title: [Waiting times in breast disease clinics and psychological well-being: speedy care is better care].
abstract: OBJECTIVE
  To examine the effect of diagnostic speed and the waiting time before surgery on the psychological well-being of patients in breast disease clinics.
  
  
  METHODS
  Prospective cohort study
  
  
  METHODS
  Women with suspected breast cancer completed questionnaires about their psychological well-being before the first outpatient clinic visit (time T1: with malignancy (n = 149); without malignancy (n = 515)), shortly after diagnosis (T2: n = 96 and n = 432, respectively) and 2-3 months later (T3: with malignancy (n = 139)). Two months after the end of treatment (T4: with malignancy (n = 202)), women with breast cancer indicated which period they considered most stressful in retrospect. Diagnostic speed and the waiting time before surgery were categorized and the relation with well-being was examined. Analyses were controlled for age and cancer stage.
  
  
  RESULTS
  Although the period before diagnosis was experienced as stressful, diagnostic speed did not affect emotional well-being after a breast cancer diagnosis. However, a diagnosis that took a long time (> 2 weeks) did affect the emotional well-being of women who were not diagnosed with breast cancer. These women were worried and distressed for a longer period of time after diagnosis than women who received the favourable news sooner. The length of the waiting time before surgery did not affect the emotional well-being of patients thereafter: women who had surgery within two weeks were not worse or better off than women who had to wait longer. Yet, patients' emotional well-being did improve considerably after surgery, which indicates that short waiting times might shorten a period of psychological distress.
  
  
  CONCLUSIONS
  The results support a speedy diagnosis and surgery. There was no support for short waiting times having a negative psychological effect.
authors.affiliation: Universitair Medisch Centrum Groningen (UMCG), Sectie Gezondheidspsychologie, The Netherlands. i.henselmans@med.umcg.nl
authors.forename: Inge
authors.initials: I
authors.lastname: Henselmans
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
authors.forename: Ans
authors.initials: A
authors.lastname: Smink
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
authors.forename: Jakob
authors.initials: J
authors.lastname: de Vries
mesh_terms: D000368:Aged; D001941:Breast Diseases / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014850:Waiting Lists