Discussion
anger, anxiety, cancer, panic, OPMD, psychological distress, mental disorders, depression
CANCER, EVENT, SAID, BLIND, EVENTS
This study has proposed for the first time in the field of dentistry the use of a graphic novel, which is aimed at adults, that is, patients who are waiting for an incisional biopsy to ascertain the presence of OPMD. A further component of the study is to assesses its efficacy in reducing patient anxiety, as measured by BDI and DASS 21scores. It was observed that patients, who were offered a comic book while waiting to undergo an incisional biopsy were more informed about this subject than those who did not. They consequently experienced less anxiety (also in accordance with the theory of reasoned action) (There is an increasing need for new tools in the field of healthcare, with which to develop strategies of effective communication in medicine and dentistry. These include; the use of colour and ludic activities, infographic videos or leaflets (It has been demonstrated that combining pictures and text improves comprehension because reading and viewing activate different information-processing systems within the brain (In oral medicine, the dread of undergoing a biopsy is significant, leading to an unpleasant emotional state, which can affect the way a patient feels, thinks, and acts. Feelings of distress operate along a continuum, ranging from commonly-shared feelings (such as vulnerability, sadness, anger, and fear) to challenges which can quickly evolve into mental disorders (e.g., depression, anxiety, panic), social isolation, and existential and spiritual crises. The distress generated by the fear of having cancer typically negatively impacts a patient’s life, and it, therefore, plays a key role in diagnostic delay and assisting a patient to return to their before-the cancer diagnosis life (Such conditions of distress are strictly related to cognitive-behavioural theory, which considers emotions and behaviour to be closely intertwined. Specifically, thoughts can be said to influence emotions and behaviour, thus it is not the actual event which causes psychological distress (i.e., the oral biopsy), but one’s perception of that event. This implies that patients’ emotional and behavioural reactions can be determined by the way in which they interpret different situations and the attributed meaning of those events (The genre of the colourful graphic novel has been adapted to the field of oral medicine, after which it was necessary to evaluate its efficacy in reducing patient anxiety as they waiting for an incisional biopsy in presence of a possible OPMD.The results of the present study seem to confirm that the application of graphic medicine to a psychoeducational approach alleviates anxiety and distress of patients. In turn, this leads to a more accurate understanding of the risk, while facilitating communication with the patient. This study has provided an example of how this approach works and how it could be integrated into medical education and dental practice.- LimitationsThis RCT has been based on a small group of patients, and the context of administering the comic book reading and test completion is not considered to be particularly appropriate. On occasions, the target reader may not identify with the comic book character because the setting does not reflect their typical habits, expressions, type of language, and other aspects related to daily life. Regrettably, it was not possible to perform a blind RCT.