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Uçaner B, Buldanli MZ, Çimen Ş, Çiftçi MS, Demircioğlu MM, Erten E, Hançerlioğullari O. Investigation of factors that may potentially affect anxiety in patients undergoing esophagogastroduodenoscopy and evaluation of sedation effect. Medicine (Baltimore) 2024; 103:e37801. [PMID: 38608054 PMCID: PMC11018157 DOI: 10.1097/md.0000000000037801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND As with any other invasive procedure, esophagogastroduodenoscopy (EGD) may lead to considerable anxiety in patients. This study aimed to investigate and compare the effects of sedated and non-sedated procedures on anxiety in patients undergoing EGD and to better recognize patient groups at risk for anxiety. METHODS In this prospective and 2-armed designed study, demographic data, including age, gender, comorbidities, height, weight, body mass index (BMI), and educational background, were collected. In this study, the Beck Anxiety Inventory (BAI) was administered to each patient before they were brought to the endoscopy unit. Subsequently, each patient who underwent EGD was telephoned on the seventh day after the procedure and the BAI was administered a second time. RESULTS Women population had higher pre-EGD and post-EGD BAI scores compared to men. No significant correlation was observed between educational background and BAI scores. Possible correlations between age, BMI, Charlson comorbidity index (CCI), and BAI scores were examined. There was a weak correlation between BMI and pre-EGD and post-EGD BAI scores. A strong and positive correlation was observed between the pre-EGD BAI score and post-EGD BAI and difference in BAI scores between groups (ΔBAI). CONCLUSION Endoscopic procedures may cause anxiety in patients as with all other invasive procedures. Patients' compliance with the procedure and having a lower level of anxiety are very significant for diagnostic and, if necessary, therapeutic success. In this study, the patient gender was evaluated as a predictor of anxiety level, whereas educational background was not a predictor.
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Affiliation(s)
- Burak Uçaner
- Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Mehmet Zeki Buldanli
- Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Şebnem Çimen
- Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sabri Çiftçi
- Department of General Surgery, Sincan Training and Research Hospital, Ankara, Turkey
| | - Mehmet Mert Demircioğlu
- Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Ela Erten
- Department of Anaesthesiology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Oğuz Hançerlioğullari
- Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
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Albayrak T, Torun Göktaş A, Eyüpoğlu S, Muhtaroğlu A, Dulger AC. Patient Anxiety in Endoscopy: A Comparative Analysis of Single vs. Dual Procedure Effects. Cureus 2024; 16:e57237. [PMID: 38686224 PMCID: PMC11056767 DOI: 10.7759/cureus.57237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
AIM This study aimed to investigate the difference in anxiety levels between patients undergoing gastroscopy only and those subjected to both gastroscopy and colonoscopy. Despite known preoperative anxiety impacts, no prior research has compared these specific patient groups. MATERIALS AND METHODS A total of 150 patients were divided equally into two groups: Group I, undergoing gastroscopy only, and Group II, undergoing gastroscopy and colonoscopy. Inclusion criteria were patients in the age range 18-70 years and having an ASA (American Society of Anesthesiologists) physical status classification of I-III. Exclusion criteria were patients outside the age range, and patients with hearing disorders, psychiatric disorders, dementia, or recent anxiolytic drug use. Anxiety was analysed using the Beck Anxiety Inventory Scale before procedures, without any premedication. RESULTS Patients in Group II had significantly higher anxiety levels, with particular increases noted in symptoms such as leg weakness and tremors, inability to relax, and fears of adverse events and death. These results highlighted a considerable elevation in anxiety among patients anticipating or undergoing combined endoscopic procedures. DISCUSSION The findings revealed that undergoing combined gastroscopy and colonoscopy procedures significantly elevated patient anxiety levels compared to gastroscopy alone. This suggests a critical need for healthcare providers to implement more strong preoperative counselling and anxiety reduction strategies for patients facing multiple procedures. Addressing this increased anxiety could lead to better patient experiences, reduced procedural complications, and improved satisfaction and outcomes.
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Affiliation(s)
- Tuna Albayrak
- Department of Anesthesiology and Reanimation, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ayşegül Torun Göktaş
- Department of Anesthesiology and Reanimation, Giresun İlhan Özdemir State Hospital, Giresun, TUR
| | - Selin Eyüpoğlu
- Department of Anesthesiology and Critical Care, Giresun Training and Research Hospital, Giresun, TUR
| | - Ali Muhtaroğlu
- Department of General Surgery, Giresun University Faculty of Medicine, Giresun, TUR
| | - Ahmet Cumhur Dulger
- Department of Gastroenterology, Giresun University Faculty of Medicine, Giresun, TUR
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3
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Aksu Ç. Effects of Music on Anxiety, Pain, and Comfort in Patients Undergoing Upper Endoscopy: A Randomized Clinical Trial. Gastroenterol Nurs 2023; 46:428-435. [PMID: 37678807 DOI: 10.1097/sga.0000000000000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 07/20/2023] [Indexed: 09/09/2023] Open
Abstract
Although upper gastrointestinal endoscopy is an important diagnostic procedure in the detection of diseases, it can cause discomfort and anxiety in patients. This study is a randomized controlled trial conducted to determine the effects of listening to music on the anxiety, pain, and comfort levels of patients undergoing upper gastrointestinal endoscopy. The patients were randomly divided into the intervention group ( n = 40), who listened to music for 45 minutes before upper gastrointestinal endoscopy, and the control group ( n = 40), which did not receive any intervention other than routine nursing care. It was observed that the pain and anxiety levels of the patients who listened to music before the procedure decreased, and their comfort levels and ease of the procedure increased. In order to reduce the pain and anxiety of patients who will undergo upper gastrointestinal endoscopy, increase the success of the procedure, and facilitate patient-doctor cooperation, encouraging patients to listen to music while awaiting the procedure can be effective.
