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Ay S, Ata N, Oncu F. Effect of an Information Video before Thyroid Biopsy on Patients Anxiety. J INVEST SURG 2021; 35:531-534. [PMID: 33557641 DOI: 10.1080/08941939.2021.1882623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM To investigate the effects of video-based information on the anxiety of patients who underwent ultrasound-guided thyroid fine-needle aspiration biopsy. METHODS Fifty consecutive patients who underwent thyroid fine needle aspiration biopsy were included in the study prospectively. Patients were divided into two groups before the biopsy. 25 patients in Group 1 received only written information about thyroid biopsy. In Group 2, 25 patients received video-based information along with written information. Baseline anxiety of all the patients was evaluated prior to procedure using STAI-S and STAI-T questionnaires. After the written information was provided to the patients in group 1, the STAI-S questionnaire was repeated. In the same way, group 2 patients were asked to repeat the STAI-S questionnaire after written and video-based information were provided. All patients were asked to evaluate pain during biopsy using visual analog scale (VAS). RESULTS There was no significant difference between the groups in terms of age and gender. Although the VAS score was lower in group 2, there was no statistically significant difference between the two groups. When the groups were compared in terms of basal anxiety scores, STAI-T was similar in both groups (p = 0.708). Although STAI-S values were similar in pre and post-information patients in Group 1, the STAI-S values in group 2 were statistically significantly decreased. CONCLUSION The video based information provided prior to thyroid biopsy draws the attention as an effective and easy to apply method to decrease the anxiety of the patients.
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Affiliation(s)
- Serden Ay
- Faculty of Medicine, General Surgery, KTO Karatay University, Konya, Turkey
| | - Nurdogan Ata
- Faculty of Medicine, Department of Otorhinolaryngology, KTO Karatay University, Konya, Turkey
| | - Fatih Oncu
- Radiology, Saglık Bilimler University, Konya Training and Research Hospital, Konya, Turkey
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Abstract
Examination of the relationship between patients' coping style, pregastroscopy information, and anxiety associated with gastroscopy in China was the aim of this study. A pretest, post-test, nonrandom assignment study with a two by two design was conducted. One hundred forty-five patients who underwent initial gastroscopy without sedation were classified into 2 groups on the basis of the coping style: information seekers or information avoiders using the Information Subscale of the Krantz Health Opinion Survey (KHOS-I). All participants were given standardized procedural information about gastroscopy as routine care. Half of each group was assigned to receive additional sensory information describing what sensation they would experience and how to cooperate to alleviate the discomfort. State anxiety assessed by the State Anxiety Scale of Spielberg's State-Trait Anxiety Inventory, blood pressure, and pulse were measured at enrollment and before gastroscopy. The information seekers and avoiders who received additional sensory information experienced significantly less state anxiety after the intervention. In contrast, the information seekers and avoiders who received standardized procedural information maintained their preintervention state anxiety level. Most patients reported their preference for sensory information. In conclusion, the provision of sensory information could significantly reduce patients' pregastroscopy anxiety regardless of patients' information coping style.
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Beg S, Ragunath K, Wyman A, Banks M, Trudgill N, Pritchard DM, Riley S, Anderson J, Griffiths H, Bhandari P, Kaye P, Veitch A. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut 2017; 66:1886-1899. [PMID: 28821598 PMCID: PMC5739858 DOI: 10.1136/gutjnl-2017-314109] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/26/2017] [Accepted: 07/12/2017] [Indexed: 12/18/2022]
Abstract
This document represents the first position statement produced by the British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, setting out the minimum expected standards in diagnostic upper gastrointestinal endoscopy. The need for this statement has arisen from the recognition that while technical competence can be rapidly acquired, in practice the performance of a high-quality examination is variable, with an unacceptably high rate of failure to diagnose cancer at endoscopy. The importance of detecting early neoplasia has taken on greater significance in this era of minimally invasive, organ-preserving endoscopic therapy. In this position statement we describe 38 recommendations to improve diagnostic endoscopy quality. Our goal is to emphasise practices that encourage mucosal inspection and lesion recognition, with the aim of optimising the early diagnosis of upper gastrointestinal disease and improving patient outcomes.
