Trajectories and Predictors of Raised State Anxiety Among Outpatients Who Have Undergone Medical Imaging Procedures

Kristy Fakes; Allison Boyes; Alix Hall; Mariko Carey; Lucy Leigh; Sandy Brown; Rob Sanson-Fisher

doi:10.1016/j.jacr.2023.06.018

Trajectories and Predictors of Raised State Anxiety Among Outpatients Who Have Undergone Medical Imaging Procedures

J Am Coll Radiol. 2024 Feb;21(2):285-294. doi: 10.1016/j.jacr.2023.06.018. Epub 2023 Jul 14.

Authors

Kristy Fakes¹, Allison Boyes², Alix Hall³, Mariko Carey⁴, Lucy Leigh⁵, Sandy Brown⁶, Rob Sanson-Fisher⁵

Affiliations

¹ Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia. Electronic address: kristy.fakes@newcastle.edu.au.
² Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia.
³ Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
⁴ Hunter Medical Research Institute, New Lambton Heights, Australia; Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.
⁵ Hunter Medical Research Institute, New Lambton Heights, Australia.
⁶ Hunter New England Imaging, John Hunter Hospital/Royal Newcastle Centre, New Lambton Heights, Australia.

PMID: 37453598
DOI: 10.1016/j.jacr.2023.06.018

Abstract

Purpose: The aim of this study was to examine the prevalence of raised state anxiety before and after medical imaging procedures, the prevalence of state anxiety trajectories, and factors associated with postprocedural raised state anxiety.

Methods: A prospective survey was administered to outpatients undergoing elective medical imaging procedures (CT, radiography, MRI, ultrasound, angiography, or fluoroscopy) recruited from one center. Participants completed a self-report survey preprocedure (time 1) and postprocedure (time 2). State anxiety was measured using the six-item State-Trait Anxiety Inventory. The point prevalence of raised state anxiety (State-Trait Anxiety Inventory score ≥33.16) at time 1 and time 2 was calculated, as was the prevalence of four state anxiety trajectories over time: persistent low anxiety, decreasing anxiety, increasing anxiety, and persistent raised anxiety. Factors predictive of raised state anxiety at time 2 were examined using logistic regression analysis.

Results: Three hundred fifteen participants completed both surveys. The prevalence of raised state anxiety at time 1 (50%) and time 2 (51%) was similar. Most patients reported persistent raised anxiety (36%) and persistent low anxiety (34%) over time. Fewer patients reported increasing anxiety (15%) and decreasing anxiety (14%). Raised state anxiety (odds ratio, 4.84; 95% confidence interval, 2.48-9.48) and lower reported health status (odds ratio, 2.48; 95% confidence interval, 1.11-5.51) at time 1 were significantly associated with greater odds of raised anxiety at time 2.

Conclusions: Raised state anxiety related to medical imaging procedures is common among outpatients. Half of patients either developed or continued to experience raised anxiety after their procedures. Outpatients may benefit from evidence-based methods of alleviating anxiety before their procedures.

Keywords: Anxiety; MRI; outpatients; surveys and questionnaires; x-ray CT.

MeSH terms

Anxiety Disorders
Anxiety* / epidemiology
Diagnostic Imaging
Humans
Outpatients*
Prospective Studies
Surveys and Questionnaires