Does intra-procedural enlightenment change the level of anxiety and pain in scheduled breast ultrasonography?

Year 2023, Volume: 14 Issue: 2, 352 - 358, 30.06.2023

Funda Ulu Öztürk , Şehnaz Tezcan

https://doi.org/10.18663/tjcl.1290435

Abstract

Aim: Scheduled breast ultrasounds are stressful procedures for women. We aimed to study the effect of informing patients during breast ultrasound and investigate associated anxiety and pain alterations.
Material and Methods: After approval of the state hospital ethics committee and informed consent, women scheduled for breast ultrasound between November 2022 and March 2023 were prospectively enrolled in this randomized controlled study. Patients were either informed during the ultrasound about the procedure itself or not. The participants completed State-Trait Anxiety Inventory for measuring anxiety and visual analog scale for pain scores, immediately before and after the examination. Demographic data, anxiety and pain scores were statistically evaluated by using chi-square test, independent samples t-test and Mann-Whitney U test. The alteration of anxiety and pain scores considering enlightenment were compared with paired samples t-test and Wilcoxon test.
Results: Among 143 patients, preprocedural anxiety was lower in oncological follow-ups and higher in positive clinical breast examination, breast self-examination and mammography subgroups. Trait and preprocedural state anxiety scores were similar between the two groups regarding enlightenment. Anxiety and pain reduction was observed after ultrasound and both were statistically significant in the informed group (p<0.001 and p=0.03, respectively).
Conclusion: Informing the patients during breast ultrasound reduces anxiety levels and pain perception.

Keywords

anxiety, breast ultrasound, pain, informing, enlightenment

Supporting Institution

Ankara Bilkent State Hospital

Project Number

2022-10/2127

Randevulu meme ultrasonları esnasında bilgilendirme yapılmasının hasta kaygısı ve meme ağrısı üzerine etkisi var mıdır?

Abstract

Amaç: Randevulu meme ultrasonları kadınlar için oldukça stresli işlemlerdir. Bu çalışma ile ultrason esnasında hastaları bilgilendirmenin, işlem ilişkili kaygı ve meme ağrısı üzerindeki etkilerini araştırmayı hedefledik.
Gereç ve Yöntemler: Şehir hastanesi etik kurulu onayı ve hasta onamı alınmasını takiben Kasım 2022 ve Mart 2023 tarihleri arasında randevulandırılmış meme ultrasonu olan hastalar prospektif olarak değerlendirildi. Hastalar bilgilendirme yapılıp yapılmamasına göre randomize-kontrollü olarak iki gruba ayrıldı. Çalışmaya katılan hastalar kaygı ölçümü için “State-Trait Anxiety Inventory” formunu, ağrı skorları için de “Visual Analog Scale” ölçeğini hem ultrasondan önce hem de ultrason bitiminde doldurdu. Demografiler veriler, kaygı ve ağrı skorları istatistiksel olarak Ki-kare testi, bağımsız örneklem t-testi ve Mann-Whitney U testi ile analiz edildi. Hasta bilgilendirmesine göre yapılan kaygı ve ağrı skorları değişimi, eşleştirilmiş örneklem t-testi ve Wilcoxon testi ile değerlendirildi.
Bulgular: 143 hastada işlem öncesi kaygı, onkolojik takip hastalarında daha düşük olup fizik muayene bulgusu olan, öz muayene yapan ve aynı gün mamografi çekimi bulunan hastalarda ise anlamlı olarak daha yüksek saptandı. Sürekli ve işlem öncesi durumluk kaygı skorları hasta bilgilendirmeye göre iki grup arasında benzer bulundu. Ultrason sonrası genel kaygı ve ağrı skorlarında azalma dikkati çekmiş olup hastaların bilgilendirildiği grupta bu düşüş anlamlı bulundu (sırasıyla p<0.001 ve p=0.03).
Sonuçlar: Meme ultrasonu çekimi esnasında hastaları bilgilendirme, kaygı seviyeleri ve meme ağrısını azaltmaktadır.