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Affiliation(s)
- Çiǧdem Aksu
- Çiǧdem Aksu, is Assistant Professor at Department of Nursing, Faculty of Health Science, Gaziantep Islamıc Science and Technology University, Gaziantep, Turkey
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Profit DD. Describing and Predicting Preprocedural Anxiety in Patients Scheduled for Advanced Gastrointestinal Endoscopy During the COVID-19 Pandemic. Gastroenterol Nurs 2023; 46:475-488. [PMID: 37639614 DOI: 10.1097/sga.0000000000000766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/26/2023] [Indexed: 08/31/2023] Open
Abstract
Advanced gastrointestinal endoscopy includes a group of specialized procedures and interventions that are being performed more frequently, with little attention given to a patient's preprocedural anxiety issues. Compounding this concern, in 2020 the COVID-19 pandemic resulted in the delay of many endoscopy cases. It is unknown how this affected the anxiety of patients preparing for advanced endoscopy procedures. Patients with higher anxiety require higher doses of anesthetic medications, and experience increased pain and decreased satisfaction. The purpose of this study was to describe the biological, psychological, and social attributes of patients and identify whether social support, COVID-19-related anxiety, delay of procedure, patient's physical status, and procedural indication category were predictors of state anxiety levels in patients undergoing advanced gastrointestinal endoscopy during the COVID-19 pandemic. The research study was a cross-sectional descriptive design with 90 patients. Patients were classified into low state and high state anxiety groups. Fifty-eight percent of patients had high state anxiety scores. Using logistic regression, social support was identified as a predictor of preprocedural anxiety (odds ratio [OR] = 0.318 [95% confidence interval, CI = 0.170, 0.597, p < .001]) as less social support was associated with higher anxiety. It is imperative that strategies to maximize social support are reinforced.
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Affiliation(s)
- Dawn Donahue Profit
- Dawn Donahue Profit, PhD, RN, is Staff Development Specialist, Nursing Staff Development, UK HealthCare, Lexington, Kentucky
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Cakir SK, Evirgen S. Three Distraction Methods for Pain Reduction During Colonoscopy: A Randomized Controlled Trial Evaluating the Effects on Pain and Anxiety. J Perianesth Nurs 2023; 38:e1-e7. [PMID: 37565937 DOI: 10.1016/j.jopan.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE The aim of this study was to compare the effects of distraction methods on pain, anxiety, and satisfaction during a colonoscopy. DESIGN This experimental research was conducted as a single-center, randomized, parallel-group trial. METHODS A total of 120 patients were recruited and randomized into 4 groups (music, stress ball, audiovisual distraction, and control). The data were collected using individual an identification form, observation form, the Visual Analog Scale, and the State-Trait Anxiety Inventory. FINDINGS Pain severity during colonoscopy was found to be lower in the intervention (music and audiovisual distraction) groups compared to the stress ball and control groups (P < .001).There was no statistically significant difference between the pre- and postanxiety levels in the intervention groups compared to the control group. After the colonoscopy, satisfaction levels were significantly higher in the music group compared to the audiovisual, control, and stress ball groups (P < .001). CONCLUSIONS Distraction methods used during colonoscopy were found to reduce pain. Although sedation is widely used during a colonoscopy procedure and is accepted as a general standard, music and VR can be used as effective alternative strategies in reducing pain for colonoscopy patients.
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Affiliation(s)
- Selda Karaveli Cakir
- Nursing Department, Health Science Faculty, Kastamonu University, Kastamonu, Turkey.
| | - Sami Evirgen
- Division of Gastroenterology, Department of Internal Medicine, Kastamonu University, Medical School, Kastamonu, Turkey
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Yu X, Deng H, Xiong Z, Gong P, Ye M, Liu T, Long X, Tian L. A scale to measure the worry level in Gastrointestinal Endoscopy with sedation: Development, reliability, and validity. Int J Clin Health Psychol 2023; 23:100410. [PMID: 37701761 PMCID: PMC10493257 DOI: 10.1016/j.ijchp.2023.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
Objective This study aims to develop a scale to measure the worry level of patients who will undergo gastrointestinal (GI) endoscopy with deep sedation, and to provide scientific references to alleviate their worries. Method Based on literature review, panel discussion, patient interview and expert consultation, we developed the first version of the scale. After two pre-investigations, the formal version of the scale was formed, and the reliability and validity were tested on 1389 respondents. Reliability was assessed by Cronbach's alpha. Construct validity was tested by confirmatory factor analysis (CFA) and the Spearman correlations analysis. Results The scale was composed of four dimensions: financial and time costs, sedation, examination, and psychology. It has 15 items. Reliability and validity were acceptable. The Cronbach's alpha of the whole scale was 0.959 and all the factor loadings were > 0.50. The Spearman correlations of the inter-dimensions ranged from 0.614 to 0.836, and the correlation coefficients between the dimensions and the total score were 0.795 to 0.957. The correlation coefficient between the total scale score and the APAIS was 0.833. Conclusions This scale has good validity and reliability, which is useful for physicians and medical institutions to take appropriate measures to reduce patients' worries.