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Affiliation(s)
- Sabina Beg
- Department of Gastroenterology, NIHR Nottingham Digestive Diseases Biomedical Research Centre, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Krish Ragunath
- Department of Gastroenterology, NIHR Nottingham Digestive Diseases Biomedical Research Centre, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Andrew Wyman
- Department of Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | - Matthew Banks
- Department of Gastroenterology, University College London Hospitals, London, UK
| | - Nigel Trudgill
- Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
| | - D Mark Pritchard
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Stuart Riley
- Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
| | - John Anderson
- Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Helen Griffiths
- Department of Gastroenterology, Wye Valley NHS Trust, Herefordshire, UK
| | - Pradeep Bhandari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK
| | - Phillip Kaye
- Department of Histopathology, Nottingham University Hospitals NHS trust, Nottingham, UK
| | - Andrew Veitch
- Department of Gastroenterology, New Cross Hospital, Wolverhampton, UK
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Ulker K, Kivrak Y. The Effect of Information About Gynecological Examination on the Anxiety Level of Women Applying to Gynecology Clinics: A Prospective, Randomized, Controlled Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e23864. [PMID: 27621913 PMCID: PMC5002923 DOI: 10.5812/ircmj.23864] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 04/05/2015] [Accepted: 05/11/2015] [Indexed: 11/16/2022]
Abstract
Background: Crowded hospital outpatient clinics and endless waiting lines that make patients feel overlooked tend to exaggerate patients’ anxiety levels. In addition, fear of pain, shyness, religious and traditional thoughts, women’s sexual role in society, and previous information and experience also contribute to people’s anxiety levels with regard to gynecologic examination. Objectives: We aimed to analyze the effect of specific information about gynecologic examination on anxiety levels of women applying to gynecology clinics. Materials and Methods: In this randomized prospective study, the women applying for a gynecological examination were randomly allocated into control, intervention 1, and intervention 2 groups. Power analysis indicated that in order to achieve a one-point decrease from the previous anxiety score of 43.85 ± 5.41 at one side alpha 0.05 with a power of 80%, at least 79 women were needed in each group. Four medical school students interviewed 75 women (25 in control, 25 in intervention 1, and 25 in intervention 2). The data were collected using the demographic, social, and economic data form, and the Turkish version of the state-trait anxiety inventory (STAI). The women in the intervention 1 and 2 groups were instructed to read a paper that contained brief information about the gynecological examination procedure and the profits obtained from forests, respectively. All participants, including the women in the control group, filled the STAI by themselves. The three groups were compared appropriately. Results: The demographics pertaining to age, gravidity and parity, miscarriage, induced abortion, ectopic pregnancy, offspring number, place of residence, working status, education level and previous experience of gynecological examination did not differ among the groups (P > 0.05). According to the STAI scores, all groups had mild state (control: 40.20 ± 10.53, intervention 1: 42.00 ± 11.98, and intervention 2: 39.53 ± 10.32) and severe continuous (control: 46.78 ± 8.65, Intervention 1: 47.25 ± 9.57, and intervention 2: 46.60 ± 9.72) anxiety levels. However, both state and continuous anxiety scores were not significantly different in all groups (P > 0.05). Conclusions: Providing brief written information about the gynecological examination procedure and the clinic’s working discipline is not sufficient to lower the anxiety of women applying for a gynecological examination.
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Affiliation(s)
- Kahraman Ulker
- Department of Obstetrics and Gynecology, Medical Faculty, Kafkas University, Kars, Turkey
| | - Yuksel Kivrak
- Department of Psychiatry, Medical Faculty, Kafkas University, Kars, Turkey
- Corresponding Author: Yuksel Kivrak, Department of Psychiatry, Medical Faculty, Kafkas University, Kars, Turkey. Tel: +90-4742251150, Fax: +90-4742251193, E-mail:
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Tarhan H, Cakmak O, Unal E, Akarken I, Un S, Ekin RG, Konyalioglu E, Isoglu CS, Zorlu F. The effect of video-based education on patient anxiety in men undergoing transrectal prostate biopsy. Can Urol Assoc J 2015; 8:E894-900. [PMID: 25553162 DOI: 10.5489/cuaj.2208] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We assess the effect of video-based education on patient anxiety during transrectal prostate biopsy. METHODS A total of 246 patients who underwent transrectal prostate biopsy were prospectively enrolled in the study. Group 1 included 123 patients who received both written and video-based education, while Group 2 included 123 patients who received only written instructions regarding prostate biopsies. State-Trait Anxiety Inventory (STAI) was used to assess state and trait anxiety (STAI-S/T) After completing the STAI-S and STAI-T questionnaires, all patients in Group 1 received written information and video-based education and they again completed STAI-S before the biopsy. On the contrary, after completing the STAI-S and STAI-T questionnaires, the patients in Group 2 received only written information and then they completed the STAI-S before the biopsy. Moreover, a visual analog scale (VAS) was used to assess pain scores during digital rectal examination, probe insertion, periprostatic local anesthesic infiltration, and biopsy. RESULTS No difference was noted between 2 groups regarding VAS scores. Comparing the 2 groups on baseline anxiety, we found that trait anxiety scores (STAI-T) were similar (p = 0.238). Pre-information STAI-S scores were similar in both groups (p = 0.889) and they both indicated high anxiety levels (score ≥42). While post-information STAI-S scores remained high in Group 2, post-information STAI-S scores significantly decreased in Group 1 (p = 0.01). CONCLUSIONS Undergoing a prostate biopsy is stressful and may cause anxiety for patients. Video-based education about the procedure can diminish patient anxiety.
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Affiliation(s)
- Huseyin Tarhan
- Tepecik Training and Research Hospital, Urology Department, Izmir-Turkey
| | - Ozgur Cakmak
- Tepecik Training and Research Hospital, Urology Department, Izmir-Turkey
| | - Elif Unal
- Tepecik Training and Research Hospital, Psychiatry Department, Izmir-Turkey
| | - Ilker Akarken
- Tepecik Training and Research Hospital, Urology Department, Izmir-Turkey
| | - Sitki Un
- Katip Celebi University, Ataturk Training and Research Hospital, Urology Department, Izmir-Turkey
| | - Rahmi Gokhan Ekin
- Tepecik Training and Research Hospital, Urology Department, Izmir-Turkey
| | | | | | - Ferruh Zorlu
- Tepecik Training and Research Hospital, Urology Department, Izmir-Turkey
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Neamsuvan O, Tuwaemaengae T, Bensulong F, Asae A, Mosamae K. A survey of folk remedies for gastrointestinal tract diseases from Thailand's three southern border provinces. JOURNAL OF ETHNOPHARMACOLOGY 2012; 144:11-21. [PMID: 22940242 DOI: 10.1016/j.jep.2012.07.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 06/30/2012] [Accepted: 07/28/2012] [Indexed: 05/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Gastrointestinal tract diseases commonly occur in Thailand. However, surveying for finding out traditional drugs has never been done. AIM OF STUDY To quantify and categorize the folk medicinal remedies that are used for healing the gastrointestinal tract by the traditional healers living in Thailand's three southern border provinces. MATERIALS AND METHODS The Pattani, Yala and Narathiwat provinces were selected. Semi-structured interviews of nine healers were conducted to collect information that included the remedy names, herbal ingredients, plant parts used, preparation, properties and treatment methods. The data were then further analyzed. RESULT The results revealed that 39 multi-species remedies and 36 single-species remedies were used to treat gastrointestinal disorders. A total of 103 plant species and 5 other materia medica were used as therapeutics. Most of the plants used were of the Zingiberaceae, Fabaceae and Euphorbiaceae families. Furthermore, it was found that although most of the healers used different remedies for a particular disease, some of the ingredients might have been similar. For example, Caesalpinia bonduc (L.) Roxb. was an ingredient used for parasitic disease remedies, and Senna alata (L.) Roxb. was used for constipation remedies. CONCLUSION A review of the literature revealed 57 plant species and 2 other materia medica that have already been tested for their biological activities, whereas 46 plant species and 3 materia medica have never been tested. Consequently, research should be performed to confirm the pharmacological properties of folk remedies.
