Patients' understanding of blood tests and attitudes to HIV screening in the emergency department of a Swiss teaching hospital: a cross-sectional observational study.

M Cavassini,O Hugli,S Peters,D Baudat,T Favre-Bulle,K Darling,R Mamin

doi:10.4414/smw.2015.14206

Abstract

In Switzerland, patients may undergo "blood tests" without being informed what these are screening for. Inadequate doctor-patient communication may result in patient misunderstanding. We examined what patients in the emergency department (ED) believed they had been screened for and explored their attitudes to routine (non-targeted) human immunodeficiency virus (HIV) screening. Between 1st October 2012 and 28th February 2013, a questionnaire-based survey was conducted among patients aged 16-70 years old presenting to the ED of Lausanne University Hospital. Patients were asked: (1) if they believed they had been screened for HIV; (2) if they agreed in principle to routine HIV screening and (3) if they agreed to be HIV tested during their current ED visit. Of 466 eligible patients, 411 (88%) agreed to participate. Mean age was 46 ± 16 years; 192 patients (47%) were women; 366 (89%) were Swiss or European; 113 (27%) believed they had been screened for HIV, the proportion increasing with age (p ≤ 0.01), 297 (72%) agreed in principle with routine HIV testing in the ED, and 138 patients (34%) agreed to be HIV tested during their current ED visit. In this ED population, 27% believed incorrectly they had been screened for HIV. Over 70% agreed in principle with routine HIV testing and 34% agreed to be tested during their current visit. These results demonstrate willingness among patients concerning routine HIV testing in the ED and highlight a need for improved doctor-patient communication about what a blood test specifically screens for.

Highlights

The term “blood test” is used ubiquitously by healthcare professionals and patients and is usually understood to mean a screening or diagnostic procedure
Patients were asked: (1) if they believed they had been screened for human immunodeficiency virus (HIV); (2) if they agreed in principle to routine HIV screening and (3) if they agreed to be HIV tested during their current emergency department (ED) visit
Mean age was 46 ± 16 years; 192 patients (47%) were women; 366 (89%) were Swiss or European; 113 (27%) believed they had been screened for HIV, the proportion increasing with age (p ≤0.01), 297 (72%) agreed in principle with routine HIV testing in the ED, and 138 patients (34%) agreed to be HIV tested during their current ED visit

Summary

Introduction

The term “blood test” is used ubiquitously by healthcare professionals and patients and is usually understood to mean a screening or diagnostic procedure. In the case of screening, the aim is to detect early disease in individuals who are asymptomatic; diagnostic testing is performed to establish the presence (or absence) of disease in patients with symptoms or a positive screening test. Specific communication is required between clinician and patient. When screening tests do not require specific patient preparation, the clinician might omit the details of tests being performed to limit consultation time and avoid unnecessary patient anxiety. If clinician-patient communication is insufficient, there is potential for patient misunderstanding as to what has been screened for [3]. The patient must be informed if an HIV test is to take place. Whilst these screening approaches may be de-

Methods

Results

Discussion

Conclusion