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Affiliation(s)
- Xiaoyu Yu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Haijun Deng
- School of Mathematics and Statistics, Guizhou University of Finance and Economics in Guizhou, China
| | - Ziyi Xiong
- Central South University in Changsha, China
| | - Pan Gong
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Mingmei Ye
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Tao Liu
- Central South University in Changsha, China
| | - Xiuyan Long
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Li Tian
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
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Ramalingam R, Senthamizhselvan K, Harichandrakumar KT, Mohan P. Effect of Premedication with Glycopyrrolate on Patient Tolerance and Procedure Outcomes in Patients Undergoing Unsedated Upper Gastrointestinal Endoscopy: A Randomized Placebo-controlled Trial. Euroasian J Hepatogastroenterol 2023; 13:55-60. [PMID: 38222964 PMCID: PMC10785133 DOI: 10.5005/jp-journals-10018-1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/05/2023] [Indexed: 01/16/2024] Open
Abstract
Background and aim An optimal topical pharyngeal anesthesia (TPA) is required for better patient tolerance and procedural outcomes of an unsedated upper gastrointestinal endoscopy (UGIE). Several additional strategies have been tried to improve patient tolerance with limited success. We hypothesized that premedication with glycopyrrolate would enhance TPA and improve patient tolerance and procedural outcomes of an unsedated UGIE. Materials and methods We conducted a randomized, double-blind, placebo-controlled trial between July 2020 and May 2022. Consecutive patients undergoing unsedated UGIE were randomly assigned to receive either intravenous glycopyrrolate or a placebo 30 minutes before TPA. Patient tolerance, comfort level for the endoscopist, cardiorespiratory fluctuations, percentage of failed esophageal intubation, and incomplete examination were studied. Results 380 patients were randomized to 190 in each arm. The median (IQR) VAS scores for the overall patient satisfaction in the glycopyrrolate and placebo groups were 8 (1) and 7 (2), respectively (p = 0.04). The median (IQR) VAS scores for endoscopist assessment of patient cooperation in the glycopyrrolate and placebo groups were 8 (1.3) and 8 (1), respectively (p = 0.04). There was no difference in the percentage of failed esophageal intubation and incomplete examination, fluctuations in heart rate, and oxygen saturation of the participants. However, the mean arterial pressure (MAP) on-table before the start of the procedure at 1 minute and 3 minutes was significantly higher in the glycopyrrolate group (p = 0.01, 0.01, and 0.04, respectively). Conclusion In unsedated UGIE, glycopyrrolate premedication significantly improves the patient tolerance and endoscopist's comfort, with minimal cardiorespiratory effects. Hence, it could be incorporated into day-care unsedated endoscopy practice.Trial registration - CTRI/2020/07/026786. How to cite this article Ramalingam R, Senthamizhselvan K, Harichandrakumar KT, et al. Effect of Premedication with Glycopyrrolate on Patient Tolerance and Procedure Outcomes in Patients Undergoing Unsedated Upper Gastrointestinal Endoscopy: A Randomized Placebo-controlled Trial. Euroasian J Hepato-Gastroenterol 2023;13(2):55-60.
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Affiliation(s)
- Rajendiran Ramalingam
- Department of Medical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Kuppusamy Senthamizhselvan
- Department of Medical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - KT Harichandrakumar
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Pazhanivel Mohan
- Department of Medical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Shafa A, Abediny R, Shetabi H, Shahhosseini S. The Effect of Preoperative Combined with Intravenous Lidocaine and Ketamine vs. Intravenous Ketamine on Pediatric Patients Undergoing Upper Gastrointestinal Endoscopy. Anesth Pain Med 2023; 13:e130991. [PMID: 37645009 PMCID: PMC10461382 DOI: 10.5812/aapm-130991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 08/31/2023] Open
Abstract
Background Ketamine is widely used in pediatric sedation. New studies have recommended combination therapy to reduce the side effects of ketamine. Objectives This study investigated the effect of adding intravenous (IV) lidocaine to ketamine on hemodynamic parameters, endoscopist satisfaction, and recovery time of children undergoing gastrointestinal endoscopy. Methods This triple-blind, randomized, controlled clinical trial was conducted in Isfahan, Iran (2021). One hundred twenty children between the ages of 1 and 6 were enrolled. Patients were divided into 2 groups. The intervention group received 1.0 mg/kg of IV lidocaine and 1.0 mg/kg of IV ketamine, and the placebo group received 1.0 mg/kg of IV ketamine and placebo 2 minutes before entering the endoscopic room. Patients in both groups were sedated with 1.0 mg/kg of propofol, 0.1 mg/kg of midazolam, and 2.0 ug/kg of fentanyl for the procedure. The pulse rate, mean arterial pressure (MAP), respiratory rate, and oxygen saturation were recorded 1 minute before injection and every 5 minutes afterward. Results The mean (SD) ages of the intervention and control groups were 3.4 (1.5) and 3.4 (1.7), respectively. The mean difference in hemodynamic parameters between the 2 groups was insignificant during the investigation (P > 0.05). Furthermore, no significant differences were found regarding endoscopist satisfaction scores and length of recovery room stay (P > 0.05). Conclusions Adding low-dose IV lidocaine to ketamine for pediatric sedation does not significantly affect the hemodynamic status, endoscopist satisfaction, and recovery time.
