Psychosocial problems caused by abdominal aortic aneurysm surveillance: A cross-sectional survey

Abstract

ObjectivePeople with abdominal aortic aneurysms (AAA) are at risk of aneurysm rupture, which is immediately life-threatening. People diagnosed with AAA that are a sub-threshold size for intervention undergo regular ultrasound surveillance in England. However, surveillance may cause psychosocial problems such as anxiety. We aimed to use an AAA-specific measure of quality of life to identify the characteristics of people in surveillance with AAA-related psychosocial problems.SettingIn the National Health Service (NHS) in England, all men are screened for AAA aged 65. They undergo annual surveillance if a small AAA is detected (3-4.4 cm) and three-monthly surveillance if a medium AAA is detected (4.5-5.4 cm). Men with larger AAAs are referred to vascular services.MethodsA postal survey of men in AAA surveillance from five regional screening centres was conducted using the e-PAQ-AAA quality of life measure which included the Psychological Consequences of Screening Questionnaire.ResultsThe response rate was 64% (734/1156). The majority of men reported no AAA-related anxiety or impact on daily living, and no screening-related psychological consequences. However, 11% (29/257) of men in three-monthly surveillance reported having AAA-related anxiety most or all of the time. Men with higher levels of anxiety and physical, emotional or social consequences of surveillance tended to be younger, from more socially deprived communities, have poorer physical health, and have relatively larger and faster-growing AAAs.ConclusionsPsychosocial problems related to AAA surveillance were not common but did affect a minority of men significantly. An intervention would be beneficial in helping men in AAA surveillance to manage such problems.

Keywords: Abdominal aortic aneurysm; psychosocial; quality of life; surveillance.