How Does Pre-Procedure Training Affect Adaptation and Anxiety Levels in Adolescents Undergoing Esophagogastroduodenoscopy?

Öz

Objective: This quasi-experimental randomised control study was conducted with the aim of determining the effect of pre-procedural training on adaptation and anxiety levels of adolescents undergoing esophagogastroduodenoscopy. Methods: The study was carried out with 60 adolescents aged 14-17 undergoing their first esophagogastroduodenoscopy between September 2018 and February 2019. The adolescents were divided into 2 groups by using a randomisation control list, which had been prepared with the microsoft excel program. Before the procedure, the group that was trained about esophagogastroduodenoscopy constituted the patient group and the untrained group was the control group. A demographic data form and the State-Trait Anxiety Inventory were completed before the procedure and a patient compliance assessment form was filled out after the procedure. Results: The mean age of the participants was 15,40±1,14 years (min: 14; max: 17), 66,7% (n=40) were female, and 61,7% (n=37) were high school students. It was determined that 46,6% (n=28) of the adolescents had anxiety before endoscopy and this was mostly due to lack of information. The state anxiety levels of the control group were significantly higher. It was determined that the adolescents in the patient group adapted to the procedure better than the adolescents in the control group, and the state anxiety point averages of adolescents who adapted well to the procedure were lower. There was no statistically significant difference between the groups when trait anxiety levels were evaluated. Conclusion: Training before esophagogastroduodenoscopy is effective in reducing anxiety and facilitating adolescents’ compliance with the procedure.

Anahtar Kelimeler

• Education
• endoscopy
• anxiety
• adolescent
• compliance

Özofagogastroduodenoskopi Uygulanan Adolesanlarda İşlem Öncesi Eğitim Uyum ve Kaygı Düzeylerini Nasıl Etkiler?

Öz

Amaç: Bu araştırma üst gastrointestinal sistem endoskopisi yapılacak ergenlere işlem öncesi verilen eğitimin, işleme uyumu ve anksiyete düzeyi üzerine etkisini belirlemek amacıyla yarı deneysel randomize kontrollü olarak gerçekleştirildi. Yöntem: Araştırma verileri, Eylül 2018-Şubat 2019 tarihleri arasında ilk kez gastroskopi işlemi yapılacak, 14-17 yaş aralığında 60 ergenle gerçekleştirildi. Ergenler, microsoft excel programı ile hazırlanan bir randomizasyon kontrol listesi kullanılarak 2 gruba ayrıldı. İşlem öncesi özofagogastroduodenoskopi konusunda eğitim alan grup hasta grubunu ve eğitim verilmeyen grup ise kontrol grubunu oluşturdu. İşlemden önce ‘Demografik veri formu’ ‘Durumluk Sürekli Kaygı Envanteri’ formları, işlemden sonra ‘Hasta Uygunluk Değerlendirme Formu’ dolduruldu. Bulgular: Araştırmaya katılanların yaş ortalamasının 15,40±1,14 yıl olduğu (min:14; maks:17), %66,7’sinin (n=40) kadın olduğu, %61,7’sinin (n=37) lise öğrencisi olduğu saptandı. Araştırmaya katılan ergenlerin %46,6’sı (n=28) endoskopi işlemi öncesi anksiyete yaşadıkları ve anksiyete sebebinin ise en çok bilgi eksikliği nedeniyle olduğu belirlendi. Kontrol grubunun durumluk kaygı düzeyleri, hasta grubundan istatistiksel olarak anlamlı düzeyde yüksek saptandı. Hasta grubundaki ergenlerin kontrol grubundaki ergenlere göre işleme daha iyi uyum sağladıkları ve işleme iyi uyum sağlayan ergenlerin durumluk kaygı puan ortalamalarının daha düşük olduğu belirlendi. Sürekli kaygı düzeyleri değerlendirildiğinde gruplar arasında istatistiksel olarak anlamlı bir farklılık saptanmadı. Sonuç: Hastalara işlem öncesi verilen eğitim, kaygı düzeyini azaltmada ve hastaların işleme uyumunu kolaylaştırmada etkili olmaktadır.