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Affiliation(s)
- Amir Shafa
- Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Abediny
- Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Shetabi
- Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sedighe Shahhosseini
- Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
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9
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Sun DJ, You YX, He XJ, Li HT, Zeng XP, Li DZ, Wang W. Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: A randomized controlled trial. Medicine (Baltimore) 2022; 101:e32339. [PMID: 36595974 PMCID: PMC9803447 DOI: 10.1097/md.0000000000032339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Colonoscopy is the main kind of way to detect and treat diseases about large intestine, but during the examination and preparation, these 2 processes are able to lead abdominal pain, abdominal distention and other discomfort feel, which will cause patients to refuse the examination and become anxious. Painless and sedative endoscopy may reduce discomfort of patients, but there is a risk of adverse effects. Many studies have shown that playing music during colonoscopy can reduce discomfort and increase acceptance of colonoscopy, but the conclusion remains controversial. The 3 approaches of random, single-blind, controlled method were used to investigate the interventions effects of piano light music on satisfaction, anxiety and pain in patients undergoing colonoscopy. METHODS A total of 216 patients were randomly divided into piano music group (n = 112, piano music played during colonoscopy) and control group (n = 104, no music during colonoscopy) to compare patients satisfaction, anxiety score, pain score, vital signs, endoscopic difficulty score, and willingness to undergo colonoscopy again. RESULTS There were no significant differences in vital signs, pre-colonoscopic state anxiety score, and trait anxiety score before and after colonoscopy, and willingness to undergo colonoscopy again between the 2 groups (P > .05). The difficulty of colonoscopy operation and the score of state anxiety after colonoscopy in the piano group were lower than those in the control group (P < .05), and the satisfaction of colonoscopy process, pain management and overall service satisfaction were better than those of the control group (P < .05), and they were more likely to listen to music in the next examination (P < .001). CONCLUSION The light music played by piano can relieve patients' anxiety, improve the satisfaction of colonoscopy process, pain management and service satisfaction, reduce the difficulty of colonoscopy, which have no obvious adverse reactions. Therefore, it is worthy of promotion.
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Affiliation(s)
- Dong-Jie Sun
- Department of Digestive Diseases, Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Yi-Xiang You
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Jian He
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Hai-Tao Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Xiang-Peng Zeng
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Da-Zhou Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Wen Wang
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
- * Correspondence: Wen Wang, Department of Digestive Diseases, The Fuzong Clinical Medical College, Fujian Medical University, 156 North Road of West No.2 Ring, Fuzhou 350025, China (e-mails: )
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Choi YJ, Park EJ, Lee YM, Kim SC, Kang B, Lee KJ, Jang HJ, Lee EH, Kim JY, Choi SY, Jin Kim H, Kang Y, Choe BH, Lee J, Yi DY. Effects of anxiety on sedation among pediatric patients undergoing esophagogastroduodenoscopy. Clin Child Psychol Psychiatry 2022; 27:793-803. [PMID: 35452583 DOI: 10.1177/13591045221096308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated whether the severity of anxiety among children undergoing endoscopy could affect sedation. We prospectively recruited patients under 18 years of age who were scheduled to undergo esophagogastroduodenoscopy (EGD). Baseline anxiety was evaluated using the Spence Children's Anxiety Scale (SCAS). Our analysis considered the type and dose of sedative drugs, degree of sedation, and complications associated with sedation according to the scale score. The mean total SCAS T-scores and each subscale score were significantly higher in the 6-12-year age group. The mean T-score among patients who exhibited irritability during EGD was higher than that among other patients, with significant differences in the Total, Obsessive Disorder, Panic Agoraphobia and General Anxiety subscales. The midazolam doses of children exhibiting irritability were more likely to need higher (p = 0.006). Other sedation-related complications were not associated with the T-scores in each subscale. Total sleep time was not associated with any T-score subscales. Anxiety levels were significantly higher among 6-12-year-olds and children exhibiting irritability. Anxiety was often associated with irritability, difficulties achieving adequate sedation during EGD, and additional sedative drug administration. We recommend higher doses or more potent drugs to facilitate endoscopy for children with high anxiety levels.
