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Bertok T, Pinkeova A, Lorencova L, Datkova A, Hires M, Jane E, Tkac J. Glycoproteomics of Gastrointestinal Cancers and Its Use in Clinical Diagnostics. J Proteome Res 2025. [PMID: 40368336 DOI: 10.1021/acs.jproteome.5c00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2025]
Abstract
Cancer is a leading cause of death worldwide, resulting in substantial economic costs. Because cancer is a complex, heterogeneous group of diseases affecting a variety of cells, its detection may sometimes be difficult. Herein we review a large group of the gastrointestinal cancers (oral, esophageal, stomach, pancreatic, liver, and bowel cancers) and the possibility of using glycans conjugated to protein backbones for less-invasive diagnoses than the commonly used endoscopic approaches. The reality of bacterial N-glycosylation and the effect of epithelial mucosa on gut microbiota are discussed. Current advantages, barriers, and advantages in the prospective use of selected glycomic approaches in clinical practice are also detailed.
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Affiliation(s)
- Tomas Bertok
- Institute of Chemistry, Slovak Academy of Sciences, Dubravska cesta 9, 845 38 Bratislava, Slovak Republic
| | - Andrea Pinkeova
- Institute of Chemistry, Slovak Academy of Sciences, Dubravska cesta 9, 845 38 Bratislava, Slovak Republic
- Glycanostics, Kudlakova 7, 841 01 Bratislava, Slovak Republic
| | - Lenka Lorencova
- Institute of Chemistry, Slovak Academy of Sciences, Dubravska cesta 9, 845 38 Bratislava, Slovak Republic
| | - Anna Datkova
- Institute of Chemistry, Slovak Academy of Sciences, Dubravska cesta 9, 845 38 Bratislava, Slovak Republic
| | - Michal Hires
- Institute of Chemistry, Slovak Academy of Sciences, Dubravska cesta 9, 845 38 Bratislava, Slovak Republic
| | - Eduard Jane
- Institute of Chemistry, Slovak Academy of Sciences, Dubravska cesta 9, 845 38 Bratislava, Slovak Republic
- Glycanostics, Kudlakova 7, 841 01 Bratislava, Slovak Republic
| | - Jan Tkac
- Institute of Chemistry, Slovak Academy of Sciences, Dubravska cesta 9, 845 38 Bratislava, Slovak Republic
- Glycanostics, Kudlakova 7, 841 01 Bratislava, Slovak Republic
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Rao AK, Kalra S, Tran D, Patel A, Al-Saadi I, Diggins LC, Rockey DC, Van Leer-Greenberg B. The Utility of Multitarget Stool DNA Testing in Community-Based Clinical Practice. Am J Gastroenterol 2025:00000434-990000000-01689. [PMID: 40197618 DOI: 10.14309/ajg.0000000000003480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Accepted: 03/05/2025] [Indexed: 04/10/2025]
Abstract
INTRODUCTION Multitarget stool DNA (MT-sDNA) tests (i.e., Cologuard) serve as screening tests for colorectal cancer (CRC) and are recommended by the US Preventive Services Task Force every 1-3 years. In this study, in a primary care setting, our aim was to evaluate the diagnostic performance of MT-sDNA testing and colonoscopy findings after a positive MT-sDNA testing result. METHODS This was a retrospective cohort study of electronic health record data including all patients who underwent MT-sDNA tests (Cologuard; Exact Sciences, Madison, WI) at 35 network primary care facilities from Winter of 2019 to Spring of 2023. Patients who were at high risk and had a prior colonoscopy or prior negative MT-sDNA test result were excluded. Assessment of pathology was as previously described, including for advanced adenomas and CRC. RESULTS Among the 5,827 patients for whom MT-sDNA testing was ordered, 3,119 patients completed the test; 482 (15%) had a positive MT-sDNA test, most of whom were women, had an average age of 65 years, and were predominantly White (Supplemental Figure 1, Table 1). Among these 482 patients, 277 (57%) had a follow-up screening colonoscopy, with 253 patients having complete colonoscopy data. Ten patients (4%) had CRC, 61 (24%) had advanced adenomas, and 184 patients (73%) had neither. The sigmoid colon was the most common site for CRC, with 8 of 10 patients having tumor, node, metastasis stage ≥1 CRC. DISCUSSION The rate of colon cancer detection (10/5,827 [0.2%] patients for whom it was ordered and 10/3,119 [0.3%] who completed the test) was lower than expected in a screening cohort. Most patients who completed MT-sDNA testing had a false-positive result for advanced adenomas or CRC (73%). Together, these findings raise questions about the effectiveness of screening based on MT-sDNA testing in an average risk population.
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Affiliation(s)
- Abhinav K Rao
- Division of Internal Medicine, Trident Medical Center, North Charleston, South Carolina, USA
- Digestive Disease Research Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shivam Kalra
- Division of Internal Medicine, Trident Medical Center, North Charleston, South Carolina, USA
| | - Danny Tran
- Division of Internal Medicine, Trident Medical Center, North Charleston, South Carolina, USA
| | - Angeli Patel
- Division of Internal Medicine, Trident Medical Center, North Charleston, South Carolina, USA
| | - Ibrahim Al-Saadi
- Division of Internal Medicine, Trident Medical Center, North Charleston, South Carolina, USA
| | - Levi C Diggins
- Division of Internal Medicine, Trident Medical Center, North Charleston, South Carolina, USA
| | - Don C Rockey
- Digestive Disease Research Center, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Brett Van Leer-Greenberg
- Division of Gastroenterology, Palmetto Primary Care Physicians, Summerville, South Carolina, USA
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Hopkins T, Bell-Brown A, Martinez-Pinto P, Henderson V, Ko LK, Isler A, Issaka RB. A Video Decision Aid Decreases Fear of Colonoscopy After an Abnormal Fecal Immunochemical Test Result: A Pilot Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2025:10.1007/s13187-025-02623-0. [PMID: 40186724 DOI: 10.1007/s13187-025-02623-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/25/2025] [Indexed: 04/07/2025]
Abstract
Colonoscopy completion after abnormal fecal immunochemical test (FIT) results is inadequate, and patient fear is a commonly reported barrier. We developed and piloted a video decision aid that addresses fear of colonoscopy among patients with abnormal FIT results. We developed a video decision aid and, in a pilot study, randomized patients in a safety-net healthcare system with abnormal FIT results and no follow-up colonoscopy to the intervention or usual care. Both groups completed a baseline survey that measured fear of colonoscopy, knowledge about colorectal cancer (CRC), self-efficacy, and intent to complete a colonoscopy, and the intervention group repeated the survey after watching the video. Sixty patients were enrolled in the study. Participants that watched the video reported a 17.7% decrease in fear of colonoscopy (p < 0.01) across six domains, including fear of the bowel prep (p < 0.01), the actual colonoscopy procedure (p < 0.01), and possible complications from the procedure (p = 0.04). Participant CRC knowledge also increased across several measures, including a 43.5% decrease in the belief that it is difficult to know which CRC prevention recommendations to follow. Overall, 78.3% of participants found the video to be helpful, and 90.6% would recommend the video to other patients with abnormal FIT results. In a safety-net population with abnormal FIT results, a video decision aid decreased fear of colonoscopy and increased knowledge about CRC. The video decision aid was acceptable to participants and can be considered an additional tool to improve follow-up of abnormal FIT results.
