Satisfaction and anxiety for women during investigation of an abnormal screening mammogram.

Five community-designed pilot projects were undertaken to reduce the time to diagnosis following an abnormal mammogram. One thousand five hundred and seventy-eight women with abnormal mammograms completed a self-administered questionnaire (71% response) which inquired about experiences and satisfaction with time delay from screening to diagnosis, the information received and support given by health professionals, and measures of anxiety and stress during this time interval. Four of the five pilot project initiatives shortened the time interval from screening to diagnosis, the greatest improvement occurring with facilitated referral from screening to diagnostic breast imaging. There was little difference among the pilot projects and control for most measures of client satisfaction and anxiety. Differences were found between biopsied and nonbiopsied women for several of these measures. Shortening the time to diagnosis positively influenced the client's perception of unnecessary delay.

The Experience of Waiting for Diagnosis After an Abnormal Mammogram.

In order to better understand the experience of women following abnormal screening mammogram and before definitive diagnosis, we undertook a series of focus group interviews in six geographic areas in the province of British Columbia, Canada. While all 33 participants had experienced abnormal mammograms within the previous year, each group included women with a range of ages and diagnostic outcomes. Verbatim transcripts of all focus groups were subjected to qualitative secondary analysis using interpretive descriptive methods. Through a process of grounded inductive analysis, conceptual themes within the data were identified and tested. The findings of this study provide an experiential account of common patterns within the structure and process of waiting for diagnosis. The accounts depict the way the women experienced time, their individual and common responses to waiting, and the impact of health system factors, including provider communication. These findings confirm that, regardless of its outcome, waiting for definitive diagnosis after an abnormal screening mammogram is an intense and often agonizing experience for the women involved and for their families. Furthermore, our results highlight the relevance of such issues as information systems, support, coordination of services, and health care communication, and underscore the important role that service delivery factors can play in making such experiences bearable.