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Affiliation(s)
- You Jin Choi
- Department of Pediatrics, 119750Inje University Ilsan Paik Hospital, Republic of Korea.,119750Inje University College of Medicine, Republic of Korea
| | - Eun Jin Park
- Department of Psychiatry, 119750Inje University Ilsan Paik Hospital, Republic of Korea
| | - Yoo Min Lee
- Department of Pediatrics, 26730Soonchunhyang University Bucheon Hospital, Republic of Korea.,26730Soonchunhyang University College of Medicine, Republic of Korea
| | - Soon Chul Kim
- Department of Pediatrics, 90158Jeonbuk National University Medical School, Republic of Korea.,90158Jeonbuk National University Hospital, Republic of Korea
| | - Ben Kang
- Department of Pediatrics, School of Medicine, 65672Kyungpook National University, Republic of Korea
| | - Kyung Jae Lee
- Department of Pediatrics, 158781Hallym University Sacred Heart Hospital, Republic of Korea.,158781Hallym University College of Medicine, Republic of Korea
| | - Hyo-Jeong Jang
- Department of Pediatrics, 65673Keimyung University School of Medicine Dongsan Medical Center, Republic of Korea
| | - Eun Hye Lee
- Department of Pediatrics, 65401Nowon Eulji Medical Center, Republic of Korea.,65401Eulji University School of Medicine, Republic of Korea
| | - Ju Young Kim
- Department of Pediatrics, 65401Eulji University Hospital, Republic of Korea
| | - So Yoon Choi
- Department of Pediatrics, 65366Kosin University Gospel Hospital, Republic of Korea.,65366Kosin University College of Medicine, Republic of Korea
| | - Hyun Jin Kim
- Department of Pediatrics, 65409Chungnam National University Hospital, Republic of Korea
| | - Yunkoo Kang
- Department of Pediatrics, 37974Yonsei University Wonju College of Medicine, Republic of Korea
| | - Byung-Ho Choe
- Department of Pediatrics, School of Medicine, 65672Kyungpook National University, Republic of Korea
| | - Jeewon Lee
- 26730Soonchunhyang University College of Medicine, Republic of Korea.,Department of Neuropsychiatry, 26730Soonchunhyang University Bucheon Hospital, Republic of Korea
| | - Dae Yong Yi
- Department of Pediatrics, 26729Chung-Ang University Hospital, Republic of Korea.,College of Medicine, 26729Chung-Ang University, Republic of Korea
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11
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Chen YJ, Yang CC, Chen ML, Liou YF, Li CR, Chen PY, Chiang HH. Effects of music on anxiety and physiological responses in patients before gastroscopy. JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/jmedsci.jmedsci_190_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Brajer-Luftmann B, Mardas M, Stelmach-Mardas M, Lojko D, Batura-Gabryel H, Piorunek T. Association between Anxiety, Depressive Symptoms, and Quality of Life in Patients Undergoing Diagnostic Flexible Video Bronchoscopy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910374. [PMID: 34639674 PMCID: PMC8507624 DOI: 10.3390/ijerph181910374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 11/26/2022]
Abstract
Bronchoscopy is one of the basic invasive procedures in pulmonology accompanied by patients’ anxiety. This study aimed to find an association between predictors of state anxiety/depression and patient’s quality of life (QOL) with pulmonary symptoms undergoing diagnostic flexible video bronchoscopy (FVB). A total of 125 adult patients before FVB were included in a prospective observational study. The quality of life (QOL) was assessed by WHOQOL-BREF questionnaire, the depression possibility by the Beck’s Depression Inventory-II (BDI-II), and the anxiety level by Spielberger’s State-Trait Anxiety Inventory (STAI-S; STAI-T). Results show that the older patients and patients with more comorbidities showed a significantly higher anxiety level. The previous FVB under deep sedation significantly reduced state anxiety. A significantly positive association was found between the STAI score and total BDI-II score. More severe symptoms of anxiety were especially related to lower QOL (physical health, psychological and environmental domains) in patients. Statistically higher trait anxiety in lower social QOL domain scores was observed. Our findings show that high state and trait anxiety were associated with higher depression scores and lower quality of life in the elderly. It seems that the elderly and patients at risk of depression development require more attention in the clinical setting to minimize the anxiety accompanying the bronchoscopy.
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Affiliation(s)
- Beata Brajer-Luftmann
- Department of Pulmonology, Allergology and Pulmonary Oncology, Poznan University of Medical Sciences, Szamarzewskiego 84 Street, 60-569 Poznan, Poland; (H.B.-G.); (T.P.)
- Correspondence: ; Tel.: +48-61-841-70-61
| | - Marcin Mardas
- Department of Oncology, Poznan University of Medical Sciences, Szamarzewskiego 84 Street, 61-569 Poznan, Poland;
| | - Marta Stelmach-Mardas
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego 84 Street, 61-569 Poznan, Poland;
| | - Dorota Lojko
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Szpitalna 27/33 Street, 61-701 Poznan, Poland;
| | - Halina Batura-Gabryel
- Department of Pulmonology, Allergology and Pulmonary Oncology, Poznan University of Medical Sciences, Szamarzewskiego 84 Street, 60-569 Poznan, Poland; (H.B.-G.); (T.P.)
| | - Tomasz Piorunek
- Department of Pulmonology, Allergology and Pulmonary Oncology, Poznan University of Medical Sciences, Szamarzewskiego 84 Street, 60-569 Poznan, Poland; (H.B.-G.); (T.P.)