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Affiliation(s)
- Talor Hopkins
- Hutchinson Institute for Cancer Outcomes Research (HICOR), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
| | - Ari Bell-Brown
- Hutchinson Institute for Cancer Outcomes Research (HICOR), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
| | | | - Vida Henderson
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
| | - Linda K Ko
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | | | - Rachel B Issaka
- Hutchinson Institute for Cancer Outcomes Research (HICOR), Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA.
- Public Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Center, 1100 Fairview Ave. N., M/S: M3-B232, Seattle, WA, 98109, USA.
- Division of Gastroenterology, University of Washington School of Medicine, Seattle, WA, USA.
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Chen YS, Feng GH, Yue QQ, Wang YF, Liu M, Zhao KH, Tang T, Huang MT, Yi WT, Yan HL, Yan JH, Zeng Y. Effects of non-pharmacological interventions on anxiety in patients undergoing colonoscopy: A network meta-analysis of randomized controlled trials. J Psychosom Res 2025; 191:112065. [PMID: 40043571 DOI: 10.1016/j.jpsychores.2025.112065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 01/07/2025] [Accepted: 02/17/2025] [Indexed: 03/16/2025]
Abstract
BACKGROUND Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered. OBJECTIVES To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies. METHODS We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the "gemtc" package based on R4.3.0. RESULTS The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (-0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(-0.96,-0.12)), video information (SMD = -1.47, 95 %CI(-2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(-2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(-2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low. CONCLUSION This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
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Affiliation(s)
- Yun-Shan Chen
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ge-Hui Feng
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Qian-Qian Yue
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Yi-Fei Wang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Min Liu
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ke-Hao Zhao
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Tian Tang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Mao-Ting Huang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Wen-Ting Yi
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Hui-Ling Yan
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Jia-Hui Yan
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ying Zeng
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China.; Hunan Engineering Research Center for Early Diagnosis and Treatment of Liver Cancer, Cancer Research Institute, Hengyang Medical School, University of South China; Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, China..
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Emerson B, Reiter PL, Klatt M, Gray DM, Hussan H, Chakraborty S, Katz ML. Development of a Brief Online Mindfulness-Based Intervention to Reduce Patient Anxiety Before a First-Time Screening Colonoscopy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2025:10.1007/s13187-025-02608-z. [PMID: 40163313 DOI: 10.1007/s13187-025-02608-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/14/2025] [Indexed: 04/02/2025]
Abstract
To describe the development of an online mindfulness-based intervention (MBI) to reduce anxiety before a first-time screening colonoscopy among average-risk patients. A qualitative study used an iterative process guided by health behavior and mindfulness theories and feedback from a convenience sample of patients, endoscopy medical staff, and community members. Patient and medical staff (n = 18) were included in formative interviews (30-45 min), eight helped during intervention development sessions (15-90 min), and four community members reviewed the MBI in individual sessions (60 min). Interviews and sessions were recorded, transcribed verbatim, and analyzed using NVivo qualitative data software. Two themes emerged from the study: (1) both patients and medical staff reported that average-risk patients have pre-procedural anxiety before a first-time screening colonoscopy, and (2) using stakeholder-engaged strategies in an iterative process with both patients and medical staff is important so the developed intervention is acceptable to the priority population and to ensure medical accuracy and avoid disruption of workflow. Using an iterative process with key stakeholders is essential to develop interventions that are feasible and acceptable. The MBI developed through this process is being compared to usual care in a pilot randomized controlled trial to determine intervention feasibility and patient acceptability and to collect preliminary efficacy data. If efficacious, the developed MBI has the potential to reduce pre-procedural anxiety which may improve patient behaviors (e.g., bowel prep adherence and quality), patient satisfaction, and clinic workflow by reducing cancellation/no-shows, the amount of sedation required, and procedural time.
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Affiliation(s)
- Brent Emerson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA.
| | - Paul L Reiter
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Maryanna Klatt
- Center for Integrative Health, Department of Family and Community Medicine, College Medicine, The Ohio State University, Columbus, OH, USA
| | - Darrell M Gray
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Hisham Hussan
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Subhankar Chakraborty
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Mira L Katz
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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Cold KM, Vamadevan A, Heen A, Vilmann AS, Rasmussen M, Konge L, Svendsen MBS. Is the Transverse Colon Overlooked? Establishing a Comprehensive Colonoscopy Database from a Multicenter Cluster-Randomized Controlled Trial. Diagnostics (Basel) 2025; 15:591. [PMID: 40075838 PMCID: PMC11898687 DOI: 10.3390/diagnostics15050591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 02/21/2025] [Accepted: 02/25/2025] [Indexed: 03/14/2025] Open
Abstract
Background and Study Aim: Colonoscopy holds the highest volume of all endoscopic procedures, allowing for large colonoscopy databases to serve as valuable datasets for quality assurance. We aimed to build a comprehensive colonoscopy database for quality assurance and the training of future AIs. Materials and Methods: As part of a cluster-randomized controlled trial, a designated, onsite medical student was used to acquire procedural and patient-specific data, ensuring a high level of data integrity. The following data were thereby collected for all colonoscopies: full colonoscopy vides, colonoscope position (XYZ-coordinates), intraprocedural timestamps, pathological report, endoscopist description, endoscopist planning, and patient-reported discomfort. Results: A total of 1447 patients were included from the 1st of February 2022 to the 21st of November 2023; 1191 colonoscopies were registered as completed, 88 were stopped due to inadequate bowel cleansing, and 41 were stopped due to patient discomfort. Of the 1191 completed colonoscopies, 601 contained polypectomies (50.4%), and 590 did not (49.6%). Comparing colonoscopies with polypectomies to those without the withdrawal time (caecum to extubating the scope) was significantly longer for all parts of the colon (p values < 0.001), except the transverse colon (p value = 0.92). The database was used to train an AI, automatically and objectively evaluating bowel preparation. Conclusions: We established the most thorough database in colonoscopy with previously inaccessible information, indicating that the transverse colon differs from the other parts of the colon in terms of withdrawal time for procedures with polypectomies. To further explore these findings and reach the full potential of the database, an AI evaluating bowel preparation was developed. Several research partners have been identified to collaborate in the development of future AIs.
