Same-day diagnosis of symptomatic breast problems: psychological impact and coping strategies
Harcourt, D., Rumsey, N. and Ambler, N. (1999) Same-day diagnosis of symptomatic breast problems: psychological impact and coping strategies. Psychology, Health & Medicine, 4 (1). pp. 57-71. ISSN 1354-8506
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Publisher's URL: http://dx.doi.org/10.1080/135485099106405
`One-stop’ clinics offering same-day investigation and diagnosis of symptomatic breast problems are becoming increasingly available. This randomized controlled trial compared the one-stop system (n 5 416) with conventional arrangements (n 5 375) involving two appointments and a delay before diagnosis is available. Semi-structured interviews and the HADS and EORTC QLQ-C30 were used to assess psychological distress at ® rst clinic attendance and at follow-up. Visual analogue scales addressed worry, impact on daily functioning and perceived satisfaction with care. The brief COPE identi® ed coping strategies used before and after diagnosis. Levels of psychological distress at ® rst clinic attendance were high. Six days later the one-stop group showed signi® cantly lower levels of anxiety (p , 0.05), but women with cancer were more distressed than those still awaiting diagnosis. Eight weeks later, speedier diagnosi s of cancer was associated with higher levels of depressive symptoms (p , 0.05). Each strategy on the brief COPE was used by a higher percentage of women diagnosed with cancer than by women diagnosed with a benign condition. Whilst speedier diagnosis reduces psychological distress for women with benign conditions, results suggest a possible detrimental effect for those with cancer. Effective coping and the appropriate provision of psychological care in one-stop clinics warrant further investigation.