Half of patients experience raised levels of anxiety before or after imaging, with a few key actions practices can take to provide relief, according to new analysis published in JACR [1].

In particular, individuals who reported being in fair/poor or good health face greater odds of experiencing anxiety after a procedure when compared to those in “very good” or “excellent” health. The authors believe this is the first study to examine the trajectory and predictors of raised anxiety among outpatients undergoing a range of different exam types, researchers detailed July 13.

“Persistent elevated anxiety was the most frequent trajectory,” wrote Kristy Fakes, PhD, with the Health Behavior Research Collaborative at the University of Newcastle in New South Wales, Australia. “These results suggest that outpatients may benefit from evidence-based methods of reducing anxiety, such as the provision of preparatory information and psychological approaches, prior to undergoing medical imaging.”

For the analysis, Fakes and co-investigators conducted a prospective survey of outpatients undergoing elective medical imaging at a single center, including CT, X-ray, MRI, ultrasound, angiography or fluoroscopy. Subjects completed questionnaires both before and after their exam, with angst measured using the six-item State-Trait Anxiety Inventory, or STAI-6, scale.

A total of 315 participants completed both surveys, reporting equal levels of raised-state anxiety before (50%) and after (51%) their exam. Those included about 36% of subjects who experienced persistent raised anxiety over time and another 34% with persistent low anxiety. Meanwhile, few reported increasing anxiety (15%) or decreasing anxiety (14%) during the process.

“This was an unexpected finding, which did not support our hypothesis, as whilst raised anxiety waiting for medical procedures may be considered common, it had been assumed post-procedure anxiety would be lower,” the authors noted.

Raised anxiety prior to the procedure also was associated with raised anxiety afterward. Fakes and co-authors urged imaging leaders to use these characteristics to better identify and prepare patients prior to their exam.

“For example, anxiety screening—utilizing the STAI-6 or another valid and reliable instrument to assess anxiety and health status rating—could be elicited via simple questions prior to the patient’s procedure and warrant investigation,” the study noted. “Further, there are a number of strategies proven to reduce anxiety in imaging populations, including through the provision of information and communication, hypnosis and music interventions. However, reviews highlight the need for further [randomized control trials] of preparatory information provision methods to reduce anxiety in a broad range of medical imaging populations.”

Read more in the Journal of the American College of Radiology at the link below.