Anahtar Kelimeler

• eğitim
• endoskopi
• anksiyete
• ergen
• uyum

Kaynakça

1. 1. Pontone S, Tonda M, Brighi M, Florio M, Pironi D, Pontone Does P. Anxiety or waiting time influence patients’ tolerance of upper endoscopy?. Saudi J Gastroenterol 2015;21(2):111–115. doi: 10.4103/1319-3767.153839.
2. 2. Lauriola M, Tomai M, Palma R, La Spina G, Foglia A, Panetta C, et al. Procedural anxiety, pain catastrophizing, and procedure-related pain during EGD and Colonoscopy. South Med J 2020;113(1):8-15. Doi:10.14423/SMJ. 0000000000001058.
3. 3. Mitsonis C, Dimopoulos N, Zavrou M, Psarra V, Giofkos C, Fiorakis C, et al. Panic Attack during Elective Gastrointestinal Endoscopy. Gastroenterol Res Pract. 2011;2011:162574. doi: 10.1155/2011/162574.
4. 4. Trevisani L, Zelante A, Sartori S. Colonoscopy, pain and fears: Is it an indissoluble trinomial? World J Gastrointest Endosc. 2014;6(6):227-33. doi: 10.4253/wjge.v6.i6.227.
5. 5. Hiremath P, Mohite V, Naregal P, Pawar S, Bhosale T. A study to assess the knowledge, attitude and pre-procedure anxiety level of patient undergoing upper GI endoscopy in Krishna Hospital, Karad, India. IJIRD 2016;5(6):243-9.
6. 6. Hydes T, Yusuf A, Pearl DS, Trebble TM. A survey of patients’ attitudes to upper gastrointestinal endoscopy identifies the value of endoscopist-patient interactive factors. Frontline Gastroenterol. 2011;2(4):242-8. doi: 10.1136/fg.2011.004325.
7. 7. Grilo Bensusan I, Herrera Martín P, Aguado Álvarez MV. Prospective study of anxiety in patients undergoing an outpatient colonoscopy. Rev Esp Enferm Dig. 2016;108(12):765-9. doi: 10.17235/ reed.2016.4104/2015.
8. 8. Lee JK, Lee YJ, Cho JH, Im JP, Park CH, Jang JY, et al. Updates on the Sedation for Gastrointestinal Endoscopy. Clin Endosc. 2019;52(5):451-7. doi: 10.5946/ce.2019.172.