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Affiliation(s)
- Oratai Neamsuvan
- Faculty of Traditional Thai Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
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The Use of Nonpharmacological Interventions to Reduce Anxiety in Patients Undergoing Gastroscopy in a Setting With an Optimal Soothing Environment. Gastroenterol Nurs 2008; 31:395-9. [DOI: 10.1097/sga.0b013e31818eb5c9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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An investigation into the information received by patients undergoing a gastroscopy in a large teaching hospital in Ireland. Gastroenterol Nurs 2008; 31:212-22. [PMID: 18542022 DOI: 10.1097/01.sga.0000324113.01651.ab] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The purpose of this article is to examine the information received by patients undergoing a gastroscopy. The growing number and complexity of day-case endoscopy increases the need for quality patient information. Provision of patient information reduces anxiety, increases knowledge, improves cooperation during endoscopy and increases compliance with discharge instructions. The study used a descriptive survey with convenience sampling (response rate 66%, N = 137). Patients received most of the standard procedural information (how and why the procedure is carried out), but they received considerably less sensory information (information regarding what they would hear, feel, smell, etc.). In addition, age and gender appeared to affect the amount of information received. Older patients received more procedural information than younger patients, and male patients received more information than female patients. The nurse was the main source of information. The majority of patients (>80%) received adequate information and were satisfied with the information received. Patients also received most of the information verbally on the day of the procedure rather than before admission. This study identified the need for patient information leaflets. The role of the nurse and the effect of age and gender on information provision are important considerations for healthcare professionals.
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Felley C, Perneger TV, Goulet I, Rouillard C, Azar-Pey N, Dorta G, Hadengue A, Frossard JL. Combined written and oral information prior to gastrointestinal endoscopy compared with oral information alone: a randomized trial. BMC Gastroenterol 2008; 8:22. [PMID: 18522729 PMCID: PMC2430967 DOI: 10.1186/1471-230x-8-22] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 06/03/2008] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about how to most effectively deliver relevant information to patients scheduled for endoscopy. Methods To assess the effects of combined written and oral information, compared with oral information alone on the quality of information before endoscopy and the level of anxiety. We designed a prospective study in two Swiss teaching hospitals which enrolled consecutive patients scheduled for endoscopy over a three-month period. Patients were randomized either to receiving, along with the appointment notice, an explanatory leaflet about the upcoming examination, or to oral information delivered by each patient's doctor. Evaluation of quality of information was rated on scales between 0 (none received) and 5 (excellent). The analysis of outcome variables was performed on the basis of intention to treat-analysis. Multivariate analysis of predictors of information scores was performed by linear regression analysis. Results Of 718 eligible patients 577 (80%) returned their questionnaire. Patients who received written leaflets (N = 278) rated the quality of information they received higher than those informed verbally (N = 299), for all 8 quality-of-information items. Differences were significant regarding information about the risks of the procedure (3.24 versus 2.26, p < 0.001), how to prepare for the procedure (3.56 versus 3.23, p = 0.036), what to expect after the procedure (2.99 versus 2.59, p < 0.001), and the 8 quality-of-information items (3.35 versus 3.02, p = 0.002). The two groups reported similar levels of anxiety before procedure (p = 0.66), pain during procedure (p = 0.20), tolerability throughout the procedure (p = 0.76), problems after the procedure (p = 0.22), and overall rating of the procedure between poor and excellent (p = 0.82). Conclusion Written information led to more favourable assessments of the quality of information and had no impact on patient anxiety nor on the overall assessment of the endoscopy. Because structured and comprehensive written information is perceived as beneficial by patients, gastroenterologists should clearly explain to their patients the risks, benefits and alternatives of endoscopic procedures. Trial registration: Current Controlled trial number: ISRCTN34382782.
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Affiliation(s)
- Christian Felley
- Division of Gastroenterology and Hepatology, University Hospitals, and University of Geneva, Geneva, Switzerland.