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Is the choice of anesthesia during gastrointestinal endoscopic procedures a result of anxiety? Arab J Gastroenterol 2021; 22:56-60. [PMID: 33551348 DOI: 10.1016/j.ajg.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/08/2020] [Accepted: 09/08/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND STUDY AIMS Esophagogastroduodenoscopy (EGD) and colonoscopy (CS) are vital endoscopic procedures in the diagnosis and follow-up of gastrointestinal tract diseases. Endoscopic procedures can be performed with or without anesthesia as per patient preferences. These procedures can cause some anxiety in almost all patients, and the degree of anxiety differs for each individual. Thus, we aimed to evaluate the trait and state anxiety levels of the patients and assess the relationship between the preference of anesthesia and anxiety levels. PATIENTS AND METHODS To investigate this issue, 723 patients who underwent elective endoscopy (EGD and/or CS) were enrolled. The researchers collected sociodemographic data and medical history records as reported by the patients. State and trait anxiety levels of the patients were evaluated using the State and Trait Anxiety Inventory (STAI). RESULTS The patients were divided into two groups as with anesthesia and without anesthesia. Of the respondents, 43.4% requested anesthesia during endoscopic procedure. Sociodemographic data, except sex, showed similar characteristics. The STAI trait scores of the two groups were similar; however, there was a significant difference in the STAI state scores of the groups (p = 0.018). A significant difference was observed in the anesthesia preference and the type of endoscopic procedure (EGD, CS, or both) (p < 0.001). Type of endoscopic procedure, STAI state scores, and sex were determined as the predictors of the anesthesia choice. CONCLUSION Endoscopic procedures are known to cause anxiety among many patients. Our findings suggest that the anesthesia preferences of patients are an important factor in preventing these situational concerns. However, this study found that being a woman and undergoing a CS procedure are important factors related to anesthesia preferences. Thus, more detailed assessments on this subject are required.
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Yang SM, Yi DY, Choi GJ, Lim IS, Chae SA, Yun SW, Lee NM, Kim SY, Choi ES. Effects of Sedation Performed by an Anesthesiologist on Pediatric Endoscopy: a Single-Center Retrospective Study in Korea. J Korean Med Sci 2020; 35:e183. [PMID: 32476304 PMCID: PMC7261697 DOI: 10.3346/jkms.2020.35.e183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Endoscopy is used for diagnosing and treating various digestive diseases in children as well as in adults. However, in pediatric patients, it is recommended that sufficient sedation should be ensured before conducting endoscopy, since insufficient sedation may cause serious complications. However, in Korea, no studies have yet described the types of sedation drugs, effects of sedation, and efficiency of endoscopy with respect to the sedation instructor. Thus, we investigated the effectiveness of sedative procedures performed by anesthesiologists. METHODS We retrospectively reviewed the medical records of patients aged < 18 years who underwent endoscopy during March 2014-July 2019. Data of sedation instructors, sedation drugs and their doses, complications, and the recovery after sedation were evaluated. RESULTS Of 257 patients, 217 underwent esophagogastroduodenoscopy (EGD) and 40 underwent colonoscopies. Before EGD, 29 patients (13.4%) underwent sedation by the pediatric endoscopist and 188 (86.6%) were sedated by the anesthesiologist. The anesthesiologist performed the sedation for all 40 patients who underwent colonoscopy. Endoscopic examinations performed by the anesthesiologist were relatively more time-consuming (401.0 ± 135.1 seconds vs. 274.9 ± 106.1 seconds, P < 0.001). We observed that in patients who underwent EGD, there was a difference in the dose of midazolam administered (P = 0.000). When comparing EGD and colonoscopy in patients undergoing sedation by the anesthesiologist, there were no significant differences in the doses of midazolam and ketamine, but the dose of propofol increased for colonoscopy (2.50 ± 0.95 mg/kg vs. 4.71 ± 1.66 mg/kg, P = 0.000). The cognitive recovery time according to drug dose was associated with propofol only in EGD with a shorter endoscopy time. The longer cognitive recovery time in colonoscopy and the discharge time of EGD and colonoscopies were not associated with propofol use. CONCLUSION When sedation is performed by an anesthesiologist, various drugs are used with sufficient doses and complications are reduced, but the discharge time does not change. For performing pediatric endoscopy in Korea, anesthesiologists should be considered for inducing anesthesia.