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Affiliation(s)
- Kristoffer Mazanti Cold
- Copenhagen Academy for Medical Education and Simulation (CAMES) Rigshospitalet, Capital Region of Denmark, 2100 Copenhagen, Denmark; (K.M.C.); (A.V.); (A.H.); (A.S.V.); (L.K.)
- Faculty of Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Anishan Vamadevan
- Copenhagen Academy for Medical Education and Simulation (CAMES) Rigshospitalet, Capital Region of Denmark, 2100 Copenhagen, Denmark; (K.M.C.); (A.V.); (A.H.); (A.S.V.); (L.K.)
| | - Amihai Heen
- Copenhagen Academy for Medical Education and Simulation (CAMES) Rigshospitalet, Capital Region of Denmark, 2100 Copenhagen, Denmark; (K.M.C.); (A.V.); (A.H.); (A.S.V.); (L.K.)
| | - Andreas Slot Vilmann
- Copenhagen Academy for Medical Education and Simulation (CAMES) Rigshospitalet, Capital Region of Denmark, 2100 Copenhagen, Denmark; (K.M.C.); (A.V.); (A.H.); (A.S.V.); (L.K.)
- Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital—Herlev and Gentofte, 2730 Herlev, Denmark
| | - Morten Rasmussen
- Danish Colorectal Cancer Screening Database (DCCSD) Steering Committee, 8200 Aarhus, Denmark;
- Bispebjerg University Hospital, 2400 Copenhagen, Denmark
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation (CAMES) Rigshospitalet, Capital Region of Denmark, 2100 Copenhagen, Denmark; (K.M.C.); (A.V.); (A.H.); (A.S.V.); (L.K.)
- Faculty of Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Morten Bo Søndergaard Svendsen
- Copenhagen Academy for Medical Education and Simulation (CAMES) Rigshospitalet, Capital Region of Denmark, 2100 Copenhagen, Denmark; (K.M.C.); (A.V.); (A.H.); (A.S.V.); (L.K.)
- Department of Computer Science, Faculty of Science, University of Copenhagen, 2200 Copenhagen, Denmark
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Yue QQ, Feng GH, Peng T, Tang T, Sun YX, Meng XR, Huang LL, Zhao KH, Huang HL, Zeng Y. What is the current state of anxiety and its related factors in Chinese patients undergoing colonoscopy? A cross-sectional study. BMC Psychol 2025; 13:169. [PMID: 40016795 PMCID: PMC11869731 DOI: 10.1186/s40359-025-02463-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 02/06/2025] [Indexed: 03/01/2025] Open
Abstract
BACKGROUND Anxiety in patients undergoing colonoscopy may also result in adverse effects, including altered vital signs such as elevated heart rate and blood pressure, exacerbation of symptoms like bloating and gastrointestinal discomfort, a decline in cooperation and satisfaction, and even colonoscopy failure. However, limited studies have explored the level of anxiety, factors that influence it, and its specific causes. METHODS A cross-sectional study was conducted, recruiting 825 patients undergoing colonoscopy in Hunan Province between January and July 2023 using stratified sampling. The Spielberger State-Trait Anxiety Inventory (STAI), a self-designed demographic characteristics questionnaire, and a colonoscopy patient anxiety influencing factor questionnaire were used. The data were analyzed in SPSS (version 26) using Mann-Whitney U, Kruskal-Wallis, and multiple regression analysis tests. RESULTS The final study included 825 participants, of whom 19.8% exhibited mild anxiety, 37.0% exhibited moderate anxiety, and 43.2% exhibited severe anxiety. The results indicated that insomnia (β=-0.080, p = 0.013), no comorbidities (β=-0.147, p < 0.001), not smoking or drinking (β=-0.158, p < 0.001), and poor health (moderate: β=-0.183, p < 0.001; poor: β=-0.164, p < 0.001) were negatively associated with anxiety levels. In contrast, marital status (β = 0.177, p < 0.001), education level (β = 0.204, p < 0.001), age (β = 0.114, p = 0.007), medical insurance (Basic Medical Insurance for Urban Residents β = 0.204, p < 0.001; Commercial medical insurance: β = 0.112, p < 0.001), care provided by relatives (β = 0.102, p = 0.002), diarrhoea (β = 0.089, p = 0.005), occupation (farmers: β = 0.099, p = 0.009; self-employed: β = 0.082, p = 0.014), and paternal upbringing (β = 0.067, p = 0.034) were positively correlated with anxiety. Several factors had a greater impact on the anxiety level of the patients: education level (β = 0.204), health status (moderate: β=-0.183; not good: β=-0.164), and marital status (β = 0.177). It probably because higher education levels may increase awareness of potential risks associated with colonoscopy, contributing to greater anxiety. The five common reasons for anxiety included the presence of bloody faeces, enemas, need for further treatment, lack of timely feedback from the physician, lack of an accurate diagnosis. CONCLUSION The level of anxiety experienced by patients during the colonoscopy phase was more severe and should be alleviated with targeted interventions based on the cause of anxiety, such as pre-procedural counseling, patient education materials, and enhanced communication with healthcare providers.
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Affiliation(s)
- Qian-Qian Yue
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ge-Hui Feng
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Tong Peng
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Tian Tang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ying-Xue Sun
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Xin-Ru Meng
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Li-Li Huang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ke-Hao Zhao
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Hui-Lin Huang
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China
| | - Ying Zeng
- Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China.
- Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, China.
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8
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Aslan K, Özer Z, Yöntem MK. Effect of Virtual Reality on Pain, Anxiety, and Vital Signs in Endoscopy. Pain Manag Nurs 2025:S1524-9042(24)00312-6. [PMID: 39809653 DOI: 10.1016/j.pmn.2024.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/28/2024] [Accepted: 11/30/2024] [Indexed: 01/16/2025]
Abstract
AIM This study was conducted to evaluate the effect of relaxation exercise with VR (Virtual Reality) glasses on pain severity, anxiety level, and vital signs in patients undergoing endoscopy. METHODS This is a quasi-experimental study including a control group with a pretest/post-test applied. This study was conducted with a total of 100 patients, including 50 patients in the intervention and 50 patients in the control group. The data were collected by using Personal Information Form, Visual Analogue Scale (VAS), Visual Anxiety Scale, Vital Signs Form and Virtual Reality Glass Application Satisfaction Form. RESULTS In the inter group evaluation, the mean systolic and diastolic blood pressure, heart rate and respiratory rate of the patients in the experimental group after endoscopy were found to be lower than the control group (p < .05). When the effect size value (Cohen d) of this finding was examined, it was found that the application of virtual reality glasses had a large effect on systolic and diastolic blood pressure and a moderate effect on respiration and heart rate. It was found that the mean VAS score of the patients in the control group after the endoscopy procedure was significantly higher than their mean values before the procedure (p = .001). There was no statistically significant difference in the mean VAS scores, anxiety scores and O2 saturation values of the patients in the experimental and control groups after the endoscopy. The mean virtual reality glasses satisfaction value of the patients was found to be 6.98. CONCLUSION Relaxation exercise performed with virtual reality glasses has positive effects on mean systolic and diastolic blood pressure values, heart rate and respiratory rate in patients undergoing endoscopy. In line with these results, it is recommended that the use of virtual reality glasses during endoscopy should be widespread by nurses.
