Abstract
A survey was carried out in order to identify elderly patients' perceptions of their health status, their health worries and their opinions regarding health screening before and after the introduction of an annual screening programme. Pre- and post-assessment self report, structured questionnaires and standardized, objectively scored, functional and medical assessments were used. The cohort was an age and sex stratified, 20% sample of those aged 75 years and over (133 patients). Results showed that 96% of patients before the assessment and 98% of patients afterwards, considered the annual assessment useful. The domiciliary visit by the health visitors resulted in one third of those patients who perceived themselves to be in good health and three quarters of those who perceived themselves to be in poor health becoming less worried about their health. Only two patients became more worried. Half of those objectively assessed as being in the medium health risk group and 68% of those in the high health risk group became less worried about their health after screening. Despite the majority of patients having welcomed the assessment their visit resulted in false, and potentially harmful, reassurance for a considerable number of individuals objectively assessed as being at medium and high health risk. An adverse consequence of health screening in elderly people may be inappropriate reassurance for those objectively assessed to be at risk. However, screening procedures are a means to an end, not an end in themselves. The identification of those at high risk should see subsequent implementation of services, investigations and increased support to relieve suffering, so it may have been that patients felt less anxious because they were anticipating relief of their problems.
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