Have you ever put off a dentist - or other medical appointment - because the thought of undergoing a filling, blood test or other medical procedure made you anxious? You’re not alone.
Board certified general and laparoscopic surgeon, Dr. K. Francis Lee, founder of the Advance Vein Care Center in Springfield, MA., said this kind of anxiety is common, and should be addressed.
Here’s what he told Prime about the condition know as procedural anxiety, and what both patients and providers can do to ease the worry.
“Acute procedural anxiety is an excessively high level of dread, distress or fear of any medical procedure in a variety of healthcare settings. These procedures can be diagnostic or therapeutic in nature, ranging from simple laboratory blood draws to MRI scans, mammograms, breast or prostate biopsies, colonoscopies, gynecologic procedures, dental or dermatologic procedures and more. These medical outpatient procedures, whether performed in either a hospital or office-based setting, have become increasingly more frequent, and so too has acute procedural anxiety.
“There are two main reasons to acknowledge and address a patient’s acute procedural anxiety. One is that it can lead patients to avoid or delay beneficial or necessary screening tests or medical procedures, which may increase unhealthy outcomes. Studies* show, for example, that people with dental anxiety have a greater number of missing teeth and root fragments. Similarly, pregnant women with “blood-injection-injury phobia” (those likely to faint at the sight of blood, the anticipation of physical injury or an injection) have been shown to have more elective C-sections, pregnancy complications and/or adverse labor and delivery outcomes. Considering the high prevalence of patients with these anxieties, the adverse health outcomes may be considerable.
“The other reason for concern is that acute procedural anxiety may cause interruption of, or interference with, the procedure itself, leading to adverse complications and outcomes that may have a harmful effect upon the patient.”
“Patients can help themselves most by educating themselves about the nature of their medical procedure using reliable sources. They should depend on their doctor’s office for factual information and avoid information from unsubstantiated internet websites or random family or neighbors’ hearsay experiences.
“Physicians’ offices should have a clearly established strategy for reducing acute procedural anxiety. For example, at Advanced Vein Care Center, we employ a comprehensive anxiety reduction approach. The first step is to recognize that every patient is unique and requires their own set of anxiety reducing care strategies.
“Second is to employ staff members who are educated and trained in ways to reduce patient anxiety. This includes the critical importance of listening to patient concerns and points of distress, and addressing, not dismissing, them. As the date of procedures approach, our staff are available on the phone to answer patients’ concerns and anxieties. Before and during the awake procedure, we provide continuous supportive therapy consisting of verbal and tactile alleviation of anxiety, monitoring and distracting from negative emotions, coaching adaptive skills such as breathing exercises, and enhancement of self-esteem. Studies* have shown that such patient-centered supportive therapy among cardiac or general surgical patients results in lower anxiety, better surgery recovery, and higher levels of satisfaction.
“At Advanced Vein Care Center, we also use music therapy during awake procedures. Some clinical trials* have found that music therapy reduces anxiety in patients undergoing various procedures ranging from “scope” procedures to even “awake craniotomies.
It is important to note that these non-medication strategies can be highly successful in reducing acute procedural anxiety. Drugs—from sedative pills to IV sedation—do work effectively, but they can also place patient at higher risk of complications. It is best to use them only when necessary and appropriate.”
* Source: UptoDate. Treatment of acute procedural anxiety in adults. Topic last updated Jan. 17, 2021.