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Affiliation(s)
- Kübra Aslan
- Graduate School of Education, Department of Nursing, Istanbul Sabahattin Zaim University, Istanbul, Turkey
| | - Zülfünaz Özer
- Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey..
| | - Mustafa Kemal Yöntem
- Department of Psychology, Faculty of Economics, Administrative and Social Sciences, University of Samsun, Samsun, Turkey
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Jiang S, Xia X, Lin M, Wang L. Nursing Intervention Based on the Interactive Attainment Model. Nurs Sci Q 2025; 38:67-75. [PMID: 39658915 DOI: 10.1177/08943184241291563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2024]
Abstract
This study aimed to examine the effectiveness of nursing that was based on the interactive attainment model in alleviating anxiety and pain during colonoscopy. This retrospective study included 213 patients, divided into intervention and control groups. Both groups underwent normal or painless colonoscopy. Anxiety and pain were evaluated using the Self-Rating Anxiety Scale and the Visual Analog Scale (VAS), respectively. The intervention group reported significantly lower anxiety and VAS pain scores compared with the control group. The interactive attainment model of nursing effectively reduces patient anxiety and pain and lowers complication rates in patients undergoing colonoscopy.
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Affiliation(s)
- Shuyin Jiang
- Department of Gastroenterology, Hangzhou First People's Hospital, Affiliated to Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China
| | - Xiaofeng Xia
- Department of Gastroenterology, Hangzhou First People's Hospital, Affiliated to Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China
| | - Min Lin
- Department of Gastroenterology, Hangzhou First People's Hospital, Affiliated to Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China
| | - Linfei Wang
- Gastrointestinal Surgery, Hangzhou First People's Hospital, Affiliated to Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, China
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Polatkan SAV, Gunay-Polatkan S, Isik O, Sigirli D. Using the Cardiac-Electrophysiological Balance Index to Predict Arrhythmia Risk After Colonoscopy. MEDICINA (KAUNAS, LITHUANIA) 2024; 61:13. [PMID: 39858995 PMCID: PMC11766922 DOI: 10.3390/medicina61010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 12/16/2024] [Accepted: 12/24/2024] [Indexed: 01/27/2025]
Abstract
Background and Objectives: Colorectal cancer is the second leading cause of cancer-related deaths in the U.S., and colonoscopy is a critical tool for colon cancer screening and diagnosis. Electrolyte disturbances and autonomic nervous system dysfunction that may occur due to bowel preparation and the colonoscopy procedure itself may play a role in the development of cardiac arrhythmia. This study aimed to assess the index of cardiac-electrophysiological balance (iCEB) to predict ventricular arrhythmia risk related to colonoscopy. Materials and Methods: Patients undergoing elective colonoscopy with a normal sinus rhythm were included. Electrocardiography (ECG) recordings both before bowel preparation and after the colonoscopy procedure were obtained. Values of the index of cardiac-electrophysiological balance (iCEB) were compared. Results: Among 36 patients, it was determined that the heart rate values of the patients before bowel preparation were higher than the heart rate values after colonoscopy [74.5 (60-108) bpm vs. 68.5 (53-108) bpm, p = 0.021]. The duration of QT interval increased (370.9 ± 27.8 ms vs. 398.7 ± 29.4 ms, p < 0.001) and the iCEB increased from 4.1 ± 0.5 to 4.5 ± 0.6 (p < 0.001), indicating a significant post-procedural risk of ventricular arrhythmias. Conclusions: These findings suggest that routine iCEB assessment post-colonoscopy could identify high-risk patients requiring closer monitoring.
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Affiliation(s)
| | - Seyda Gunay-Polatkan
- Department of Cardiology, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey;
| | - Ozgen Isik
- Department of General Surgery, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey;
| | - Deniz Sigirli
- Department of Biostatistics, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey;
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11
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Triantafyllou K, Sidhu R, Tham T, Tziatzios G, Guy C, Messmann H, Arvanitakis M, Hassan C, Bisschops R, Gralnek IM. Sedation practices in Gastrointestinal Endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) survey. Endoscopy 2024; 56:964-974. [PMID: 39496289 DOI: 10.1055/a-2416-4866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2024]
Affiliation(s)
- Konstantinos Triantafyllou
- Second Academic Department of Gastroenterology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Reena Sidhu
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
- Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Tony Tham
- Department of Gastroenterology and Hepatology, Ulster Hospital, Dundonald, Northern Ireland
| | - Georgios Tziatzios
- Department of Gastroenterology, General Hospital of Nea Ionia "Konstantopoulio-Patision", Athens, Greece
| | - Claire Guy
- TUM School of Medicine and Health, Technische Universität München, Munich, Germany
| | - Helmut Messmann
- Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany
| | - Marianna Arvanitakis
- Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Cesare Hassan
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - Raf Bisschops
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, and TARGID, KU Leuven, Leuven, Belgium
| | - Ian Mark Gralnek
- Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel
- Rappaport Family Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
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12
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Marchildon M, Jackson J, Rankin J. Factors influencing inpatient bowel preparation: a scoping review. J Gastroenterol Hepatol 2024; 39:2487-2503. [PMID: 39165168 PMCID: PMC11660208 DOI: 10.1111/jgh.16721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 07/09/2024] [Accepted: 08/06/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND AND AIM Inpatients undergoing colonoscopy experience a higher-than-average rate of inadequate bowel preparation (compared to outpatients) leading to canceled procedures, increased stress on the patient, increased time in hospital, and increased cost to the healthcare system. The aim of this scoping review was to identify research surrounding inpatient bowel preparation and to identify modifiable and non-modifiable factors that influence the adequacy of bowel preparation in hospitalized patients undergoing colonoscopy and establish areas where nursing interventions may help improve overall bowel preparation rates. METHODS An initial search of MEDLINE, CINAHL, Scopus, and Embase was undertaken to identify seed articles, followed by a structured search using keywords and subject headings. Studies conducted between 2000 and 2022 and published in English were included. A total of 37 full-text studies were screened for inclusion, with 22 meeting inclusion criteria. RESULTS Advanced age, decreased mobility, constipation, extended length of stay, and multiple comorbidities were identified as non-modifiable factors associated with inadequate bowel preparation. Narcotic use, failure to follow preparation instruction, and delayed time to colonoscopy were identified as modifiable factors associated with poor bowel preparation. CONCLUSIONS Educational interventions and interprofessional programs, using a multifaceted approach, increase the odds of adequate bowel preparation, including nursing tip sheets, troubleshooting flowsheets, and bowel movement assessment scoring.
