172P
Does Patient Empowerment Moderate the Effects of Health Anxiety on Mental Well-Being? a Cross-Sectional Study at a Community-Based Chinese Medicine Clinic
Health anxiety is marked by a preoccupation with serious diseases, a strong belief that one is suffering from one or more diseases despite lack of diagnosis, and a heightened vigilance on bodily sensations that can be associated with them. Health anxiety often leads to more frequent healthcare use, greater somatization, and impaired mental well-being. Although psychotherapy is recommended in severe cases of health anxiety, there has been little discussion on the role of patient-centered care in alleviating the impact of health anxiety. Given that one of the goals of patient empowerment is to help them cope with illness, this study investigates whether a sense of empowerment in patients can moderate the effects of health anxiety on mental well-being.
Methods
Recruitment took place at a government-funded outpatient clinic which provides traditional Chinese medicine consultations in Hong Kong, China. Patients were invited to participate in a survey before attending the consultation session offered by the Chinese medicine practitioners. Measures included health anxiety (Whiteley Index-7), patient empowerment (Patient Enablement Instrument), depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), and bodily distress (Body-Mind-Spirit Well-being Scale). During the three-month recruitment period, 733 patients participated in the survey.
Results
Compared to the local general population, patients seeking help at Chinese medicine outpatient clinic had greater health anxiety and mental distress. Health anxiety correlated positively with depression, anxiety and bodily distress, but not patient empowerment. General linear model analysis showed that patient empowerment – after controlling for sex, age, income level, and service satisfaction – was found to moderate the effect of health anxiety on depression and anxiety, but not bodily distress (Partial eta squares for the interaction term of health anxiety and patient empowerment were .010 for anxiety and .018 for depression, both ps < .05.). Specifically, in highly empowered patients, the correlations between health anxiety and depression and anxiety were weaker compared to less empowered patients.
Implications
Although this study showed no correlation between patient empowerment and health anxiety, it provides evidence of a moderating effect of patient empowerment, suggesting that patients who feel they can cope with the illness may feel less anxious or depressed, despite their ongoing health anxiety. If the findings are confirmed by further longitudinal and experimental studies, one implication would be that rather than directly treating hypochondriasis, healthcare providers and social workers can focus on helping patients cope with their illnesses, real or perceived.