Nursing and Public Health

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Pielęgniarstwo i Zdrowie Publiczne Nursing and Public Health

2020, vol. 10, nr 1, January-March, p. 13–18

doi: 10.17219/pzp/112223

Publication type: original article

Language: English

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Factors affecting patient tolerance of unsedated upper gastrointestinal tract endoscopy

Czynniki wpływające na tolerancję endoskopii górnego odcinka przewodu pokarmowego bez sedacji

Barbara Maślanka-Seiffert1,2,A,B,D,F, Piotr Seiffert3,A,B,D,F, Agnieszka Olchowska-Kotala4,C,E,F, Radosław Kempiński5,A,E,F

1 Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice

2 Geriatric Ward, The Municipal Hospital of Chorzów, Poland

3 John Paul II Geriatric Hospital, Katowice, Poland

4 Department of Humanistic Sciences in Medicine, Wroclaw Medical University, Poland

5 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

Abstract

Background. Endoscopy of the upper gastrointestinal tract is a widely used diagnostic procedure. It can be a source of anxiety, discomfort and even pain for the patients.
Objectives. The aim of the study was to assess the discomfort and anxiety associated with gastroscopy, examine their determinants and describe patients’ preferences regarding medical procedures and personnel behavior.
Material and Methods. The study involved 50 patients (21 men and 29 women) who underwent an endoscopy of the upper gastrointestinal tract. The State-Trait Anxiety Inventory (STAI) was employed, as well as the authors’ own two-part questionnaire, which was conducted before and after the endoscopy.
Results. The average level of anxiety was 40.72 STAI points and the emetic reflex was its main source (52%). The average level of discomfort felt during the gastroscopy was 2.84 and was related to both age (p = 0.001), security and privacy during the examination (p = 0.03), as well as to the level of anxiety prior to examination (p = 0.05). The severity of the discomfort was not associated with gender, education or subjective assessment of knowledge about the examination. Half of the patients would have liked to be sedated. A majority of the respondents (61%) indicated that verbal reassurance is a desirable form of behavior of the medical staff.
Conclusion. The main cause of patients’ anxiety is fear of the discomfort associated with the emetic reflex. The discomfort experienced by patients during endoscopy is linked to their age group, with younger participants experiencing greater discomfort, higher levels of anxiety prior to the examination, and a lower sense of security and privacy. Patients value verbal reassurance, procedural information and behavioral instructions during the endoscopy. General sedation is preferred by patients.

Streszczenie

Wprowadzenie. Endoskopia górnego odcinka przewodu pokarmowego jest rozpowszechnionym badaniem diagnostycznym. Może stanowić dla pacjenta źródło lęku, dyskomfortu, a nawet bólu.
Cel pracy. Celem badania była ocena dyskomfortu i lęku związanego z gastroskopią, zbadanie ich determinantów oraz określenie oczekiwań pacjentów odnośnie do procedur medycznych i zachowania personelu.
Materiał i metody. Przebadano 50 pacjentów (21 mężczyzn i 29 kobiet) poddanych endoskopii górnego odcinka przewodu pokarmowego. Do badania wykorzystano Inwentarz Stanu i Cechy Lęku STAI oraz dwuczęściową autorską ankietę przeprowadzaną przed endoskopią i po niej.
Wyniki. Średni poziom lęku wynosił 40,72 pkt STAI, a odruch wymiotny był jego głównym źródłem (52%). Średni poziom odczuwanego dyskomfortu podczas gastroskopii wynosił 2,84 i był związany zarówno z wiekiem (p = 0,001), bezpieczeństwem i prywatnością podczas badania (p = 0,03), jak i poziomem lęku przed badaniem (p = 0,05). Nasilenie dyskomfortu nie było związane z płcią, wykształceniem i subiektywną oceną wiedzy o badaniu. Połowa pacjentów zadeklarowała chęć użycia sedacji. Spośród respondentów 61% wskazało, że wsparcie werbalne jest pożądaną formą zachowania personelu medycznego.
Wnioski. Główną przyczyną niepokoju pacjentów jest lęk przed dyskomfortem związanym z odruchem wymiotnym. Dyskomfort odczuwalny podczas endoskopii jest większy u młodszych pacjentów, związany z wyższym poziomem lęku przed badaniem i mniejszym poczuciem bezpieczeństwa i prywatności. Pacjenci doceniają wsparcie werbalne, informacje proceduralne i instrukcje behawioralne podczas endoskopii, a także oczekują możliwości zastosowania optymalnej sedacji.

Key words

anxiety, gastroscopy, discomfort

Słowa kluczowe

lęk, gastroskopia, dyskomfort

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