9. 9. Hagiwara S, Nakayama Y, Tagawa M, Arai K, Ishige T, Murakoshi T, et al. Pediatric Patient and Parental Anxiety and Impressions Related to Initial Gastrointestinal Endoscopy: A Japanese Multicenter Questionnaire Study. Scientifica (Cairo). 2015;2015 797564. doi:10.1155/2015/797564.
10. 10. Behrouzian F, Sadrizadeh N, Nematpour S, Seyedian SS, Nassiryan M, Zadeh AJF. The Effect of Psychological Preparation on the Level of Anxiety before Upper Gastrointestinal Endoscopy. J Clin Diagn Res. 2017;11(7):VC01-VC04. doi: 10.7860/JCDR/2017/24876.10270.
11. 11. Volkan B, Bayrak NA, Ucar C, Kara D, Yıldız S. Preparatory information reduces gastroscopy-related stress in children as confirmed by salivary cortisol. Saudi J Gastroenterol 2019;25(4):262-7. doi: 10.4103/sjg.SJG49318.
12. 12. Chorney JM, Tan ET, Martin SR, Fortier MA, Kain ZN. Children’s behavior in the postanesthesia care unit: The development of the Child Behavior Coding System-PACU (CBCS-P). J Pediatr Psychol 2012;37(3):338-47. doi: 10,1093 / jpepsy / jsr101.
13. 13. Li WHC, Chung JOK, Ho KY, Kwok BMC. Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatr 2016;16:36. doi: 10.1186/s12887-016-0570-5.
14. 14. Liang Y, Xin W, Yang Y, Li X. Application of care bundles in bowel preparation for colonoscopy in children. Ann Palliat Med 2019;8(4):476-82. doi: 10.21037/apm.2019.09.01.
15. 15. Pehlivan S, Ovayolu N, Koruk M, Pehlivan Y, Ovayolu O, Gülşen MT. Effect of providing iṅ formation to the patient about upper gastrointestinal endoscopy on the patient’s perception, compliance and anxiety level associated wiht the procedure. Turk J Gastroenterol 2011;22(1):10-17. doi: 10.4318/tjg.2011.0150.
16. 16. Lee E, Shafer LA, Walker JR, Waldman C, Michaud V, Yang C, et al. Information experiences, needs, and preferences of colonoscopy patients: A pre-colonoscopy survey. Medicine (Baltimore). 2019;98(20):e15738. doi: 10.1097/MD.0000000000015738.
17. 17. Ö ner N, Le Compte A. State-Trait Anxiety Inventory Handbook. Istanbul: Boğaziçi University Publications; 1985.
18. 18. Entire J, Sahota J, Hydes T, Trebble TM. An evaluation of patient attitudes to colonoscopy and the importance of endoscopist interaction and the endoscopy environment to satisfaction and value. Scand J Gastroenterol 2013;48(3):366-73. doi: 10.3109/00365521.2012.758768.
19. 19. Ceyhan Ö, Tekinsoy Kartın P, Taşcı S. The effect of endoscopy training on patients’ anxiety level. Pamukkale Med J 2018;11(3):293-300.
20. 20. Uğraş M, Alan S. Evaluation of the results of upper gastrointestinal system endoscopies for children, F.U Med J of Health Sciences 2012;26(1):31-4.
21. 21. Lee YJ, Kim ES, Park KS, Cho KB, Jang BK, Chung WJ, et al. Education for ward nurses iṅ fluences the qality of iṅ patient’s bowel preparation for colonoscopy. Medicine 2015;94(34):1423. doi: 10.1097/MD. 0000000000001423.
22. 22. Kutlutürkan S, Görgülü Ü, Fesci H, Karavelioğlu A. The effect of providing pre-gastrointestinal endoscopy written educational material on patients’ anxiety: A randomised controlled trial. Int J Nurs Stud 2010;47(9):1066-1073. doi: 10.1016/j. ijnurstu.2010.01.007.
23. 23. Nasiri J, Khatib N, Kheiri S, Najafi M. The influence of escort during upper endoscopy and colonoscopy on patient satisfaction and anxiety. J Family Med Prim Care. 2016;5(1):134-8. doi: 10.4103/2249-4863.184638.
24. 24. Arabul M, Kandemir A, Çelik M, Alper E, Akpinar Z, Aslan F, et al. Impact of an iṅ formation video before colonoscopy on patient satisfaction and anxiety. Turk J Gastroenterol 2012; 23: 523-9. Doi: 10,4318 / tjg. 2012.0416.
25. 25. Ertem A, Yava A, Demirkılıç U. Determination of the opinions and suggestions of the patients undergoing cardiac surgery on preoperative informed consents. TGKDC 2013;21(2):378-91. doi: 10.5606/ tgkdc.dergisi.2013.7388.
26. 26. Tanaka K, Oikawa N, Terao R, Negishi Y, Fujii T, Kudo T, et al. Evaluations of psychological preparation for children undergoing endoscopy. JPGN 2011;52(2):227-9. doi: 10.1097 / MPG.0b013e3181f25f57.
27. 27. Töredi E. Anxiety levels and affecting factors in children between the ages of 7-14 appealing to an oral and dental health center (Master’s Thesis). B.Ü Institute of Health Sciences; 2017.
28. 28. Aydın Sayılan A, Öztekin SD. Esophagogastroduodenoscopy before procedure of the patients to be applied conscious sedation with anxiety levels the relationship between implementation determination. In: Avcı C, Avtan L. editors. 11. National Endoscopic Laparoscopic Surgery Congress Information; 2013 Oct 2-6; Antalya: Turkey; 2013.p.29.
29. 29. Hsueh FC, Chen CM, Güneş CA, Chou YC, Hsiao SM. A study on the effect of a health education intervention on anxiety and pain during colonoscopy procedures. J Nurs Res 2016;24(2):181-9. doi:10.1097/ jnr. 0000000000000112.
30. 30. Johnson DA, Barkun AN, Cohen LB, Dominitz JA, Kaltenbach T, Martel M, et al. Optimizing adeuqacy of bowel cleasing for colonoscopy: recommendations from the US Multi-Society task force on colorectal cancer. Gastroenterology 2014;147(4):903-24. doi: 10.1053/j.gastro.2014.07.002.
31. 31. Peterson M. Improving health literacy of colonoscopy patients through reinforced teaching of bowel preparation using preprocedure phone calls 2017; 1-25.