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Guz H, Sunter AT, Bektas A, Doganay Z. The frequency of the psychiatric symptoms in the patients with dyspepsia at a university hospital. Gen Hosp Psychiatry 2008; 30:252-6. [PMID: 18433657 DOI: 10.1016/j.genhosppsych.2008.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 02/14/2008] [Accepted: 02/14/2008] [Indexed: 11/24/2022]
Abstract
OBJECTIVE According to the psychiatric hypothesis, the symptoms of dyspepsia may be due to depression, anxiety or a somatization disorder. We investigated the frequency of psychiatric symptoms in patients undergoing endoscopic procedures with dyspepsia, either with or without pathological findings, and compared this with control subjects without dyspeptic symptoms. METHODS Ninety patients with dyspeptic symptoms and 90 control subjects participated in the study. Both the patients and the controls were asked to complete a questionnaire about socio-demographic characteristics, the Turkish version of the Spielberger State-Trait Anxiety Inventory (STAI) and the Symptom Check List-90 (SCL-90). In order for us to determine whether the criteria for any of the conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were met, the patients were asked to take part in the Structured Clinical Interview for DSM-IV disorders. RESULTS Of the participants, 47.8% had a psychiatric disorder according to DSM-IV criteria, somatoform disorder (44.2%) being the most common. While 42.2% patients were determined to have a pathological finding using endoscopic evaluation, 57.8% had no findings. Together with the somatization and obsessive-compulsive disorder subscale scores, the total SCL-90 score and the mean trait anxiety score were statistically significantly higher in participants with no pathological findings. There were trends for anxiety (13.2% vs. 7.7%) and mood (2.6% vs. 0.0%) disorders to be more frequent in patients with pathological findings, while somatoform disorder+depressive disorder (17.3% vs. 5.2%) was more frequent in patients with no findings, although the differences were not statistically significant (Z=0.7, P>.05). The scores of state-trait anxiety, somatization, obsession-compulsion, depression, anxiety, phobic anxiety and psychotism subscales, and the total SCL-90 score were statistically significantly higher in those participants without a pathological finding than in the controls. CONCLUSIONS Regarding the high frequency of psychiatric disorders in patients with dyspeptic symptoms, we think that such patients should be evaluated by two separate departments, gastroenterology and psychiatry.
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Affiliation(s)
- Hatice Guz
- Department of Psychiatry, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
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Abstract
BACKGROUND AND AIM Increasing numbers of endoscopies are being carried out in children. The purpose of our study was to evaluate the provision of information about the admission and procedure and the functional and economic impact of day-case gastroscopy on children and their families. METHODS We administered a structured questionnaire to families of children undergoing elective gastroscopy, with daily follow up by telephone over the next 3 days. RESULTS One-hundred-and-three children were recruited. All had seen a consultant gastroenterologist (usually the proceduralist) prior to the endoscopy, who had obtained signed consent; 89% of families remembered receiving an explanation from the doctor carrying out the procedure. Nearly all (94%) described the information they received as adequate. However, only one-third of families recalled receiving an explanatory brochure and very few had toured the Day Surgical Unit or seen the complimentary video. Thirty percent were unhappy with the time spent at the Day Surgical Unit and an apparent failure to warn of possible delays, 8% felt that they were not given adequate information prior to discharge, and 39% of children failed to attend school the day after the procedure. Although tiredness or sleepiness was common, no correlation was found between the presence of symptoms and school absence. Complaints about the admission included overcrowding, lack of privacy, excessive noise, and failure to cater for adolescents. Fifty percent of parents took leave from work, but most manipulated work rosters and holidays so that costs to them and to the workplace were minimal. CONCLUSION Information provision about the procedure and admission appears to be adequate in most families of children undergoing day-case gastroscopy, but may be improved in some areas. Failure to remember elements of the consent and explanatory process is common. Minor morbidity is also common after the procedure.
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Affiliation(s)
- Susan G Jimenez
- Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia
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Guennoc X, Samjee I, Jousse-Joulin S, Devauchelle V, Roudaut A, Saraux A. Quality and impact of information about interventional rheumatology: a study in 119 patients undergoing fluoroscopy-guided procedures. Joint Bone Spine 2007; 74:353-7. [PMID: 17574895 DOI: 10.1016/j.jbspin.2006.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Accepted: 06/07/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the quality of patient information about fluoroscopy-guided rheumatologic procedures, and to look for an impact on the patient's experience of the procedure. METHODS One hundred and nineteen patients completed questionnaires before and after undergoing fluoroscopy-guided interventions. We looked for associations between the information supplied by the rheumatologist who recommended the procedure and pain, anxiety, awareness of potential complications, and the match between patient expectations and actual experience. RESULTS 62.8% of patients reported receiving information about the procedure. Only 20.5% reported receiving specific information about potential adverse events, although 80.9% felt this information would have been useful. Most patients (74.8%) would have liked to receive additional information. Only 10.1% patients were given written information. Mean (+/-SD) anticipated pain severity as assessed in the waiting room before the procedure on a 0-10 scale was 4.5+/-2.4 in women and 4.2+/-2.3) in men. Actual pain severity during the procedure as assessed on the same scale was 2.7+/-2.6 in women and 2.2+/-1.6 in men. The level of information about the procedure did not influence anticipated or actual pain severity. Anxiety was reported by 59.8% patients and was more common in women (P<0.001), in patients given written information (P=0.05), and in patients undergoing their first intervention (P=0.05). Information was perceived as alleviating anxiety by 69.9% patients, and 77.3% of patients felt they would experience less anxiety if they had the procedure a second time. Only 21.2% patients were able to name a potential adverse event, and this proportion was not influenced by receiving written information. A mismatch between expectations about the procedure or its duration and actual experience was reported by 17 (17/69, 24.6%) and 34 (34/98, 34.7%) patients, respectively, with no significant differences across study subgroups. CONCLUSION Information about interventional rheumatology procedures is required for ethical principles and legislation. Patients increasingly expect detailed information, which may increase the likelihood that the procedure unfolds smoothly. Our results indicate a need for optimizing patient information. Standardized written material deserves to be evaluated as a means of better meeting the informational needs of patients.
