The assessment and treatment of concerns and anxiety in patients undergoing presurgical monitoring for epilepsy

Purpose: This study investigated the impact of a treatment information pack age on patients being monitored fbr possible surgical treatment for tempora l lobe epilepsy. Methods: One hundred patients were randomly assigned to either a high- or l ow-information preparation condition. Levels of anxiety were tested soon af ter admission by using the Hospital Anxiety and Depression Scale (HADS), Th e State-Trait Anxiety Inventory (STAI), and a newly devised questionnaire t o assess specific concerns and anxieties of epilepsy patients presenting fo r monitoring and surgery, the Concerns About Epilepsy Monitoring Questionna ire (CAEMQ). Dispositional desire for information was assessed by the Mille r Behavioural al Style Scale (MBSS) to investigate whether coping dispositi on affected coping styles in the hospital setting. Patients assigned to the high-information condition were exposed to an intervention package, which included viewing a video depicting two separate interviews with patients wh o had undergone surgery as well as an information package, which described the various tests that the patient would undergo in the course of the monit oring procedure. Patients assigned to the low-information group were given information that the hospital provided to all patients in their care. All s ubjects were then retested on anxiety levels a few days later. Results: Those in the high-information group showed a significant decrease in anxiety and depression levels compared with those in the low-information group. Conclusions: Within the main findings, an effect of dispositional style was found. Identification as either a monitor or blunter on the MESS showed di fferent coping strategies on arrival in hospital as measured by the CAEMQ, indicating that the level of information given to patients with epilepsy on arrival needs to be mediated by awareness of these two dispositional style s so that they obtain maximal benefit from the information to which patient s with epilepsy are exposed.