Research Article: Short-term mental distress in research participants after receiving cardiovascular risk information

Date Published: May 24, 2019

Publisher: Public Library of Science

Author(s): Åsa Grauman, Mats G. Hansson, Arvid Puranen, Stefan James, Jorien Veldwijk, Andreas Zirlik.

http://doi.org/10.1371/journal.pone.0217247

Abstract

Understanding of how cardiovascular risk information influence individuals is critical for the practice of risk assessment and the management of patients with cardiovascular disease.

The objective of this study was to investigate change in mental distress among research participants after undergoing a cardiovascular risk assessment and receiving individual test results.

In 2017, a questionnaire measuring mental distress after taking part in a risk assessment was distributed among 615 participants in the Swedish Cardiopulmonary Bio Image Study in Uppsala, Sweden, aged 50–64 years. Outcome measures were re-assessed after three months (30% were lost to follow-up).

There were no differences in outcomes after three months for participants with normal test results or for participants who were referred to primary health care. Mental distress increased in participants who were referred to the hospital, and were further explained by the fact that these participants were diagnosed with coronary artery stenosis.

CV risk information can be provided to individuals with lower levels of risk without concerns of inducing mental distress. However, in order to prevent unnecessary worry in contexts similar to this study, one should be prepared for different risk outcomes and plan for support for individuals with higher risk. The increased utility of powerful, yet not fully mature, imaging techniques requires careful considerations extending beyond medical risks and benefits; the clinician must also take into account the risk of mental distress and secure support when necessary.

Partial Text

The Swedish CArdioPulmonary BioImage Study (SCAPIS) was initiated to predict and prevent cardiovascular diseases (CVD) and chronic obstructive pulmonary disease (COPD). The study includes thorough health examinations of 30,000 Swedish men and women aged 50–64 years. After conducting the health examinations, the participants receive their personal test results including several CV risk factors. As seen in the SCAPIS pilot study, the baseline examinations of study participants will identify a substantial proportion of individuals with specific risk factors for CVD [1]. The current study was initiated following reports of individual participants expressing concern about receiving CV risk information and how it affected them. On the one hand, information was considered as positive and proactive; on the other hand, participants expressed concerns that the information may negatively affect their quality of life.

Descriptive statistics of the participants in the follow-up sample (n = 434) are presented in Table 1, both in total and stratified by exposure.

Psychosocial stress, is a strong risk factor for cardiovascular diseases. Concerns about how receiving CV risk information would affect the research participants in SCAPIS was investigated in this study. Our results provide evidence that these concerns are not substantiated for those with lower levels of risk, since no increase in mental distress was observed either for participants with normal test results nor for participants referred to PHCC. Most participants also reported low levels of worry about experiencing a myocardial infarction at baseline. That might reflect an expectation of normal findings and a perception of the health examination as a way to confirm their health, rather than discovering something [21].

Accordingly to our results, CV risk information can be provided to individuals with lower levels of risk without concerns of inducing mental distress. However, in order to prevent unnecessary worry in contexts similar to this study, one should be prepared for different risk outcomes and plan for support for individuals with higher risk. Furthermore, the increased utility of powerful, yet not fully mature, imaging techniques requires careful considerations extending beyond medical risks and benefits; the clinician must also take into account the risk of mental distress and secure support when necessary.

 

Source:

http://doi.org/10.1371/journal.pone.0217247

 

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