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Affiliation(s)
- Xavier Guennoc
- Rheumatology Department, Brest Teaching Hospital, CHU de Brest, 29609 Brest, France.
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Coolen JCG, Florisson JMG, Bissett IP, Parry BR. Evaluation of knowledge and anxiety level of patients visiting the colorectal pelvic floor clinic. Colorectal Dis 2006; 8:208-11. [PMID: 16466561 DOI: 10.1111/j.1463-1318.2005.00879.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Discussing defaecating disorders is difficult for patients and many view anal physiology investigations (ultrasound, manometry, electromyography and pudendal nerve studies) as distasteful. This pilot study sought to assess whether present information sheets supplied to patients and the visit to the colorectal Pelvic Floor Clinic itself influenced patients' knowledge and anxiety. PATIENTS AND METHODS Thirty Pelvic Floor Clinic patients from Auckland City Hospital were included. Each patient filled in a questionnaire before and after the clinic. This included objective questions about their knowledge of the structure and function of the pelvic floor and satisfaction with and understanding of the information sheet. Both visual analogue scale (VAS) and multiple choice questions (MCQ) were used. Their subjective and objective knowledge were compared. Anxiety was assessed on a visual analogue anxiety scale (VAAS). Results were expressed as VAS scores or percentage correct and relationships were tested using Fisher's Exact test and paired T-test. RESULTS Subjective knowledge increased in 93% of the patients. The doctor's explanation led to a greater increase in subjective knowledge than the information sheet (35/100 mm, P<0.001 and 10/100 mm, P=0.01, respectively). Subjective improvement in knowledge did not however, translate into an increase in objective knowledge (P=0.63). The information sheet was read by 87% of the patients. The information sheet had reduced anxiety only in 23% of the patients and increased in 10%. Anxiety levels were not significantly influenced by the information sheet, but reduced significantly by the clinic visit in 87% of patients (P<0.001). The mean anxiety level reduced from 44/100 to 12/100 after the clinic visit. CONCLUSION Anxiety levels are high in those visiting the Pelvic Floor Clinic. It appears that it is the interaction with the doctor that has a profound influence on anxiety levels and subjective knowledge rather than written information.
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Affiliation(s)
- J C G Coolen
- University of Maastricht, Maastricht, the Netherlands, and Department of Surgery, Auckland Hospital, New Zealand
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Trevisani L, Sartori S, Gaudenzi P, Gilli G, Matarese G, Gullini S, Abbasciano V. Upper gastrointestinal endoscopy: Are preparatory interventions or conscious sedation effective? A randomized trial. World J Gastroenterol 2004; 10:3313-7. [PMID: 15484307 PMCID: PMC4572302 DOI: 10.3748/wjg.v10.i22.3313] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Conscious sedation (CS) and non-pharmacological interventions have been proposed to reduce anxiety and allow better execution of EGD. The aim of this study was to assess whether CS, supplementary information with a videotape, or presence of a relative during the examination could improve the tolerance to EGD.
METHODS: Two hundred and twenty-six outpatients (pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 groups: Co-group (62 pts): throat anaesthesia only; Mi-group (52 pts): CS with i.v. midazolam; Re-group (58 pts): presence of a relative throughout the procedure; Vi-group (54 pts): additional information with a videotape. Anxiety was measured using the "Spielberger State and Trait Anxiety Scales". The patients assessed the overall discomfort during the procedure on an 100-mm visual analogue scale, and their tolerance to EGD answering a questionnaire. The endoscopist evaluated the technical difficulty of the examination and the tolerance of the patients on an 100-mm visual analogue scale and answering a questionnaire.
RESULTS: Pre-endoscopy anxiety levels were higher in the Mi-group than in the other groups (P < 0.001). On the basis of the patients' evaluation, EGD was well tolerated by 80.7% of patients in Mi-group, 43.5% in Co-group, 58.6% in Re-group, and 50% in Vi-group (P < 0.01). The discomfort caused by EGD, evaluated by either the endoscopist or the patients, was lower in Mi-group than in the other groups. The discomfort was correlated with "age" (P < 0.001) and "groups of patients" (P < 0.05) in the patients' evaluation, and with "gender" (females tolerated better than males, P < 0.001) and "groups of patients" (P < 0.05) in the endoscopist's evaluation.
CONCLUSION: Conscious sedation can improve the tolerance to EGD. Male gender and young age are predictive factors of bad tolerance to the procedure.
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Affiliation(s)
- Lucio Trevisani
- Digestive Endoscopy Service, Department of Internal Medicine, S. Anna Hospital, Ferrara, Italy.
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15
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Abstract
Studies have recorded significant patient discomfort during flexible sigmoidoscopy when it is performed without sedation/analgesia. This study observed whether a single dose of 50 mcg intravenous fentanyl reduces pain, improving compliance, acceptability, and completion rates. In a prospective study, 109 consecutive patients were offered the option of 50 mcg intravenous fentanyl or no analgesia. Patient's pre-procedure expectations, objective pain scores, and willingness to undergo a subsequent procedure using the same technique were recorded. Endoscopist recorded the success, complications, and objective pain scores for each patient. Of the 46 patients (42%) choosing fentanyl, 9 (20%) experienced moderate/severe pain as against 26 (41%) of the 63 patients (58%) opting for no analgesia (p < 0.05). Further, 52% receiving fentanyl had a significantly better experience compared to their pre-procedure expectations as against 33% who received no analgesia (p < 0.05). No patient receiving fentanyl expressed unwillingness to undergo the procedure again using the same technique, whereas 16 (25%) of those receiving no analgesia indicated they would not (p < 0.01). Endoscopists recorded moderate/severe pain in 13 patients (12%), whereas 35 patients (32%) recorded moderate/severe pain (p < 0.001). Analgesia for endoscopy should involve patient choice. However, a single dose of 50 mcg fentanyl reduced patient discomfort and improved satisfaction. It appeared safe and likely to improve patient compliance and acceptability for flexible sigmoidoscopy.
