronic Publication: 2018 Sep 14 (Print Publication: 2018).
DOI:	10.1136/bmjoq-2018-000437
Abstrakt:	Introduction: The utilisation of chest CT for the evaluation of pulmonary disorders, including low-dose CT for lung cancer screening, is increasing in the USA. As a result, the discovery of both screening-detected and incidental pulmonary nodules has become more frequent. Despite an overall low risk of malignancy, pulmonary nodules are a common cause of emotional distress among adult patients. Methods: We conducted a multi-institutional quality improvement (QI) initiative involving 101 participants to determine the effect of a pulmonary nodule fact sheet on patient knowledge and anxiety. Males and females aged 35 years or older, who had a history of either screening-detected or incidental solid pulmonary nodule(s) sized 3-8 mm, were included. Prior to an internal medicine or pulmonary medicine clinic visit, participants were given a packet containing a pre-fact sheet survey, a pulmonary nodule fact sheet and a post-fact sheet survey. Results: Of 101 patients, 61 (60.4%) worried about their pulmonary nodule at least once per month with 18 (17.8%) worrying daily. The majority 67/101 (66.3%) selected chemotherapy, chemotherapy and radiation, or radiation as the best method to cure early-stage lung cancer. Despite ongoing radiographic surveillance, 16/101 (15.8%) stated they would not be interested in an intervention if lung cancer was diagnosed. Following review of the pulmonary nodule fact sheet, 84/101 (83.2%) reported improved anxiety and 96/101 (95.0%) reported an improved understanding of their health situation. Patient understanding significantly improved from 4.2/10.0 to 8.1/10.0 (p<0.01). Conclusion: The incorporation of a standardised fact sheet for subcentimeter solid pulmonary nodules improves patient understanding and alleviates anxiety. We plan to implement pulmonary nodule fact sheets into the care of our patients with low-risk subcentimeter pulmonary nodules. Competing Interests: Competing interests: None declared.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu