Searching for safety signals: The experience of medical surveillance amongst men with testicular teratomas

The aim of this study is to compare the experience of a group of men with S tage 1 testicular teratomas who were being managed through a surveillance p rogramme (n = 25) with a group of patients who had received chemotherapy fo r more advanced disease (n=22). The study employed a two-phase sequential d esign that combined quantitative and qualitative methods of data analysis. In the first phase, the hospital anxiety and depression scales (HADS) were used to screen for psychological morbidity. Twelve (48%) of the men assigne d to the surveillance programme scored in the 'borderline' or 'clinical cas e' range on the anxiety subscale of the HADS, compared with six (27%) in th e chemotherapy group. There was a significant negative correlation in the s urveillance group between 'time since diagnosis' and an elevated anxiety su bscale score on the HADS. Interviews were then conducted with 25 participan ts; a grounded theory approach was used to analyse the transcripts. The hyp othesis that human beings are seekers of safety signals provided an explana tory model to account for the higher incidence of self-reported anxiety amo ngst the men in the surveillance programme. Copyright (C) 2000 John Wiley & Sons, Ltd.