The role of general practitioners in stepwise notification - From anxiety test results of the chest x-rays abnormality patients

Abstract

Objective. To verify the role of general practitioner (GP) in notifying the patient that he/she has cancer, from the viewpoint of stepwise notification. Methods. To investigate the characteristic anxiety and conditional anxiety, We performed the State-Trait Anxiety Inventory (STAI) in 82 patients who visited Osaka Medical College Hospital between February 1999 and October 2001, for detailed examination of abnormal shadow in the chest. Furthermore, anxiety increase index (state anxiety-trait anxiety) was compared among subgroups by gender, age of patient, presence or absence of an attendant, final diagnosis (whether or not the patient had lung cancer) and the source of referral (those who had been advised by a general practitioner to undergo detailed examination; "GP group" and those who had undergone a health check and had come without any advice before visiting; "HC group"). Results. As to the comparison of anxiety increase index, there was no significant difference between the two groups in the gender, age of patient, presence or absence of attendant and final diagnosis. However, the values differed significantly between the HC group and GP group (7.6 ± 8.8 and 3.5 ± 8.6, respectively), indicating a significantly lower figure in the GP group (p = 0.0358). In other words, the anxiety was less in the subjects of GP group who had already received some explanation from the attending physician (general practitioner) in comparison with those of HC group who came to consultation without any previous explanation on the chest x-rays abnormality. Conclusion. As a part of stepwise notification the explanation of the general practitioner is considered to be effective in the cancer notification and helps alleviate the anxiety of patients. In this regard, the attending physician (general practitioner) is expected to play an important part in notifying the patient of the presence of cancer.