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Affiliation(s)
| | | | - Janet Rankin
- Faculty of NursingUniversity of Calgary in QatarDohaQatar
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13
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Shamali M, Vilmann P, Johansen NR, Konradsen H. Virtual reality intervention to improve quality of care during colonoscopy: a hybrid type 1 randomized controlled trial. Gastrointest Endosc 2024; 100:914-922.e2. [PMID: 38851457 DOI: 10.1016/j.gie.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND AND AIMS Effective management of patients' pain, anxiety, and discomfort during colonoscopy is crucial for successful completion of the procedure, patient adherence to follow-up examinations, and patient satisfaction. Virtual reality (VR) interventions, as a nonpharmacologic and innovative solution, have demonstrated promising results in managing these outcomes. Nevertheless, there is limited evidence on their effectiveness and implementation. This trial aimed to test clinical effectiveness and identify factors to facilitate the implementation of VR during colonoscopy. METHODS A hybrid type 1 effectiveness implementation, parallel randomized controlled, open-label trial was conducted. Fifty patients were randomized (1:1) to a VR or a control group. The effectiveness (pain, anxiety, discomfort, medication use, and satisfaction) and implementation (reach, adoption, implementation, and maintenance) outcomes were assessed before, during, and after colonoscopy. RESULTS Patients in the VR group reported significantly lower pain (P = .043) and discomfort (P <.0001) during colonoscopy, had a higher number of completed colonoscopies without sedation (P = .003), and showed higher satisfaction (P = .032). The major barrier to the implementation and maintenance of the VR intervention was inadequate VR content design. Staff were most worried about altered patient communications, unclear responsibilities, increasing workload, and patient safety. Patients expressed willingness to reuse VR glasses and to suggest them to other patients. CONCLUSIONS VR can be used as a nonpharmacologic method for pain management and for overcoming anxiety and discomfort during colonoscopy. VR can improve patients' satisfaction and diminish the need for sedative medications; accordingly, it has the potential to promote cooperation and compliance among patients and increase screening colonoscopy rates. (Clinical trial registration number: NCT05723861.).
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Affiliation(s)
- Mahdi Shamali
- GastroUnit, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.
| | - Peter Vilmann
- GastroUnit, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels René Johansen
- GastroUnit, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Hanne Konradsen
- GastroUnit, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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14
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Saab O, Al-Obaidi H, Merza N, Bhagat U, Al-Sagban A, Algodi M, Abuelazm M, El-Serag H. The Impact of Visual Distraction Interventions on Patients' Pain and Anxiety During Colonoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Gastroenterol 2024:00004836-990000000-00372. [PMID: 39495815 DOI: 10.1097/mcg.0000000000002086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 09/17/2024] [Indexed: 11/06/2024]
Abstract
BACKGROUND AND OBJECTIVE Patients undergoing colonoscopy may experience psychological distress related to the procedure, which may deter adherence and acceptance of future colonoscopies. Visual/audiovisual distraction interventions to alleviate colonoscopy-related pain and anxiety have been developed. This study aims to investigate the impact of these interventions on colonoscopy-related outcomes. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) testing the efficacy of visual/audiovisual distraction. Eligible studies were systematically retrieved by searching PubMed, EMBASE, WOS, SCOPUS, and Cochrane through June 2024 and extracted by 2 investigators. Continuous and dichotomous outcome variables were pooled using Cohen's d and risk ratio (RR) with confidence interval (CI) using Stata MP version 17. We assessed heterogeneity using the χ2 test and I2 statistic (PROSPERO ID: CRD42024555902). RESULTS We included 13 RCTs with 1439 patients randomized to an active intervention (n=804) or usual care (n=635). Only 3 RCTs were endoscopists-blinded studies, whereas the rest were open-label. The interventions included playing nature scene videos, real-time videos of the colonoscopy, or movies preferred by the patients. The active intervention arm was associated with a significant reduction in the pain experienced during colonoscopy (Cohen's d: -0.57, 95% CI [-0.79, -0.35], P<0.0001), reduced anxiety related to colonoscopy (Cohen's d: -0.66, 95% CI [-1.15, -0.18], P=0.01), and increased patients' satisfaction (Cohen's d: 0.65, 95% CI [0.49, 0.80], P<0.0001) compared with patients who received the usual care during colonoscopy. There were no significant differences between both groups in the willingness to re-undergo the procedure (RR: 1.11, 95% CI [0.98, 1.25], P=0.09), analgesia use (Cohen's d: -0.21, 95% CI [-0.42, 0.0], P=0.05), or total procedure duration (Cohen's d: -0.12, 95% CI [-0.24, 0.0], P=0.06). CONCLUSIONS Visual/audiovisual distraction interventions decrease colonoscopy-associated pain and anxiety and increase patients' satisfaction. These are promising interventions to improve patient compliance and quality of care during colonoscopy.
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Affiliation(s)
- Omar Saab
- Department of Hospital Medicine, Cleveland Clinic Foundation, OH
| | - Hasan Al-Obaidi
- Department of Medicine, Jamaica Hospital Medical Canter, Jamaica NY
| | - Nooraldin Merza
- Department of Gastroenterology, Toledo, University of Toledo, OH
| | - Umesh Bhagat
- Department of Hospital Medicine, Cleveland Clinic Foundation, OH
| | | | - Marwah Algodi
- Department of Medicine, University of Baghdad College of Medicine, Baghdad, Iraq
| | - Mohamed Abuelazm
- Department of Medicine, Tanta University Faculty of Medicine, Tanta Egypt
| | - Hashem El-Serag
- Department of Medicine, Baylor College of Medicine, Houston, TX
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15
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Zhang Y, Sheng C, Fan Z, Liu Y, Liu X, Duan H, Dai H, Lyu Z, Yang L, Song F, Song F, Huang Y, Chen K. Risk-stratified screening and colorectal cancer incidence and mortality: A retrospective study from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Prev Med 2024; 187:108117. [PMID: 39178994 DOI: 10.1016/j.ypmed.2024.108117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 08/26/2024]
Abstract
OBJECTIVE To determine whether risk stratification can optimize the benefits of flexible sigmoidoscopy (FSG) screening. METHODS The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial was conducted from 1993 to 2001 in the United States. A colorectal cancer (CRC) risk stratification tool was developed in the control arm (n = 64,207) from the PLCO cohort and validated in the UK Biobank (n = 270,726). PLCO participants (n = 130,021) were classified into low-, medium-, and high-risk groups. Cumulative incidence and mortality were estimated using the Kaplan-Meier method. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between screening and CRC incidence and mortality. RESULTS The CRC risk stratification tool was based on age, gender, body mass index, smoking status, family history of CRC, diabetes, regular use of aspirin, and CRC screening history. Compared with the control arm, FSG screening was significantly associated with a reduction in mortality in both the medium-risk (HR = 0.76, 95% CI = 0.63-0.92) and high-risk groups (0.58, 0.46-0.73), but not in the low-risk group (0.85, 0.61-1.19). FSG screening also reduced distal CRC incidence and mortality in the medium-risk and high-risk groups. Furthermore, it was associated with a reduction in incidence (0.74, 0.59-0.92) and mortality (0.59, 0.40-0.87) of proximal colon cancer in the high-risk group. CONCLUSIONS FSG screening yielded more benefits for the high-risk group than for the low-risk and medium-risk groups, supporting the development of a risk-stratified CRC screening strategy.
