title: Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study.
abstract: OBJECTIVE
  Every patient could feel anxious when he waits in a radiological department to undergo diagnostic exams. The aim of our study is to evaluate the impact of the radiological exams on patient anxiety.
  
  
  METHODS
  We evaluated 343 patients (mean age 54.83 years) who underwent different types of diagnostic exams in the Department of Diagnostic Imaging at our Hospital from April 2013 to August 2014. We administered to patients the State and Trait Anxiety Inventory Test, which detected with high sensitivity both state anxiety and trait anxiety. A team of clinical psychologists and radiologists evaluated the scores obtained.
  
  
  RESULTS
  83 out of 343 patients were excluded because refused to file the questionnaire. 31 % of the patients were submitted to MR, 18 % to breast imaging, 10 % to X-ray, 22 % Computer Tomography and 19 % to ultrasound, as previously described. 41 % of patients were submitted to the examination because of an oncologic disease, while 59 % because of non-oncological disease. Therefore, it was found that high levels of anxiety were present in most (about 91 %) of the patients and the scores varied according to the imaging examination and to the examination's reason: anxiety level was higher in non-oncological patients (54 %) and in patients waiting to undergo to MRI exams (29 %).
  
  
  CONCLUSIONS
  Our data suggest that the diagnostic exams are stressful events for the patient, also in non-oncological patients. So, it is important to adequate the radiological staff to receive the patient, to inform him and perform exams with emotive involvement with a targeted education. Also, further studies are needed to evaluate the anxiety level and the quality of the images, because the anxiety can result in a somatic disorder with hyperactivity of the autonomic nervous system which may affect the patient's physical examination, causing problems in the evaluation of radiological images making to non-cooperative patient. MRI imaging is the examination that more of all led to an anxious state of patients but the main stressor is not related to the type of diagnostic examination, but to the uncertainty of the diagnosis, therapy and prognosis.
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Re
authors.affiliation: Dipartimento di discipline chirurgiche Oncologiche e stomatologiche, DICHIRONS, University of Palermo, Policlinico Paolo Giaccone, Via Liborio Giuffrè 5, 90127, Palermo, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: De Luca
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Filippa
authors.initials: F
authors.lastname: Muscarneri
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Dorangricchia
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy. dariopicone@hotmail.it.
authors.forename: Dario
authors.identifier: http://orcid.org/0000-0001-6719-7969
authors.initials: D
authors.lastname: Picone
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Vernuccio
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Salerno
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Tona
authors.affiliation: Unità operative a Struttura Complessa di Radiologia Generale e di Pronto Soccorso, A.O.R.N. "A. Cardarelli", Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
authors.affiliation: Dipartimento di discipline chirurgiche Oncologiche e stomatologiche, DICHIRONS, University of Palermo, Policlinico Paolo Giaccone, Via Liborio Giuffrè 5, 90127, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.affiliation: Section of Radiology-Di.Bi.Med., University of Palermo, Policlinico Paolo Giaccone, Via del Vespro 129, 90127, Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lagalla
authors.affiliation: Dipartimento di discipline chirurgiche Oncologiche e stomatologiche, DICHIRONS, University of Palermo, Policlinico Paolo Giaccone, Via Liborio Giuffrè 5, 90127, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cicero
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology*; D003952:Diagnostic Imaging / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Anxiety; Diagnostic imaging; Oncology; Quality of life; STAI; Social support