Which factors affect anxiety level before upper gastrointestinal endoscopy?

Yıl 2012, Cilt: 20 Sayı: 3, 67 - 71, 01.12.2012

Hakan Ünal () Gamze Özçürümez () Fieniz Saritafi () Murat Korkmaz () Haldun Selçuk ()

https://doi.org/10.17940/endoskopi.74819

Öz

Background and Aims: High levels of anxiety prior to upper gastrointestinal endoscopy can adversely impact the procedure quality and patient safety. We aimed to evaluate the relationship between patient anxiety level before the procedure and patient characteristics among patients scheduled to undergo upper gastrointestinal endoscopy. Materials and Methods:Patients aged 18 and over who underwent a planned upper gastrointestinal system endoscopy due to dyspeptic complaints were included in the study. Data on patient cha-racteristics and anxiety levels were collected using two forms (Patient Infor-mation Form and Beck Anxiety Inventory), which they were asked to comp-lete before the procedure. After the procedure, endoscopy results and Helico-bacter pylori status were recorded on a separate form for each patient. After all patients' data were collected, anxiety level and patient characteristics data were compared.Results: Three hundred and forty-six patients were included in the study. Pre- procedural anxiety levels of the patients were determined to be mild, moderate, and severe in 78.9%, 15.6%, and 5.5% of the patients, respectively. While the anxiety level was higher among female patients and patients with Helicobacter pylori positivity, no association was found betwe-en the anxiety level and age, body mass index, history of endoscopy, applica-tion of sedation, or endoscopic diagnosis. Conclusions: Patient safety and quality of the procedure must be ensured at the highest level during the gas-trointestinal system endoscopy procedures. We found that detection of pati-ent characteristics that can adversely affect these two factors, like high pre-procedural anxiety level, is one of the important components that would help reach this goal

Anahtar Kelimeler

Gastrointestinal endoscopy, anxiety, anxiety scale

Üst gastrointestinal endoskopi işlemi öncesi anksiyete düzeyini etkileyen faktörler

Öz

Amaç: Gastrointestinal sistem endoskopi işlemleri öncesinde hastaların anksiyete düzeyi artmaktadır. İşlem öncesi yüksek anksiyete düzeylerinin varlığı işlem kalitesi ve güvenliğini olumsuz yönde etkilemektedir. Biz bu çalışmada üst gastrointestinal sistem endoskopisi öncesi anksiyete düzeyinin hastaya ait özellikler ile ilişkisini değerlendirmeyi amaçladık.Gereç ve Yöntem: Dispeptik yakınmalar nedeni ile üst gastrointestinal sistem endoskopisi planlanan 18 yaş üstü hastalar çalışmaya alındı. İşlem öncesi doldurmaları istenen iki form (hasta bilgileri formu ve BECK Anksiyete Ölçeği) ile hasta özellikleri ve anksiyete düzeyleri belirlendi. İşlem sonrası endoskopi bulguları ve Helicobakter durumu her hasta için oluşturulan özel formlara kayıt edildi. Tüm hasta verileri toplandıktan sonra anksiyete düzeyleri ile hastaya ait veriler karşılaştırıldı.Bulgular: Toplam 346 hastanın değerlendirildiği çalışmamızda hastaların %78,9'unda hafif, %15,6 sında orta, %5,5'inde yüksek düzeyde işlem öncesi anksiyete varlığı saptandı. Anksiyete düzeyi kadın hastalarda ve Helikobakter pylori pozitif saptanan hastalarda daha yüksek iken; hasta yaşı, vücut kitle indeksi, endoskopi hikayesi, sedasyon uygulanma durumu ve endoskopik tanı ile anksiyete düzeyi arasında ilişki saptanmadı.Sonuç: Günümüzde kullanımı çok yaygınlaşmış olan gastrointestinal sistem endoskopi işlemlerinde hasta güvenliği ve işlem kalitesi en üst düzeyde tutulmalıdır. İşlem öncesi yüksek anksiyete düzeyi gibi bu iki faktörü olumsuz yönde etkileyebilecek hastaya ait özelliklerin belirlenmesi bu amaca hizmet edecek önemli bileşenlerden biri olarak karşımıza çıkmaktadır

