Exploring the psychological morbidity of waiting for sinus surgery using a mixed methods approach.
BACKGROUND
Patients with chronic rhinosinusitis (CRS) often have to endure significant wait times for endoscopic sinus surgery (ESS). The pyschiatric impact of placement on a waitlist for ESS has not been explored.


METHODS
Questionnaires measuring CRS symptom severity and health-related anxiety and stress (SNOT-22, HADS, WPAI-GH) were sent to patients diagnosed with CRS and currently on a waitlist for ESS. Fifteen representative waitlisted patients participated in one-on-one semi-structured interviews discussing their experience with their wait for ESS. A deductive thematic analysis was used to interpret the interview data using a quantitative driven mixed methods analysis.


RESULTS
Participants waiting for ESS reported worsening clinical symptomatology during their waiting period. Participants reported waitlist and CRS impact on both work and social aspects of their lives. The HADS scale showed no overall significant level of depression or anxiety in the HADS screening questionnaire. The qualitative data describe the effects of the symptom burden of CRS.


CONCLUSIONS
Patients waitlisted for ESS did not demonstrate any significant level of psychiatric distress, however variability exists. The qualitative arm of this study elucidates how patients cope with their wait.
Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada.
Gordon Fung-Zak
GF
Tsang
Department of Otolaryngology-Head & Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada.
Carmen L
CL
McKnight
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Laura Minhui
LM
Kim
Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. LeeJo@smh.ca.|Department of Otolaryngology-Head & Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada. LeeJo@smh.ca.
John M
JM
Lee
D001007:Anxiety / Q000209:etiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012220:Rhinitis / Q000523:psychology / Q000601:surgery*; D012852:Sinusitis / Q000523:psychology / Q000601:surgery*; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014850:Waiting Lists
Anxiety; Chronic rhinosinusitis; Depression; Endoscopic sinus surgery; HADS; Mixed methods; Qualitative; Rhinology; Survey; WPAI; Waitlist