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Affiliation(s)
- Yu Zhang
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Chao Sheng
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Zeyu Fan
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Ya Liu
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Xiaomin Liu
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Hongyuan Duan
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Hongji Dai
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Zhangyan Lyu
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Lei Yang
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, 100142 Beijing, China
| | - Fangfang Song
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Fengju Song
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China
| | - Yubei Huang
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China.
| | - Kexin Chen
- Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Prevention and Control of Human Major Diseases, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, 300060 Tianjin, China.
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Toto F, Marangelo C, Scanu M, De Angelis P, Isoldi S, Abreu MT, Cucchiara S, Stronati L, Del Chierico F, Putignani L. A Novel Microbial Dysbiosis Index and Intestinal Microbiota-Associated Markers as Tools of Precision Medicine in Inflammatory Bowel Disease Paediatric Patients. Int J Mol Sci 2024; 25:9618. [PMID: 39273567 PMCID: PMC11395508 DOI: 10.3390/ijms25179618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Recent evidence indicates that the gut microbiota (GM) has a significant impact on the inflammatory bowel disease (IBD) progression. Our aim was to investigate the GM profiles, the Microbial Dysbiosis Index (MDI) and the intestinal microbiota-associated markers in relation to IBD clinical characteristics and disease state. We performed 16S rRNA metataxonomy on both stools and ileal biopsies, metabolic dysbiosis tests on urine and intestinal permeability and mucosal immunity activation tests on the stools of 35 IBD paediatric patients. On the GM profile, we assigned the MDI to each patient. In the statistical analyses, the MDI was correlated with clinical parameters and intestinal microbial-associated markers. In IBD patients with high MDI, Gemellaceae and Enterobacteriaceae were increased in stools, and Fusobacterium, Haemophilus and Veillonella were increased in ileal biopsies. Ruminococcaceae and WAL_1855D were enriched in active disease condition; the last one was also positively correlated to MDI. Furthermore, the MDI results correlated with PUCAI and Matts scores in ulcerative colitis patients (UC). Finally, in our patients, we detected metabolic dysbiosis, intestinal permeability and mucosal immunity activation. In conclusion, the MDI showed a strong association with both severity and activity of IBD and a positive correlation with clinical scores, especially in UC. Thus, this evidence could be a useful tool for the diagnosis and prognosis of IBD.
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Affiliation(s)
- Francesca Toto
- Immunology, Rheumatology and Infectious Diseases Research Area, Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Chiara Marangelo
- Immunology, Rheumatology and Infectious Diseases Research Area, Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Matteo Scanu
- Immunology, Rheumatology and Infectious Diseases Research Area, Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Paola De Angelis
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Sara Isoldi
- Pediatric Gastroenterology and Hepatology Unit, Santobono-Pausilipon Children's Hospital, 80122 Naples, Italy
| | - Maria Teresa Abreu
- Crohn's and Colitis Center, Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Salvatore Cucchiara
- Maternal Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, 00185 Rome, Italy
| | - Laura Stronati
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Federica Del Chierico
- Immunology, Rheumatology and Infectious Diseases Research Area, Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Lorenza Putignani
- Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics and Immunology, Rheumatology and Infectious Diseases Research Area, Unit of Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
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17
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Travis E, Kerrison RS, O'Connor DB, Ashley L. Barriers and facilitators to colonoscopy for cancer detection: patient and practitioner perspectives. Psychol Health 2024; 39:1263-1283. [PMID: 36373225 DOI: 10.1080/08870446.2022.2141241] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To further understand the barriers and facilitators to attending colonoscopy examination following a positive routinely offered stool test result, from the perspective of patients and Specialist Screening Practitioners (SSPs). METHODS Qualitative semi-structured interviews were conducted. Participants (N = 32) were patients (n = 20) who, as part of the Bowel Cancer Screening Programme (BCSP) in England, were invited to attend a colonoscopy examination, and SSPs (n = 12), who worked for the BCSP in England. Framework analysis included inductive and deductive coding. RESULTS Anxiety was as a key barrier cited by patients and SSPs, arising from the moment the patient received the invitation letter. Notably, procedural-related anxieties centred upon the fear of pain and discomfort and test invasiveness. The role of family, friends and the SSP were recognised by patients and SSPs to facilitate participation. Many patients, yet not SSPs, emphasised an obligation to attend all medical test invitations. CONCLUSION Practically orientated strategies suggested by patients and SSPs address the patient barriers identified. These include earlier information to patients on the option of sedation for pain relief, earlier notification of potential financial support for patients unable to fund their own travel costs, and fewer uses of the term cancer within written materials.