Keywords

Kaygı, stres, meme ultrasonu, ağrı, bilgilendirme

Project Number

2022-10/2127

References

• 1. Mettler FA Jr, Bhargavan M, Faulkner K, Gilley DB, Gray JE, Ibbott GS, et al. Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources--1950-2007. Radiology 2009 Nov;253(2):520-31. doi: 10.1148/radiol.2532082010.
• 2. La Grutta L, La Grutta S, Galia M, Lo Piccolo G, Gentile G, La Tona G, et al. Acceptance of noninvasive computed tomography coronary angiography: for a patient-friendly medicine. Radiol Med 2014 Feb;119(2):128-34. doi: 10.1007/s11547-013-0319-2.
• 3. National Cancer Institute (2015) Female breast cancer: Cancer stat facts—for health professionals (PDQ®). https://seer.cancer. gov/statfacts/html/breast.html. Accessed 2 Dec 2015.
• 4. Pifarré P, Simó M, Gispert JD, Pallarés MD, Plaza P, Martínez- Miralles E. Pruebas de diagnóstico por la imagen: ¿generan ansiedad? [Diagnostic imaging studies: do they create anxiety?]. Rev Esp Med Nucl 2011 Nov-Dec;30(6):346-50. Spanish. doi: 10.1016/j.remn.2011.03.003.
• 5. Johnson KM, Bradley KA, Bush K, Gardella C, Dobie DJ, Laya MB. Frequency of mastalgia among women veterans. Association with psychiatric conditions and unexplained pain syndromes. J Gen Intern Med 2006 Mar;21 Suppl 3(Suppl 3):S70-5. doi: 10.1111/j.1525-1497.2006.00378.x.
• 6. Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clin Proc 2004 Mar;79(3):353-72. doi: 10.4065/79.3.353.
• 7. Ader DN, Browne MW. Prevalence and impact of cyclic mastalgia in a United States clinic-based sample. Am J Obstet Gynecol 1997 Jul;177(1):126-32. doi: 10.1016/s0002-9378(97)70450-2.
• 8. Spielberger CD. Stait-trait anxiety inventory for adults: Manual, Instrument and Scoring Guide. Menlo Park, CA: Mind Garden, Inc, 1983.
• 9. Lo Re G, De Luca R, Muscarneri F, Dorangricchia P, Picone D, Vernuccio F, et al. Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study. Radiol Med 2016 Oct;121(10):763-8. doi: 10.1007/s11547-016-0664-z.
• 10. Sutton S, Saidi G, Bickler G, Hunter J. Does routine screening for breast cancer raise anxiety? Results from a three wave prospective study in England. J Epidemiol Community Health 1995 Aug;49(4):413-8. doi: 10.1136/jech.49.4.413.
• 11. Lell MM, Ditt H, Panknin C, Sayre JW, Klotz E, Ruehm SG, et al. Cervical CT angiography comparing routine noncontrast and a late venous scan as masks for automated bone subtraction: feasibility study and examination of the influence of patient motion on image quality. Invest Radiol 2008 Jan;43(1):27-32. doi: 10.1097/RLI.0b013e31815597ac.
• 12. Carlsson S, Carlsson E. 'The situation and the uncertainty about the coming result scared me but interaction with the radiographers helped me through': a qualitative study on patients' experiences of magnetic resonance imaging examinations. J Clin Nurs 2013 Nov;22(21-22):3225-34. doi: 10.1111/jocn.12416.
• 13. Öztürk FU, Turnaoğlu H, Uslu N. Preferred music lowers anxiety levels and pain perception while promoting patient satisfaction in women undergoing ultrasound-guided breast biopsy: randomized controlled study. Acta Radiol 2023 Mar;64(3):993- 998. doi: 10.1177/02841851221116131.
• 14. Bugbee ME, Wellisch DK, Arnott IM, Maxwell JR, Kirsch DL, Sayre JW, et al. Breast core-needle biopsy: clinical trial of relaxation technique versus medication versus no intervention for anxiety reduction. Radiology 2005;234:73-78. doi:10.1148/ radiol.2341030163.
• 15. Soo MS, Jarosz JA, Wren AA, Soo AE, Mowery YM, Johnson KS, et al. Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue. J Am Coll Radiol 2016;13:526-534. doi: 10.1016/j. jacr.2015.12.004.
• 16. Haun M, Mainous RO, Looney SW. Effect of music on anxiety of women awaiting breast biopsy. Behav Med 2001;27:127-132.
• 17. Balleyguier C, Arfi-Rouche J, Haddag L, Canale S, Delaloge S, Dromain C. Breast pain and imaging. Diagn Interv Imaging 2015 Oct;96(10):1009-16. doi: 10.1016/j.diii.2015.08.002.
• 18. Zarei F, Pishdad P, Hatami M, Zeinali-Rafsanjani B. Can breast ultrasound reduce patient's level of anxiety and pain? Ultrasound 2017 May;25(2):92-97. doi: 10.1177/1742271X17690021.