2015 Arte Poster Competition First Place Winner: Assessing the Correlation Between Patient Anxiety and Satisfaction for Mohs Surgery

September 2015 | Volume 14 | Issue 9 | Features | 1070 | Copyright © September 2015

Maren C. Locke MD,a Eric C. Wilkerson MD,a Rachel L. Mistur MS,b Mahrukh Nisar MD,a W. Elliot Love DOa

aMetroHealth Medical Center; Case Western Reserve University School of Medicine, Cleveland, OH
bUniversity of Cincinnati Department of Dermatology, Cincinnati, OH

Abstract
Skin cancer and the surgical treatment thereof have the potential to be sources of great anxiety for patients. Examination of patient satisfaction, anxiety, and contributing factors has the potential to provide information surgeons can use to implement practices that have an impact on patient anxiety and satisfaction regarding dermatologic surgery. This study used a prospective interview to catalog patients’ anxiety and experiences before and during the surgical process. Our results indicate that several pre- and perioperative factors have the potential to decrease a patient’s overall anxiety. Notably, 33% of surgical patients reported a decrease in anxiety from the time of diagnosis until the day of surgery. Factors that contributed to this included a call discussing the diagnosis and what to expect on the day of surgery as well as reading written material or searching the internet for more information regarding the procedure. Furthermore, a call from the physician compared to a call from a nurse or other team member showed a greater effect on decreasing anxiety. During the surgical procedure, our results highlight several factors that can decrease a patient’s anxiety. Most notably, eating, watching TV, bringing a guest, and engaging in small talk with surgeon and staff during the procedure subjectively decreased patients’ anxiety. In summary, our results suggest that patients respond to a variety of factors to reduce anxiety and that each patient derives relief from anxiety in different manners. Therefore, offering a spectrum of comforting or distracting activities during the Mohs procedure is ideal and may reduce the need for pharmacologic anxiolytics.

J Drugs Dermatol. 2015;14(9):1070-1072.

First Place Winner

INTRODUCTION

Skin cancer and the surgical treatment thereof have the potential to be sources of great anxiety for patients. Many pre- and perioperative experiences can have a positive or negative effect on the anxiety patients experience during Mohs surgery. Patients’ perceived experience can have a significant impact on overall satisfaction, which physicians strive to maximize. Furthermore, patient satisfaction is increasingly being correlated with quality of care. Examination of patient satisfaction, anxiety, and contributing factors has the potential to provide information surgeons can use to implement practices that have an impact on patient anxiety and satisfaction regarding dermatologic surgery.

METHODS

This is a prospective survey-based study conducted at MetroHealth Medical Center in Cleveland, Ohio. Approval for the study was granted by the MetroHealth Medical Center Institutional Review Board (IRB). Patients scheduled for Mohs surgery for the treatment of skin cancer between November 2014 and January 2015 were approached to participate in this study. Thirty-six subjects consented for participation and completed an oral survey conducted by an interviewer regarding their experiences.
Within one week prior to the surgical procedure, the first part of the survey was conducted to catalogue the anxiety level of