DOES ANXİETY AND DEPRESSION BEFORE ENDOMETRİAL BIOPSY İNCRİASE PAİN PERCEPTİON?

Year 2024, Volume: 25 Issue: 3, 322 - 327, 18.07.2024

Fatih Çelik Ayşe Yalçınkaya Yılmaz

https://doi.org/10.18229/kocatepetip.1374056

Abstract

OBJECTIVE: The aim of this study is to determine the effect of pre-procedure anxiety and depression levels on pain perception in women undergoing endometrial curettage and to investigate the possible factors contributing to pain perception in these women.
MATERIAL AND METHODS: In this study, 82 premenopausal women who underwent endometrial curettage due to abnormal uterine bleeding were reviewed. The Turkish version of the Hospital Anxiety and Depression Scale (HADS) was used to assess the psychological status of the participants. Patients were asked to evaluate the pain they felt during the procedure and 60 minutes after the procedure by using a visual analog scale.
RESULTS: The VAS (Visual Analog Scale) scores during the procedure showed a positive and significant correlation with the pre-procedural HADS anxiety scores (r=0.255, p=0.021) and depression scores (r=0.424, p=0.001). The VAS scores recorded 60 minutes after the procedure also showed a positive and significant correlation with pre-procedural anxiety scores (r=0.213, p=0.045) and depression scores (r=0.191, p=0.046). The VAS scores related to the procedure were significantly influenced by the waiting time in the hospital (p=0.001) and anxiety scores (p=0.001). The VAS scores recorded 60 minutes after the procedure (p=0.001) were significantly influenced by the duration of the procedure (p=0.002), anxiety scores (p=0.128), and depression scores (p=0.002)
CONCLUSIONS: Anxious and/or depressive mood may increase the perception of endometrial biopsy-related pain. Various precautions such as reducing the waiting time or informing the patient during the waiting period might be beneficial in terms of reducing pre-procedural anxiety and depression levels.

Keywords

Anxiety, Curettage, Depression, Pain.

ENDOMETRİAL BİYOPSİ ÖNCESİ KAYGI VE DEPRESYON AĞRI ALGISINI ARTTIRIR MI?

Abstract

AMAÇ: Bu çalışmanın amacı, endometriyal küretaj uygulanan kadınlarda işlem öncesi anksiyete ve depresyon düzeylerinin ağrı algısı üzerindeki etkisini belirlemek ve bu kadınlarda ağrı algısına katkıda bulunan olası faktörleri araştırmaktır.
GEREÇ VE YÖNTEM: Bu çalışmada, anormal uterin kanama nedeniyle endometrial küretaj uygulanan 82 premenopozal kadın gözden geçirildi. Katılımcıların psikolojik durumlarını değerlendirmek amacıyla Hastane Anksiyete ve Depresyon Ölçeği'nin (HADÖ) Türkçe versiyonu kullanıldı. Hastalardan işlem sırasında ve işlemden 60 dakika sonra hissettikleri ağrıyı görsel analog ölçekte değerlendirmeleri istendi.
BULGULAR: İşlem sırasındaki Vizüel Analog Skala (VAS) puanları, işlem öncesi HADÖ anksiyete puanları (r=0,255, p=0,021) ve depresyon puanları (r=0,424, p=0,001) ile pozitif ve anlamlı korelasyon göstermiştir. İşlemden 60 dakika sonra kaydedilen VAS skorları, işlem öncesi anksiyete skorları (r=0,213, p=0,045) ve depresyon skorları (r=0,191, p=0,046) ile pozitif ve anlamlı korelasyon göstermiştir. İşleme bağlı VAS skorları, hastane içi bekleme süresi (p=0,001) ve anksiyete skorlarından anlamlı derecede etkilenmiştir. (p=0,001). İşlemden 60 dakika sonra kaydedilen VAS skorları, işlem süresinden (p=0,002), anksiyete skorlarından (p=0,128,) ve depresyon skorlarından (p=0,002) anlamlı derecede etkilenmiştir (p= 0,001).
SONUÇ: Kaygılı ve/veya depresif ruh hali endometrial biyopsiye bağlı ağrı algısını arttırabilmektedir. Bekleme süresinin kısaltılması veya bekleme süresi içerisinde hastanın bilgilendirilmesi gibi çeşitli önlemler, işlem öncesi kaygı ve depresyon düzeyinin azaltılmasına yönelik etki göstermesi açısından faydalı olabilir.

Keywords

Anksiyete, Küretaj, Depresyon, Ağrı

Ethical Statement

Afyonkarahisar Sağlık Bilimleri Üniversitesi Etik Kurulundan 2011-KAEK-2 numarasıyla etik onay alınmıştır.

