Impact of life-threatening risk information on the evolution of patients' anxiety and risk recall: the specific context of informed consent for experimental stem cell transplant.
OBJECTIVE
This study examines risk recall and evolution of patients' anxiety after transmission of life-threatening risk information in an informed consent procedure for experimental HSCT.


METHODS
Informed consent interviews were audio-recorded and transcribed. Patient risk recall was obtained through comparing information provided in the interview to information recalled by patients following the interview. The evolution of patients' anxiety was assessed through comparing patients' post- to patients' pre-interview anxiety using the STAI-State. Physicians' communication skills and risk framing were analyzed.


RESULTS
Twenty patients were included. Patients recalled on average 4 risks (S.D.=1.6) out of 9 different risks transmitted (S.D.=2) which corresponds to a recall rate of 44% (S.D.=15.5). Patients' anxiety remained on average stable (Mean=0.4; S.D.=9.1). Linear regression analysis showed that risk recall was predicted positively by the number of risks transmitted (B=.30; P=.032) and by patients' problem-focused coping (B=.21; P=.008). The evolution of anxiety was predicted positively by the number of times benefits were transmitted (B=.83; P=.003) and negatively by the level of anxiety before the interview (B=-.50; P=.001).


CONCLUSIONS
Results show the limits of patients' risk recall in the context of informed consent for a life-threatening procedure.


CONCLUSIONS
This study highlights the necessity to develop strategies allowing tailoring of risk transmission to every patient's needs.
Merckaert
Isabelle
I
Université Libre de Bruxelles, Institut Jules Bordet, Brussels, Belgium.
Libert
Yves
Y
Bron
Dominique
D
Jaivenois
Marie-France
MF
Martiat
Philippe
P
Slachmuylder
Jean-Louis
JL
Razavi
Darius
D
D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001530:Belgium; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D016014:Linear Models; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010817:Physician-Patient Relations; D012306:Risk