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Affiliation(s)
| | | | | | - Laura Ashley
- Leeds School of Social Sciences, Leeds Beckett University, Leeds, UK
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18
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Yang T, Zhou Y, Wang M, Zhang L, Liu B, Sun L, Shi F, Yuan Y, Zhang G. Effects of remimazolam tosilate on gastrointestinal hormones and gastrointestinal motility in patients undergoing gastrointestinal endoscopy with sedation: a randomized control trial. Postgrad Med J 2024; 100:635-641. [PMID: 38538569 DOI: 10.1093/postmj/qgae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/18/2024] [Accepted: 03/06/2024] [Indexed: 08/20/2024]
Abstract
PURPOSE To investigate the impacts of remimazolam tosilate on gastrointestinal hormones and motility in patients undergoing gastrointestinal endoscopy with sedation. METHODS A total of 262 American Society of Anesthesiologists Physical Status I or II patients, aged 18-65 years, scheduled for gastrointestinal endoscopy with sedation, were randomly allocated into two groups (n = 131 each): the remimazolam tosilate group (Group R) and the propofol group (Group P). Patients in Group R received 0.2-0.25 mg/Kg remimazolam tosilate intravenously, while those in Group P received 1.5-2.0 mg/kg propofol intravenously. The gastrointestinal endoscopy was performed when the Modified Observer's Assessment of Alertness/Sedation scores were ≤3. The primary endpoints included the endoscopic intestinal peristalsis rating by the endoscopist; serum motilin and gastrin levels at fasting without gastrointestinal preparation (T0), before gastrointestinal endoscopy (T1), and before leaving the Post Anesthesia Care Unit (T2); and the incidences of abdominal distension during Post Anesthesia Care Unit. RESULTS Compared with Group P, intestinal peristalsis rating was higher in Group R (P < .001); Group R showed increased motilin and gastrin levels at T2 compared with Group P (P < .01). There was a rise in motilin and gastrin levels at T1 and T2 compared with T0 and at T2 compared with T1 in both groups (P < .01). The incidence of abdominal distension was lower in Group R (P < .05). CONCLUSION Compared with propofol used during gastrointestinal endoscopy with sedation, remimazolam tosilate mildly inhibits the serum motilin and gastrin levels, potentially facilitating the recovery of gastrointestinal motility.
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Affiliation(s)
- Tianyi Yang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Yinji Zhou
- Department of Hepatobiliary Pancreatic Surgery, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Mingshan Wang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Lina Zhang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Bing Liu
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Lixin Sun
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Fei Shi
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Yang Yuan
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
| | - Gaofeng Zhang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong 266071, People's Republic of China
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Bashkin O, Boltean R, Ben-Lulu R, Aharon M, Elhayany R, Yitzhak A, Guterman R, Abu-Freha N. A Patient-Centered Approach to Communication during Endoscopic Procedures: The Importance of Providing Information to Patients. Eur J Investig Health Psychol Educ 2024; 14:1688-1699. [PMID: 38921077 PMCID: PMC11202659 DOI: 10.3390/ejihpe14060111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
The study aimed to explore patients' experiences and perceptions throughout the various stages of endoscopic procedures and examine the association between patient-centered communication and the patient's experience. A total of 191 patients responded to pre- and post-procedure surveys that inquired about fear and pain, patients' satisfaction regarding the information provided to them, perceptions and experience. Pain was associated with post-procedure fear (r = 0.63, p < 0.01) and negatively associated with reported patient experience at the end of the visit (r = -0.17, p < 0.01). Significant positive associations were found between patient experience and satisfaction from the information provided before (r = 0.47, p < 0.01) and the information provided after the procedure (r = 0.51, p < 0.001). A predictive model found that perceptions toward the physicians, satisfaction from information provided before discharge, and feelings of trust are predictors of the patient experience (F = 44.9, R2 = 0.61, p < 0.001). Patients' satisfaction with information provided before and after the procedure can positively affect the patients' experience, leading to a decrease in fear and anxiety and increasing compliance with medical recommendations. Strategies for PCC with endoscopic patients should be developed and designed in a participatory manner, taking into account the various aspects associated with the patient experience.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Rita Boltean
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Revaya Ben-Lulu
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Mor Aharon
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Ruhama Elhayany
- Assuta Medical Center, Beer-Sheva 8489507, Israel; (R.E.); (A.Y.); (R.G.)
| | - Avraham Yitzhak
- Assuta Medical Center, Beer-Sheva 8489507, Israel; (R.E.); (A.Y.); (R.G.)
| | - Revital Guterman
- Assuta Medical Center, Beer-Sheva 8489507, Israel; (R.E.); (A.Y.); (R.G.)
| | - Naim Abu-Freha
- Assuta Medical Center, Beer-Sheva 8489507, Israel; (R.E.); (A.Y.); (R.G.)
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20
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Lazar Barzegar S, Mohammadi S, Shamsalinia A, Saberifar M. The Effects of White Noise on Preprocedural Anxiety and Vital Signs Among Older Adults Undergoing Colonoscopy. J Perianesth Nurs 2024; 39:386-390. [PMID: 37966399 DOI: 10.1016/j.jopan.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE A significant portion of individuals undergoing colonoscopy report stress and anxiety before the procedure. The efficacy of white noise as a nonpharmacological intervention on state anxiety and vital signs of individuals waiting for colonoscopy has not been investigated in previous studies. The current study aimed to analyze the effect of white noise on preprocedural anxiety and vital signs among older adults undergoing colonoscopy. DESIGN A pre-test/post-test quasi-experimental study. METHODS Subjects (N = 60) were older adults in the colonoscopy unit and divided into experimental (n = 30) and control groups (n = 30). The subjects in the experimental group listened to the white noise via binaural headphones for 20 minutes, while the control group received routine pre-endoscopic care. State anxiety and vital signs were assessed before and after intervention using the State-Trait Anxiety Inventory and vital signs monitor, respectively. The data were analyzed using SPSS-25 software. FINDINGS No statistically significant differences were found between the two groups on demographic characteristics, state-anxiety, systolic and diastolic blood pressure, pulse rate, and respiratory rate before the intervention (P > .05). A significant difference was found between the experimental and control groups in terms of state-anxiety (P = .00) and pulse rate (P = .003) after the intervention. No significant differences were found between the two groups in terms of systolic blood pressure (P = .69), diastolic blood pressure (.59), and respiratory rate (P = .164) after the intervention. CONCLUSIONS This study provides preliminary evidence supporting the use of white noise in older adults undergoing colonoscopy to reduce anxiety. The authors recommend that this intervention, as a nonpharmacological and easily administered approach, is adopted to reduce precolonoscopy anxiety. Continued investigation into the effect of white noise on vital signs is recommended.
