Abstract
Purposes. The diagnosis of an asymptomatic life-threatening disease is a diffi cult experience for the patient who is requested to make a decision whether to undergo treatment that carries the risk of complications and death. The patient's decision-making process concerning the surgery is seldom based on the same premises as the doctor's recommendation. The aim of the study was to assess whether the patient's strong initial emotional reaction may lead to his/her rational decision over surgery for the asymptomatic life-threatening disease.
Method. The study involved two groups of inpatients (N=50), scheduled surgery of either asymptomatic abdominal aortic aneurysm (AAA) or asymptomatic internal carotid artery stenosis (ICA). A self-report questionnaire used in the study measured one psychosocial and three psychological categories: (1) self-image and attitude towards own life, (2) attitude towards illness, (3) attitude towards surgery, (4) attitudes of the social environment towards the patient and his/her disease. The statistical analysis was performed using the chi2 test.
Results. Patients with asymptomatic ICA stenosis represented a more positive attitude towards themselves than did AAA patients (p<0.05). In the latter patient group the primary source of information about the disease and its treatment was the primary care physician. The patients with ICA stenosis more often consulted other doctors to get a second opinion and to verify their information about the disease (p<0.05). Consequently, there were differences as regards the motives behind the patients' decision about surgery (p<0.001).
Conclusions. The initial strong emotional reaction leads to a rational decision on surgery, although the decision-making process is completely different in patients with AAA and ICA stenosis, depending not only on the affected site, but also on possible consequences of treatment refusal. The patients' attitudes toward self and the disease are different according to the disease location and type of the possible outcome. The fi ndings allow to develop appropriate strategies aimed at obtaining the patient's informed consent to surgical treatment of severe asymptomatic life-threatening diseases.