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Affiliation(s)
- Sung Min Yang
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
| | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea.
| | - Geun Joo Choi
- Department of Anesthesiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - In Seok Lim
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Soo Ahn Chae
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sin Weon Yun
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Na Mi Lee
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
- Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea
| | - Su Yeong Kim
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea
| | - Eung Sang Choi
- Department of Pediatrics, Hanil General Hospital, Seoul, Korea
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Mari A, Khoury T, Mahajnah M, Kadah A, Ahmad HS, Baker FA, Pellicano R, Mahamid M, Sbeit W. Pre-endoscopic tachycardia predicts increased sedation dose and lower adenoma detection rate in patients undergoing endoscopic procedures: a case control study. Minerva Med 2020; 111:115-119. [PMID: 32166934 DOI: 10.23736/s0026-4806.20.06468-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Tachycardia prior to endoscopic procedures is commonly encountered which reflect patient anxiety status. Despite this frequent occurrence, it is unclear if in a patient with tachycardia sedation dose should be modified. The aim of our study was to assess the effect of pre-endoscopic tachycardia on sedation dose. METHODS A retrospective analysis of all patients who underwent upper endoscopy and colonoscopy at EMMS Nazareth hospital were performed. We excluded patients with diseases and medications affecting the heart rate. RESULTS A total of 2855 patients were included in the study. Two-hundred and thirty-seven patients had tachycardia before endoscopy (8.3%, group A) as compared to 2618 (group B) patients who had heart rate ≤100 beats per minute. The mean dosage of propofol in group A was significantly higher (62.6±33.2 mg vs. 57.4±29.9 mg) than in group B (P=0.01). There was no difference in the cecal intubation rate among the two groups (P=0.9). Notably, the adenoma detection rate was significantly lower among group A patients as compared to group B (13.6% vs. 22.8%, P=0.02) patients. There were no sedation related complications. CONCLUSIONS Tachycardia prior to endoscopic procedures was associated with higher sedative dosage and lower adenoma detection rate, however no major complications were recorded. These data should be taken into consideration to optimize procedure quality.
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Affiliation(s)
- Amir Mari
- Unit of Gastroenterology and Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel - .,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel -
| | - Tawfik Khoury
- Unit of Gastroenterology and Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.,Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel
| | - Muhammad Mahajnah
- Department Internal Medicine, Hillel Yaffe Medical Center, Hadera, Israel.,The Faculty of Medicine Technion, Haifa, Israel
| | - Anas Kadah
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.,Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel
| | - Helal S Ahmad
- Unit of Gastroenterology and Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Fadi A Baker
- The Faculty of Medicine Technion, Haifa, Israel.,Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel
| | | | - Mahmud Mahamid
- Unit of Gastroenterology and Endoscopy, The Nazareth Hospital, EMMS, Nazareth, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.,Department of Gastroenterology, Sharee Zedek Medical Center, Jerusalem, Israel
| | - Wisam Sbeit
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.,Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel
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Çelebi D, Yılmaz E, Şahin ST, Baydur H. The effect of music therapy during colonoscopy on pain, anxiety and patient comfort: A randomized controlled trial. Complement Ther Clin Pract 2020; 38:101084. [DOI: 10.1016/j.ctcp.2019.101084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 02/07/2023]
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Naseri-Salahshour V, Taher M, Karimy M, Abedi A, Fayazi N, Sajadi M, Abredari H. The effect of presence of family members on the anxiety level of candidates for esophagogastroduodenoscopy: A randomized controlled trial. Med J Islam Repub Iran 2019; 33:62. [PMID: 31456986 PMCID: PMC6708088 DOI: 10.34171/mjiri.33.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Indexed: 12/12/2022] Open
Abstract
Background: Anxiety and its control is a public health problem worldwide. This study was conducted to determine the effect of family members' presence on the anxiety level of patients who were candidates for esophagogastroduodenoscopy (EGD). Methods: This randomized controlled trial study was performed in Shahid Chamran hospital in city of Saveh in IR Iran. In this study, 96 patients who were candidates for EGD and met the inclusion criteria were assigned into control and intervention groups by simple random sampling method. The demographic questionnaire and Spiel Berger's State and Trait Anxiety Questionnaire (STAI) were used to measure anxiety. Results: No significant difference was found between the 2 groups in the mean level of anxiety before intervention (p= 0.13). After intervention, the level of anxiety decreased significantly in the intervention group (p= 0.001). However, the mean level of anxiety was not significant in the control group after intervention (p= 0.09). Conclusion: The results of the present study showed that the presence of family members during endoscopy may reduce the patient's anxiety level, and thus it is recommended as a non-pharmaceutical, beneficial, and safe intervention.
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Affiliation(s)
- Vahid Naseri-Salahshour
- Medical-Surgical Nursing Department, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Taher
- Medical-Surgical Nursing Department, School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
| | - Mahmood Karimy
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ahmadreza Abedi
- Traditional and Complementary Medicine Research Center (TCMRC), Medical-Surgical Nursing Department, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Neda Fayazi
- Critical Care Nursing Department, School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
| | - Mahbobeh Sajadi
- Pediatrics Nursing Department, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Hamid Abredari
- Medical-Surgical Nursing Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Abstract
AIMS: Flexible bronchoscopy is a common procedure performed in pulmonary medicine, critical care, and thoracic surgery. In this study, we aimed to assess the prevalence and predictors of anxiety in patients undergoing diagnostic bronchoscopy. METHODS: This is a prospective study conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. All patients undergoing diagnostic bronchoscopy filled the State-Trait Anxiety Inventory questionnaire before the procedure. Bronchoscopy was performed either through the mouth or the nose, based on the bronchoscopist preference. Lidocaine (1%–2%) spray was used for administering topical anesthesia. Results were collected, and statistical analysis was performed using t-test to measure statistically significant (P < 0.05). RESULTS: A total of 117 patients participated in this study. High anxiety score was found in 45% of the patients. Older patients significantly showed higher anxiety score than younger patients (53 years vs. 46 years, P = 0.034). Similarly, patients with higher body mass index (BMI) showed a statistically significant increase in anxiety score (28 vs. 25, P = 0.041). Premedication with pethidine significantly reduced the anxiety levels (26.9% vs. 73.1%, P = 0.031). Logistic regression demonstrated that old age and outpatient settings were significant predictors of higher anxiety scores. CONCLUSION: Diagnostic bronchoscopy can cause high anxiety in many patients. Prebronchoscopy anxiety assessment can help bronchoscopists to anticipate the anxiety levels of patients, and then further use it to tailor sedation requirements. Special attention should be given to older patients, patients with high BMI, and the ones undergoing bronchoscopy in outpatient settings.