References

• 1. Sharma S, Makaju R, Shrestha S, Shrestha A. Histopathological findings of endometrial samples and its correlation between the premenopausal and postmenopausal women in abnormal uterine bleeding. Kathmandu Univ Med J (KUMJ) 2014;12(48):275-8.
• 2. Damle RP, Dravid NV, Suryawanshi KH, et al. Clinicopathological spectrum of endometrial changes in peri- menopausal and post-menopausal abnormal uterine bleeding: a 2 years study. J Clin Diagn Res. 2013;7(12):2774-6.
• 3. Abid M, Hashmi AA, Malik B, et al. Clinical pattern and spectrum of endometrial pathologies in patients with abnormal uterine bleeding in Pakistan: need to adopt a more conservative approach to treatment. BMC Womens Health 2014;14:132.
• 4. Kitiyodom S. The adequacy of endometrial sampling: comparison between manual vacuum aspiration and metal curettage method. J Med Assoc Thai. 2015;98(6):523-7.
• 5. Liu H, Wang FL, Zhao YM, Yao YQ, Li YL. Comparison of Pipelle sampler with conventional dilatation and curettage (D&C) for Chinese endometrial biopsy. J Obstet Gynaecol 2015;35(5):508-11.
• 6. Kass-Wolff JH, Fisher JE. Evidence-based pain management for endometrial biopsies and IUD insertions. Nurse Pract 2014;39(3):43-50.
• 7. Kosus N, Kosus A, Demircioglu RI, et al. Transcervical intrauterine levobupivacaine or lidocaine infusion for pain control during endometrial biopsy. Pain Res Manag 2014;19(2):82-6.
• 8. Cengiz H, Dagdeviren H, Kaya C, Yesil A, Caypınar SS. Comparing the efficacy of intrauterine lidocaine and paracervical block in decreasing the pain associated with endometrial biopsy: a randomized trial. Arch Gynecol Obstet 2014;289(3):609-14.
• 9. Somchit W, Lertkhachonsuk AA, Vallipakorn SA. Naproxen for pain relief during endometrial biopsy: a randomized controlled trial. J Med Assoc Thai 2015;98(7):631-5.
• 10. Kaya C, Sener EB, Koksal E, et al. Comparison of placebo and intrauterine lidocaine with/or without rectal diclofenac sodium suppositories used in office endometrial biopsy. J Pak Med Assoc 2015;65(1):29-34.
• 11. Aydemir O, Guvenir T, Kuey L, Kultur S. Hastane anksiyete ve depresyon olcegi Turkce formunun guvenilirligi ve gecerliligi. Turk Psikiyatri Dergisi 1977;8:280-7.
• 12. Hui SK, Lee L, Ong C, Yu V, Ho LC. Intrauterine lignocaine as an anesthetic during endometrial sampling: a randomized double-blind controlled trial. BJOG. 2006;113(1):53-7.
• 13. Güney M, Oral B, Mungan T. Intrauterine lidocaine plus buccal misoprostol in the endometrial biopsy. Int J Gynaecol Obstet. 2007;97(2):125-8.
• 14. Api O, Ergen B, Api M, Ugurel V, Emeksiz MB, Unal O. Comparison of oral nonsteroidal analgesic and intrauterine local anesthetic for pain relief in uterine fractional curettage: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 2010;203(1):28.e1-7.
• 15. Tang J, Gibson SJ. A psychophysical evaluation of the relationship between trait anxiety, pain perception, and induced state anxiety. J Pain. 2005;6(9):612-9.
• 16. Thompson T, Keogh E, French CC, Davis R. Anxiety sensitivity and pain: generalisability across noxious stimuli. Pain. 2008;134(1-2):187-96.
• 17. Esteve MR, Camacho L. Anxiety sensitivity, body vigilance and fear of pain. Behav Res Ther. 2008;46(6):715- 27.
• 18. Miner J, Biros MH, Trainor A, Hubbard D, Beltram M. Patient and physician perceptions as risk factors for oligo analgesia: a prospective observational study of the relief of pain in the emergency department. Acad Emerg Med. 2006;13(2):140-6.
• 19. Marinsek M, Kovacic D, Versnik D, Parasuh M, Golez S, Podbregar M. Analgesic treatment and predictors of satisfaction with analgesia in patients with acute undifferentiated abdominal pain. Eur J Pain. 2007;11(7):773- 8.
• 20. Carta G, Palermo P, Marinangeli F, et al. Waiting time and pain during office hysteroscopy. J Minim Invasive Gynecol. 2012;19(3):360-4.
• 21. Kokanali MK, Cavkaytar S, Guzel Aİ, et al. Impact of preprocedural anxiety levels on pain perception in patients undergoing office hysteroscopy. J Chin Med. 2014;77(9):477-81.
• 22. Harkness K, Morrow L, Smith K, et al. The effect of early education on patient anxiety while waiting for elective cardiac catheterization. Eur J Cardiovasc Nurs. 2003;2(2):113-21.
• 23. Angioli R, De Cicco Nardone C, et al. Use of music to reduce anxiety during office hysteroscopy: a prospective randomized trial. J Minim Invasive Gynecol. 2014;21(3):454-9.