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Affiliation(s)
- Sanjoy Basu
- Endoscopy Unit, St Mary's Hospital, PO30 5TG Isle of Wight, UK.
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16
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Lee SY, Son HJ, Lee JM, Bae MH, Kim JJ, Paik SW, Yoo BC, Rhee JC, Kim S. Identification of factors that influence conscious sedation in gastrointestinal endoscopy. J Korean Med Sci 2004; 19:536-40. [PMID: 15308844 PMCID: PMC2816887 DOI: 10.3346/jkms.2004.19.4.536] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Although several studies examined factors that influence conscious sedation, investigation was limited into the gender and age. The aim of this prospective study is to identify the clinical variables of successful conscious sedation during gastrointestinal endoscopy. A total of 300 subjects who underwent gastrointestinal endoscopy were enrolled in a prospective fashion. They completed a questionnaire to assess height, weight, drinking, smoking, education level, recent medication, past medical history, previous experience of conscious sedation, preprocedural anxiety, and apprehension about the procedure. Efficacy of sedation and amnesia were evaluated by the subject and the endoscopist. Amnesic and sedative effects were proportionally related with age (p<0.0001). Preprocedural anxiety level was higher in women (p=0.0062), younger subjects (p=0.035), slender subjects (p=0.041), and in those without previous experience of conscious sedation (p=0.0034). This anxiety level was also related to increased pain (p=0.0026) and alertness (p=0.0003) during the procedure. Lower dose of midazolam is needed for sedation in older subjects. Subjects with a high level of preprocedural anxiety such as women, younger subjects, slender subjects, and those without previous experience of conscious sedation should be sedated with great caution because generally, they complain of much more severe pain and alertness during the procedure.
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Affiliation(s)
- Sun-Young Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jung Son
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Min Lee
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mun Hee Bae
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae J. Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Chul Yoo
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Chul Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seonwoo Kim
- Biostatistics unit of Samsung Biomedical Research Institute, Seoul, Korea
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17
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Maguire D, Walsh JC, Little CL. The effect of information and behavioural training on endoscopy patients' clinical outcomes. PATIENT EDUCATION AND COUNSELING 2004; 54:61-65. [PMID: 15210261 DOI: 10.1016/s0738-3991(03)00195-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2002] [Revised: 05/18/2003] [Accepted: 06/09/2003] [Indexed: 05/24/2023]
Abstract
This study was designed to examine the effects of preparatory information and behavioural training on patients about to undergo an endoscopy procedure. Forty-five first-time endoscopy patients (aged 20-70 years), were randomly assigned to one of three groups (cognitive, cognitive/behavioural and control group). The cognitive group received a 12 min preparation with sensory and procedural information relating to the sensations and sequence of events associated with the endoscopy procedure. The cognitive/behavioural group received, in addition, instruction in deep breathing exercises, tongue depressor task and swallowing technique. Results indicated that patients in the two experimental conditions experienced significantly fewer signs of behavioural distress during endoscopy. The cognitive group required a significantly shorter time to induce the scope. There were no statistical differences between the groups however, for mood, physiological and anxiety measures, although a positive trend was evident for the two intervention groups.
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Affiliation(s)
- Deirdre Maguire
- Department of Psychology, National University of Ireland, Galway, Ireland
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18
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Jones MP, Ebert CC, Sloan T, Spanier J, Bansal A, Howden CW, Vanagunas AD. Patient anxiety and elective gastrointestinal endoscopy. J Clin Gastroenterol 2004; 38:35-40. [PMID: 14679325 DOI: 10.1097/00004836-200401000-00009] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Esophagogastroduodenoscopy (EGD) and colonoscopy (CS) are commonly performed procedures that can cause anxiety related to potential findings, embarrassment and concern over discomfort. The objective of this study is to evaluate patient anxiety associated with diagnostic, sedated outpatient endoscopy and to correlate endoscopists' estimations of patient anxiety with those of the patient. METHODS Consecutive patients referred for diagnostic upper endoscopy or colonoscopy were evaluated. Anxiety was rated at baseline and immediately before the procedure using the State-Trait Anxiety Index (STAI-Y). Patients were categorized as whether they had been previously seen by a gastroenterologist in the clinic or were referred directly by another physician for endoscopy. Patients were also asked to rate their knowledge of the procedure using a visual analog scale. Physicians rated patient anxiety and procedure difficulty using 100 mm visual analog scales. Sedation administered during each procedure was recorded. RESULTS Ninety-four patients were enrolled; 47 had been referred from the gastroenterology clinic and 47 had been directly referred from primary care physicians. Thirty-nine percent completed baseline and pre-procedure STAI-Y. Endoscopy was associated with a significant increase in state anxiety (baseline, 31.2 +/- 1.8; procedure, 39.8 +/- 2.2; P = 0.001) but not trait anxiety (baseline, 35.4 +/- 1.7; procedure, 36.2 +/- 1.6; P = 0.59). Procedural state anxiety was not influenced by age, sex, referral source, type of procedure or perceived procedural knowledge but was correlated with trait anxiety (r = 0.38; P = 0.02). Physician estimates of patient anxiety did not correlate with either procedural state anxiety (r = -0.15; P = 0.37) or the change in state anxiety from baseline to the procedure (r = -0.04; P = 0.82). CONCLUSIONS Diagnostic outpatient endoscopy is associated with modest increases in state anxiety that are not significantly influenced by age, sex, procedure type, indication, or referral source. Endoscopists' ability to estimate patient anxiety is poor but this may reflect the generally mild increases in state anxiety that were encountered.