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Affiliation(s)
- Ahmed A Aljohaney
- Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Yang C, Sriranjan V, Abou‐Setta AM, Poluha W, Walker JR, Singh H. Anxiety Associated with Colonoscopy and Flexible Sigmoidoscopy: A Systematic Review. Am J Gastroenterol 2018; 113:1810-1818. [PMID: 30385831 PMCID: PMC6768596 DOI: 10.1038/s41395-018-0398-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 10/06/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Addressing procedure-related anxiety should improve adherence to colorectal cancer screening programs and diagnostic colonoscopy. We performed a systematic review to assess anxiety among individuals undergoing colonoscopy or flexible sigmoidoscopy (FS). METHODS We searched multiple electronic databases for studies evaluating anxiety associated with colonoscopy or FS published from 2005 to 2017. Two reviewers independently identified studies, extracted data, and assessed study quality. The main outcomes were the magnitude of pre-procedure anxiety, types of concerns, predictors of anxiety, and effectiveness of anxiety-lowering interventions in individuals undergoing lower endoscopy. The protocol was prospectively registered in PROSPERO. RESULTS Fifty-eight studies (24,490 patients) met the inclusion criteria. Patients undergoing colonoscopy had a higher mean level of anxiety than that previously reported in the general population, with some studies reporting more than 50% of patients having moderate-to-severe anxiety. Areas of anxiety-related concern included bowel preparation, difficulties with the procedure (embarrassment, pain, possible complications, and sedation), and concerns about diagnosis; including fear of being diagnosed with cancer. Female gender, higher baseline anxiety, functional abdominal pain, lower education, and lower income were associated with greater anxiety prior to colonoscopy. Providing higher-quality information before colonoscopy, particularly with a video, shows promise as a way of reducing pre-procedure anxiety but the studies to date are of low quality. CONCLUSIONS A large proportion of patients undergoing colonoscopy report anxiety before the procedure. Improvement in pre-procedure information delivery and evaluation of approaches to reduce anxiety is required, especially for those with predictors of pre-procedure anxiety.
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Affiliation(s)
- Chengyue Yang
- 1Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Vaelan Sriranjan
- 2Faculty of Science, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ahmed M. Abou‐Setta
- 3George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - William Poluha
- 4Sciences and Technology Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - John R. Walker
- 5Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harminder Singh
- 1Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Erkılınç S, Aksoy Kala N, Kuru Pekcan M, Güzel Aİ, Çınar M, Yılmaz N. The effect of a pre-procedure information video on anxiety levels in patients undergoing hysterosalpingography: A prospective case-control study. J Turk Ger Gynecol Assoc 2018; 19:137-141. [PMID: 29588258 PMCID: PMC6085530 DOI: 10.4274/jtgga.2017.0118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To evaluate the effect of a pre-procedural information video on anxiety levels in patients undergoing hysterosalpingography (HSG). Material and Methods: Among a total of 131 primary or secondary infertile patients, 66 were shown an information video and 67 control patients received standard care between August 2014 and January 2016. The video included information on the procedure, personnel, and the room for the procedure; the video was shown on the morning of the procedure. Patients were randomized using the complete randomization technique through which patients were included in the study and control groups week by week, randomly. The Beck Anxiety Inventory scale was conducted to the patients one hour before the procedure Results: There were no differences in demographic data. The history of previous gynecologic operations was higher in the control group. The Beck Anxiety score was significantly lower in the study group compared with the control group (6 vs 10). Conclusion: Our findings suggest that as an easy intervention to implement, a pre-procedural video education may be a beneficial tool for the management of HSG-related anxiety.
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Affiliation(s)
- Selçuk Erkılınç
- Clinic of Gynecologic Oncology, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Nazlı Aksoy Kala
- Clinic of Gynecology and Obstetrics, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Tukey
| | - Meryem Kuru Pekcan
- Clinic of Gynecology and Obstetrics, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Tukey
| | - Ali İrfan Güzel
- Clinic of Gynecology and Obstetrics, University of Health Sciences, Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
| | - Mehmet Çınar
- Clinic of Gynecology and Obstetrics, University of Health Sciences, Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
| | - Nafiye Yılmaz
- Clinic of Gynecology and Obstetrics, University of Health Sciences, Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey
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