Assessing Patient Anxiety During Mohs Micrographic Surgery
| Status: | Not yet recruiting |
|---|---|
| Conditions: | Anxiety |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 3/10/2019 |
| Start Date: | April 2019 |
| End Date: | June 2019 |
| Contact: | Emily Unrue |
| Email: | eunrue@wakehealth.edu |
| Phone: | 336-716-3775 |
This study will assess the anxiety that patients are experiencing during a Mohs micrographic
surgery. The study will compare the feelings of anxiety experienced by patients returning for
Mohs surgery after already undergoing the surgery at least one time to feelings experienced
by patients who have never had Mohs surgery before. The study will also compare the feelings
experienced by patients who have read a vignette about the typical Mohs experience to the
feelings of patients who have not read a vignette.
surgery. The study will compare the feelings of anxiety experienced by patients returning for
Mohs surgery after already undergoing the surgery at least one time to feelings experienced
by patients who have never had Mohs surgery before. The study will also compare the feelings
experienced by patients who have read a vignette about the typical Mohs experience to the
feelings of patients who have not read a vignette.
There has been a continual increase in cases of nonmelanoma skin cancer and melanoma over the
last several decades. With the increase in incidence, there is also the need for increased
treatment. Mohs micrographic surgery (MMS) is highly efficacious, with cure rates in the
upper 90% for both basal cell carcinoma and squamous cell carcinoma, the two most common
forms of skin cancer. MMS is used for tumors in cosmetically sensitive areas or areas of
recurrence.
While MMS is usually performed in the outpatient setting, it may be an anxiety provoking
experience for patients, ranging from the fear of a cancer diagnosis, to concerns about the
procedural events of the surgery and associated pain, to the anticipation of their final
cosmetic result. During a MMS procedure, unlike many other types of surgery or procedures,
the patient is awake and aware of his or her surroundings, with periods of waiting
interspersed throughout the procedure. Such aspects can lead to the high level of
perioperative anxiety in MMS patients. The effects of listening to music, watching
preoperative informational videos, and the use of web-based applications have been used to
attempt to decrease anxiety in MMS patients. However, causes for differences in anxiety level
between first time MMS patients and patients returning for a subsequent MMS procedure are not
well characterized.
One approach to reduce patient anxiety involves patient education, where patients are
presented statistics about the small likelihood of complication from the MMS procedure.
However, patients interpret these data very subjectively. The study team proposes an
alternative approach to patient education through patient vignettes. A previous study
explored using a narrative video that included patient testimonials, but this video also used
patient-physician interaction and drawings. In this study, patients will be provided short
vignettes, that would include information about the experience of a typical MMS patient.
last several decades. With the increase in incidence, there is also the need for increased
treatment. Mohs micrographic surgery (MMS) is highly efficacious, with cure rates in the
upper 90% for both basal cell carcinoma and squamous cell carcinoma, the two most common
forms of skin cancer. MMS is used for tumors in cosmetically sensitive areas or areas of
recurrence.
While MMS is usually performed in the outpatient setting, it may be an anxiety provoking
experience for patients, ranging from the fear of a cancer diagnosis, to concerns about the
procedural events of the surgery and associated pain, to the anticipation of their final
cosmetic result. During a MMS procedure, unlike many other types of surgery or procedures,
the patient is awake and aware of his or her surroundings, with periods of waiting
interspersed throughout the procedure. Such aspects can lead to the high level of
perioperative anxiety in MMS patients. The effects of listening to music, watching
preoperative informational videos, and the use of web-based applications have been used to
attempt to decrease anxiety in MMS patients. However, causes for differences in anxiety level
between first time MMS patients and patients returning for a subsequent MMS procedure are not
well characterized.
One approach to reduce patient anxiety involves patient education, where patients are
presented statistics about the small likelihood of complication from the MMS procedure.
However, patients interpret these data very subjectively. The study team proposes an
alternative approach to patient education through patient vignettes. A previous study
explored using a narrative video that included patient testimonials, but this video also used
patient-physician interaction and drawings. In this study, patients will be provided short
vignettes, that would include information about the experience of a typical MMS patient.
Inclusion Criteria:
- Any patient undergoing Mohs micrographic surgery for cutaneous cancer, soft tissue
tumors, and adnexal tumors
- Subjects with a working knowledge of English
- Age 18-80
Exclusion Criteria:
- Patients unable to fill out a paper or electronic survey or read a short pamphlet on
prior patient experiences, or those unwilling to have either of the previously stated
items read aloud to them.
- Individuals less than 18 or greater than 80 years old (line of questioning necessary
for the study may be beyond understanding in this group)
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