Are there psychological consequences due to the delay of diagnostic mammograms after an initial abnormal screening for women in Cook County, Illinois

In Cook County, IL, there is a significant disparity in access to public health care services between under insured and insured women who use Stroger Hospital. This is especially evident in the difference in the amount of time it takes for women to receive a diagnostic mammogram after an initial abnormal screening mammogram. In October 2006, the approximate number for women waiting to get an appointment for a mammogram at the public hospital was 12,000 women. Seven thousand of these women were waiting for screening mammograms while the remaining 5,000 women were waiting up to twelve months for a diagnostic mammogram (Ganschaw, personal communication, October 2007). Out of these 12,000 women some were breast cancer survivors waiting for their regular checkups; for others, the standard screening mammography was inconclusive, and they were waiting to take more definitive diagnostic tests. One potential consequence of this backlog and waiting for a diagnosis is a negative psychological impact for the women who experience this delay. The hypothesis of this paper is that a potential consequence of waiting for a diagnostic mammogram and a subsequent diagnosis is negative psychological effects. In this study, the author attempts to confirm the hypothesis, which has been partially supported by conversations with heath care providers, that symptoms of anxiety and depression increase as a result of the significant delay women experience while waiting for a diagnostic mammogram in Cook County, IL. Additionally, it is hypothesized that women waiting for definitive test results would have increased feelings of anxiety and depression over a control group of women who were not waiting for any type of medical test results. Thirty women were surveyed for the experiment group from local Cook County hospitals with the K6 Scale of Non-Specific Psychological Distress, which was gathered from the literature. Twenty-three control group women were surveyed. The K6 measure consists of six questions asking women if, in the past thirty days they have felt nervous, hopeless, restless, depressed, that everything was an effort, or worthless. After the scores were calculated, descriptive statistics were run on demographic data, correlations were run to test the strength of the relationships between variables, and a t-test was run to compare the thirty women in the experiment group who waited longer than one month for a diagnostic mammogram to those who waited less than one month. A t-test was also run to compare symptoms of anxiety and depression for the experiment group and the control group. Findings from this study show that in the experiment group, there was no statistical difference in overall scores of anxiety and depression between women who waited more or less than one month for a diagnostic mammogram. This means the increased wait time did not increase negative psychological symptoms associated with anxiety or depression. There was also no statistical difference in terms of total anxious or depressive symptoms between women in the experiment and control groups. Yet, in general, overall K6 scores were higher for the experiment group. Additionally, there was a strong relationship between feelings of hopelessness and overall feelings of anxiety and depression to the amount of time a woman waited. Hopelessness also had a high correlation to overall increased feelings of anxiety and depression.