Over-reassurance and undersupport after a 'false alarm': a systematic review of the impact on subsequent XXXX symptom attribution and help seeking.

@entity5 @entity1 @entity135
OBJECTIVES: This literature review examined research into the impact of a previous 'all-clear' or non- @entity5 diagnosis following symptomatic presentation ('false alarm') on symptom attribution and delays in help seeking for subsequent possible @entity5 symptoms. DESIGN AND SETTING: The comprehensive literature review included original research based on quantitative, qualitative and mixed data collection methods. We used a combination of search strategies, including in-depth searches of electronic databases (PubMed, EMBASE, PsychInfo), searching key authors and articles listed as 'related' in PubMed, and reference lists. We performed a narrative synthesis of key themes shared across studies. @entity1 : The review included studies published after 1990 and before February 2014 reporting information on adult @entity1 having experienced a false alarm following symptomatic presentation. We excluded false alarms in the context of screening. PRIMARY AND SECONDARY OUTCOME MEASURES: We evaluated the effect of a 'false alarm' on symptom attribution and help seeking for new or recurrent possible @entity5 symptoms. RESULTS: Overall, 1442 papers were screened and 121 retrieved for full-text evaluation. Among them, 19 reported on false alarms and subsequent symptom attribution or help seeking. They used qualitative (n=14), quantitative (n=3) and mixed methods (n=2). Breast (n=7), gynaecological (n=3), colorectal (n=2), testicular (n=2), and @entity135 (n=2) were the most studied. Two broad themes emerged underlying delays in help seeking: (1) over-reassurance from the previous 'all-clear' diagnosis leading to subsequent symptoms being interpreted as benign, and (2) unsupportive healthcare experiences in which symptoms were dismissed, leaving @entity1 concerned about appearing hypochondriacal or uncertain about the appropriate next actions. The evidence suggested that the effect of a false alarm can persist for months and even years. CONCLUSIONS: In conclusion, over-reassurance and undersupport of @entity1 after a false alarm can undermine help seeking in the case of new or recurrent potential @entity5 symptoms, highlighting the need for appropriate @entity1 information when investigations rule out @entity5 .