Anahtar Kelimeler

Gastrointestinal endoskopi, anksiyete, anksiyete skalası

Kaynakça

• Abuksis G, Mor M, Segal N, et al. A patient education program is cost- effective for preventing failure of endoscopic procedures in a gastroente- rology department. Am J Gastroenterol 2001; 96: 1786-90.
• Shepherd HA, Bowman D, Hancock B, Anglin J, Hewett D. Postal con- sent for upper gastrointestinal endoscopy. Gut 2000; 46: 37-9.
• van Vliet MJ, Grypdonck M, van Zuuren FJ, Winnubst J, Kruitwagen C. Preparing patients for gastrointestinal endoscopy: the influence of infor- mation in medical situations. Patient Educ Couns 2004; 52: 23-30.
• Gebbensleben B, Rohde H. [Anxiety before gastrointestinal endoscopy-- a significant problem?]. Dtsch Med Wochenschr 1990; 115: 1539-44.
• Drossman DA, Brandt LJ, Sears C, Li Z, Nat J, Bozymski EM. A prelimi- nary study of patients' concerns related to GI endoscopy. Am J Gastro- enterol 1996; 91: 287-91.
• Brandt LJ. Patients' attitudes and apprehensions about endoscopy: how to calm troubled waters. Am J Gastroenterol 2001; 96: 280-4.
• Johnson JE, Morrissey JF, Leventhal H. Psychological preparation for an endoscopic examination. Gastrointest Endosc 1973; 19: 180-2.
• Hayes A, Buffum M, Lanier E, Rodahl E, Sasso C. A music intervention to reduce anxiety prior to gastrointestinal procedures. Gastroenterol Nurs 2003; 26: 145-9.
• Levy N, Landmann L, Stermer E, Erdreich M, Beny A, Meisels R. Does a detailed explanation prior to gastroscopy reduce the patient's anxiety? Endoscopy 1989; 21: 263-5.
• Jones MP, Ebert CC, Sloan T, et al. Patient anxiety and elective gastroin- testinal endoscopy. J Clin Gastroenterol 2004; 38: 35-40.
• Campo R, Brullet E, Montserrat A, et al. Identification of factors that inf- luence tolerance of upper gastrointestinal endoscopy. Eur J Gastroente- rol Hepatol 1999; 11: 201-4.
• Trevisani L, Sartori S, Putinati S, et al. [Assessment of anxiety levels in patients during diagnostic endoscopy]. Recenti Prog Med 2002; 93: 240- 4.
• Lee DW, Chan AC, Wong SK, et al. Can visual distraction decrease the dose of patient-controlled sedation required during colonoscopy? A prospective randomized controlled trial. Endoscopy 2004; 36: 197-201.
• Muzzarelli L, Force M, Sebold M. Aromatherapy and reducing preproce- dural anxiety: a controlled prospective study. Gastroenterol Nurs 2006; 29: 466-71.
• Ersoz F, Toros AB, Aydogan G, Bektas H, Ozcan O, Arikan S. Assess- ment of anxiety levels in patients during elective upper gastrointestinal endoscopy and colonoscopy. Turk J Gastroenterol 2010; 21: 29-33.
• Abraham NS, Fallone CA, Mayrand S, Huang J, Wieczorek P, Barkun AN. Sedation versus no sedation in the performance of diagnostic upper gastrointestinal endoscopy: a Canadian randomized controlled cost-out- come study. Am J Gastroenterol 2004; 99: 1692-9.
• Christe C, Janssens JP, Armenian B, Herrmann F, Vogt N. Midazolam se- dation for upper gastrointestinal endoscopy in older persons: a randomi- zed, double-blind, placebo-controlled study. J Am Geriatr Soc 2000; 48: 1398-403.
• Hashimoto T, Adachi K, Ishimura N, et al. Safety and efficacy of gluca- gon as a premedication for upper gastrointestinal endoscopy--a compa- rative study with butyl scopolamine bromide. Aliment Pharmacol Ther 2002; 16: 111-8.
• Trevisani L, Sartori S, Gaudenzi P, et al. Upper gastrointestinal endos- copy: are preparatory interventions or conscious sedation effective? A randomized trial. World J Gastroenterol 2004; 10: 3313-7.
• Speilberger C. State-Trait Anxiety Inventory for adult, self-evaluation qu- estionaire STAI form Y-1 and Y-2. Redwood City, CA: Mind Garden, 1977.
• Mahajan RJ, Johnson JC, Marshall JB. Predictors of patient cooperation during gastrointestinal endoscopy. J Clin Gastroenterol 1997; 24: 220- 3.
• Haug TT, Wilhelmsen I, Berstad A, Ursin H. Life events and stress in pa- tients with functional dyspepsia compared with patients with duodenal ulcer and healthy controls. Scand J Gastroenterol 1995; 30: 524-30.
• Pajala M, Heikkinen M, Hintikka J. Mental distress in patients with func- tional or organic dyspepsia: a comparative study with a sample of the ge- neral population. Aliment Pharmacol Ther 2005; 21: 277-81.
• Talley NJ, Phillips SF, Bruce B, Twomey CK, Zinsmeister AR, Melton LJ 3rd. Relation among personality and symptoms in nonulcer dyspepsia and the irritable bowel syndrome. Gastroenterology 1990; 99: 327-33.
• Addolorato G, Mirijello A, D'Angelo C, et al. State and trait anxiety and depression in patients affected by gastrointestinal diseases: psychometric evaluation of 1641 patients referred to an internal medicine outpatient setting. Int J Clin Pract 2008; 62: 1063-9.
• Kountouras J, Deretzi G, Zavos C, et al. Association between Helicobac- ter pylori infection and acute inflammatory demyelinating polyradiculo- neuropathy. Eur J Neurol 2005; 12: 139-43.
• Kountouras J, Gavalas E, Zavos C, et al. Alzheimer's disease and Helico- bacter pylori infection: defective immune regulation and apoptosis as proposed common links. Med Hypotheses 2007; 68: 378-88.