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Affiliation(s)
- Michael P Jones
- Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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19
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Ratanalert S, Soontrapornchai P, Ovartlarnporn B. Preoperative education improves quality of patient care for endoscopic retrograde cholangiopancreatography. Gastroenterol Nurs 2003; 26:21-5. [PMID: 12582293 DOI: 10.1097/00001610-200301000-00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The goal of this study was to evaluate the effect of preoperative education on patient satisfaction and cooperation during an endoscopic retrograde cholangiopancreatography (ERCP) procedure. Risk reduction was also studied in terms of decreased meperidine administration. Subjects were preoperatively educated by the endoscopy nurse regarding the ERCP procedure and how to communicate with the nurse during the procedure. Forty-five patients with a mean age of 58 years participated in the study. Effective patient cooperation was achieved. All subjects were satisfied with the educational process and the ERCP team. These findings suggest preoperative education is a cost-effective intervention in enhance patient cooperation and patient satisfaction for patients undergoing ERCP.
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Affiliation(s)
- Siriporn Ratanalert
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand.
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20
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Ayral X, Gicquere C, Duhalde A, Boucheny D, Dougados M. Effects of video information on preoperative anxiety level and tolerability of joint lavage in knee osteoarthritis. ARTHRITIS AND RHEUMATISM 2002; 47:380-2. [PMID: 12209483 DOI: 10.1002/art.10559] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the impact of video information on preoperative anxiety of patients scheduled to undergo joint lavage for knee osteoarthritis, and tolerability of the lavage. METHODS A video film on joint lavage (duration 4 minutes, 20 seconds) was made by medical communication professionals, based on recommendations of the medical and paramedical staff of the Institute of Rheumatology. Patients diagnosed with knee osteoarthritis and scheduled for lavage were assigned, using a preestablished list of randomization, to either the video group or the no-video group. In the operating room, preoperative anxiety level was measured on a 100-mm visual analog scale (VAS), and tolerability was assessed using a 4-grade scale. RESULTS One hundred twelve patients (56 patients in each group) were included and completed the trial. Preoperative anxiety was lower by half for patients who had viewed the video (VAS 13 +/- 20 versus 26 +/- 27; P = 0.0056). Tolerability of knee lavage was also significantly better in the video group (very tolerable 91% versus 48%; P < 0.0001). CONCLUSION This prospective, controlled, randomized study confirms the usefulness of video information prior to an invasive rheumatology procedure.
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Affiliation(s)
- Xavier Ayral
- Service de Rhumatologie B, Hôpital Cochin (AP-HP), Université René Descartes, Paris, France.
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21
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Callaghan P, Chan HC. The effect of videotaped or written information on Chinese gastroscopy patients' clinical outcomes. PATIENT EDUCATION AND COUNSELING 2001; 42:225-230. [PMID: 11164321 DOI: 10.1016/s0738-3991(00)00125-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The researchers compared videotaped information with specific written information on Chinese out-patients' post-gastroscopy anxiety and satisfaction levels. We randomly allocated 30 out-patients having scheduled gastroscopy to receive videotaped or detailed written information, and assessed the effect of the information on patients' post-gastroscopy BP, pulse and self-reported anxiety and satisfaction levels. Patients receiving videotaped information had better post-gastroscopy outcomes on all measures, but the results were not statistically significant. BP and Pulse rates increased after the intervention within each group but the changes were statistically significant in the group receiving detailed written information only. A-state scores decreased in both groups after the intervention but these changes were not statistically significant. Education and age significantly influenced post-gastroscopy state anxiety scores. The researchers conclude that information may have little effect on Chinese gastroscopy patients' outcomes, irrespective of the method of providing it. Education and age may influence patients' reports of anxiety.
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Affiliation(s)
- P Callaghan
- Department of Mental Health and Learning Disability Nursing, City University, Philpot Street, E1 2EA, London, UK.
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22
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Jamieson J. Anesthesia and sedation in the endoscopy suite? (influences and options). Curr Opin Anaesthesiol 1999; 12:417-23. [PMID: 17013344 DOI: 10.1097/00001503-199908000-00004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Advances in technology and pharmacology have enabled gastrointestinal endoscopists to expand the diagnostic and therapeutic capabilities of the specialty. Research into the impact of the endoscopy environment on patient stress, acknowledgement of the various patient coping styles, development and deployment of procedural preparative programs and information streamlining have been shown to be of value in decreasing anxiety and reducing sedative requirements. Being aware of procedure-related stressors, and factors associated with complications, allows us to tailor our sedation or anesthesia plan to the individual patient.
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Affiliation(s)
- J Jamieson
- Department of Anesthesiology, Memorial University of NFLD, Health Sciences Center, St John's, Newfoundland, Canada
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23
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24
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Mahajan L, Wyllie R, Steffen R, Kay M, Kitaoka G, Dettorre J, Sarigol S, McCue K. The effects of a psychological preparation program on anxiety in children and adolescents undergoing gastrointestinal endoscopy. J Pediatr Gastroenterol Nutr 1998; 27:161-5. [PMID: 9702646 DOI: 10.1097/00005176-199808000-00006] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Like adults, children often experience anxiety associated with medical procedures. The purpose of this study was to investigate the effects of a program of psychological preparation for children undergoing endoscopy. METHODS Sixty patients aged 6 to 19 years (mean, 12.2 years) were randomized into one of two groups. Group 1 received routine preparation before endoscopy. Group 2 received psychological preparation consisting of demonstration of materials that would be encountered during the procedure, use of a doll as a model, or use of a book with photographs of a child who had previously undergone endoscopy. Patients in both groups completed the Spielberger State-Trait Anxiety Inventory in the clinic and just before endoscopy. The Observational Scale of Behavioral Distress was completed by a blinded observer during each procedure. The attending physician (blinded) assessed patient cooperation. Vital signs were recorded in clinic and just before endoscopy. Parents and patients completed questionnaires after endoscopy. RESULTS Analysis of the Spielberger State-Trait Anxiety Inventory showed patients in group 2 were significantly less anxious before endoscopy (p < 0.0001). They also required less meperidine (p < eq 0.04) per kilogram body weight and were more cooperative during the examination (p = 0.042). There was significantly less autonomic nervous system stimulation in those who had undergone psychological preparation (change in heart rate, p < 0.001; change in systolic blood pressure, p = 0.04). Statistically significant differences were found in the patients' response to questions after endoscopy regarding perceived anxiety during the procedure (p = 0.003) and the parents' response to questions regarding their own conditions (p = 0.026) and that of their child (p < 0.001). CONCLUSION Psychological preparation before endoscopy significantly decreases patient and parental anxiety. Such preparation may allow for a reduction in sedative medications and thereby enhance procedural safety.
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Affiliation(s)
- L Mahajan
- Section of Pediatric Gastroenterology and Nutrition, Cleveland Clinic Foundation, OH 44195, USA
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25
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Abstract
With hopes of alleviating discomfort and improving the tolerance of patients undergoing endoscopy, we have assessed the influence of various background conditions in the endoscopy room. Two hundred twenty-one candidates for upper endoscopy were randomly allocated to four groups, each with one of the following conditions in the endoscopy room: background music and conversation related to the patient's complaints (n=50); background music and conversation unrelated to the patient (n=53); background music only, with the staff maintaining silence (n=49); and complete silence (n=47). Before endoscopy patients answered a 26-item questionnaire that included an evaluation of their degree of anxiety before the examination. Conscious sedation was induced by using 3 mg midazolam. After complete recovery from sedation, patients answered another set of questions. Patients in all four groups felt quite comfortable with the atmosphere in which gastroscopy was performed. Neither music, conversation, nor silence had a great effect on patients as far as improving tolerance or diminishing anxiety. Therefore, endoscopists and nurses may have a free hand in choosing the prevailing conditions during the examination. This conclusion may be valid for both patients and the staff involved in other invasive procedures performed under light sedation.
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Affiliation(s)
- E Stermer
- Department of Gastroenterology, Bnei Zion Medical Center, Haifa, Israel
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26
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Abstract
We examined a number of patient variables, including three different scales of preprocedure patient anxiety, to determine which best predicted patient cooperation and satisfaction with gastrointestinal endoscopy. We prospectively evaluated 251 patients undergoing outpatient diagnostic esophagogastroduodenoscopy and colonoscopy under conscious sedation. All were given a questionnaire on arrival to our endoscopy center that included three measures of preprocedure anxiety: (a) a single question asking how anxious the patient was (termed "Anxiety I" scale); (b) a visual linear analog scale of anxiety; and (c) the Hospital Anxiety and Depression scale. Patient cooperation during the procedure was rated by the attending endoscopist. Patients were telephoned the next day to complete a questionnaire assessing their endoscopic experience. Logistic regression analysis was used to construct models for predicting which patients were most likely to have difficulty during their procedures from both the endoscopists' and the patients' standpoint. Statistical analysis identified three parameters that by themselves significantly correlated with patient cooperation during endoscopy: age (p = 0.008), Anxiety I scale (p = 0.03), and visual linear analog anxiety score (p = 0.02). When used together, age, type of procedure, and Anxiety I scale were the best predictors of patient cooperation from the standpoint of the endoscopist. Age, type of procedure, Anxiety I scale, and education level were the best predictors of satisfaction with endoscopy from the perspective of the patient. Good cooperation during endoscopy was associated with greater patient satisfaction.
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Affiliation(s)
- R J Mahajan
- Division of Gastroenterology, University of Missouri Health Sciences Center, Columbia 65212, USA
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27
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Abstract
We evaluated what effect an escort present during upper endoscopy had on the attitude and anxiety level of patients and on the escorts. The study consisted of 206 patients (ages 15-85, 47% male) and their escorts. Both patients and escorts were interviewed before the procedure. Escorts were then randomly divided into two groups-on-the-spot escorts, who present throughout the procedure, as opposed to waiting-room escorts. Both groups were reinterviewed following the procedure. Before the procedure, 80% of the patients understood the nature of endoscopy. Thirteen percent believed the procedure to be dangerous, and only 33% were totally worry-free. Fifty percent preferred to be escorted during the procedure, while 17% refused. Following the procedure, 89% of the patients who were escorted in the endoscopy room expressed satisfaction. Fifty-two percent of the patients found the procedure to be mild, with a higher proportion among escorted patients. Among the escorts, 63% felt that their close presence had lessened their own fears and anxiety regarding the procedure, and 72% believed their presence to have been supportive to the patient. Having an escort present throughout endoscopy appears to be a promising approach.
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Affiliation(s)
- M Shapira
- Gastroenterology Unit, Poriyah Hospital, Tiberias, Israel
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