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Affiliation(s)
- Sara Lazar Barzegar
- Department of Nursing, Babol University of Medical Sciences, Babol, Mazandaran, Iran
| | - Sepideh Mohammadi
- Department of Nursing, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Mazandaran, Iran.
| | - Abbas Shamsalinia
- Department of Nursing, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Mazandaran, Iran
| | - Morteza Saberifar
- Mazandaran University of Medical Sciences, Tonekabon, Mazandaran, Iran
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21
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Emerson B, Reddy M, Reiter PL, Shoben AB, Klatt M, Chakraborty S, Katz ML. Mindfulness-based Interventions Across the Cancer Continuum in the United States: A Scoping Review. Am J Health Promot 2024; 38:560-575. [PMID: 38205783 DOI: 10.1177/08901171241227316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To review mindfulness-based interventions (MBIs) tested in randomized controlled trials (RCT) across the cancer continuum. DATA SOURCE Articles identified in PubMed, CINAHL, Web of Science, PsycINFO, and Embase. STUDY INCLUSION AND EXCLUSION CRITERIA Two independent reviewers screened articles for: (1) topic relevance; (2) RCT study design; (3) mindfulness activity; (4) text availability; (5) country (United States); and (6) mindfulness as the primary intervention component. DATA EXTRACTION Twenty-eight RCTs met the inclusion criteria. Data was extracted on the following variables: publication year, population, study arms, cancer site, stage of cancer continuum, participant demographic characteristics, mindfulness definition, mindfulness measures, mindfulness delivery, and behavioral theory. DATA SYNTHESIS We used descriptive statistics and preliminary content analysis to characterize the data and identify emerging themes. RESULTS A definition of mindfulness was reported in 46% of studies and 43% measured mindfulness. Almost all MBIs were tested in survivorship (50%) or treatment (46%) stages of the cancer continuum. Breast cancer was the focus of 73% of cancer-site specific studies, and most participants were non-Hispanic white females. CONCLUSION The scoping review identified 5 themes: (1) inconsistency in defining mindfulness; (2) differences in measuring mindfulness; (3) underrepresentation of racial/ethnic minorities; (4) underrepresentation of males and cancer sites other than breast; and (5) the lack of behavioral theory in the design, implementation, and evaluation of the MBI.
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Affiliation(s)
- Brent Emerson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Menaka Reddy
- School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Paul L Reiter
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Abigail B Shoben
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Maryanna Klatt
- Center for Integrative Health, Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Subhankar Chakraborty
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Mira L Katz
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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22
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Rosvall A, Axelsson M, Toth E, Kumlien C, Gershater MA. Development and content validity testing of a colonoscopy-specific patient-reported experience measure: the Patient Experience Colonoscopy Scale (PECS). J Patient Rep Outcomes 2024; 8:32. [PMID: 38498225 PMCID: PMC10948700 DOI: 10.1186/s41687-024-00710-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND In endoscopic care, favourable patient experiences before, during and after a colonoscopy are essential for the patient's willingness to repeat the procedure. To ensure that significant experiences are measured, patients should be involved in creating the measurement instruments. Thus, the aim of the present study was to develop a colonoscopy-specific PREM by (1) operationalising patient experiences before, during and after a colonoscopy procedure and (2) evaluating its content validity. METHODS The colonoscopy-specific PREM was developed in two stages: (1) operationalisation with item generation and (2) content validity testing. A previously developed conceptual model, based on a systematic literature review that illustrates patients' (n = 245) experiences of undergoing a colonoscopy, formed the theoretical basis. To assess the degree to which the PREM reflected patients' experiences before, during and after a colonoscopy procedure, content validity was tested-through face validity with healthcare professionals (n = 4) and cognitive interviews with patients (n = 14) having experienced a colonoscopy. Content validity index (CVI) was calculated to investigate the relevance of the items. RESULTS The Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM consisting of five different constructs: health motivation, discomfort, information, a caring relationship and understanding. Each construct was defined and generated into a pool of items (n = 77). After face-validity assessment with healthcare professionals, a draft 52-item version of the PECS was ready for content validity testing by the patients. During cognitive interviews the patients contributed valuable insights that led to rewording and removal of items. Results from the CVI suggest that the PECS and its content are relevant (I-CVI range 0.5-1, S-CVI/Ave = 0.86). The final PECS consists of 30 items representing a colonoscopy-specific PREM. CONCLUSION The PECS is a new 30-item PREM instrument designed for adult elective colonoscopy patients after they have undergone the procedure. Each item in the PECS derives from a conceptual model based on a systematic literature review. Patients and healthcare professionals were involved in developing the PECS, which measures colonoscopy-specific patient experiences before, during and after the procedure. The content validity testing positively contributed to the development of the PECS. Psychometric properties need to be evaluated further.
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Affiliation(s)
- Annica Rosvall
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Ervin Toth
- Department of Gastroenterology, Skåne University Hospital, Malmö, Lund University, Lund, Sweden
| | - Christine Kumlien
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Department of Cardio-Thoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
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Bagshaw P, Cameron C, Aramowicz J, Frampton C, Pretty C. Randomized controlled trial of effects of a familiarization video and patient-controlled Entonox inhalation on patient stress levels and clinical efficacy of flexible sigmoidoscopy without analgesia or sedation for investigation of fresh rectal bleeding. J Gastroenterol Hepatol 2024; 39:464-472. [PMID: 38054398 DOI: 10.1111/jgh.16433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND AND AIM Flexible sigmoidoscopy (FS) without analgesia or sedation can be unpleasant for patients, resulting in unsatisfactory examinations. Prior familiarization videos (FVs) and intra-procedural Entonox inhalation have shown inconsistent effects. This study investigated their effects on undesirable participant factors (anxiety, stress, discomfort, pain, satisfaction, later unpleasant recall of procedure, and vasovagal reactions) and clinical effectiveness (extent of bowel seen, lesions detected, and procedural/recovery times). METHODS This cluster-randomized single-center study evaluated 138 participants undergoing FS. There were 46 controls, 49 given access to FV, and 43 access to both FV and self-administered Entonox. Participant factors were measured by self-administered questionnaires, independent nurse assessments, and heart rate variability (HRV) metrics. RESULTS Questionnaires showed that the FV group was slightly more tense and upset before FS, but knowledge of Entonox availability reduced anxiety. Nonlinear HRV metrics confirmed reduced intra-procedural stress response in the FV/Entonox group compared with controls and FV alone (P < 0.05). Entonox availability allowed more bowel to be examined (P < 0.001) but increased procedure time (P < 0.05), while FV alone had no effect. FV/Entonox participants reported 1 month after FS less discomfort during the procedure. Other comparisons showed no significant differences between treatment groups, although one HRV metric showed some potential to predict vasovagal reactions. CONCLUSIONS Entonox availability significantly improved clinical effectiveness and caused a slight reduction in undesirable participant factors. The FV alone did not reduce undesirable participant factors or improve clinical effectiveness. Nonlinear HRV metrics recorded effects in agreement with stress reduction and may be useful for prediction of vasovagal events in future studies.
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Affiliation(s)
- Philip Bagshaw
- Canterbury Charity Hospital Trust, Christchurch, New Zealand
| | | | - Jaana Aramowicz
- Canterbury Charity Hospital Trust, Christchurch, New Zealand
| | | | - Christopher Pretty
- Pūhanga | Engineering, University of Canterbury, Christchurch, New Zealand
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24
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O-Pad N, Supachai K, Boonyapibal A, Suebwongdit C, Panaiem S, Sirisophawadee T. Bowel Preparation Burden, Rectal Pain and Abdominal Discomfort: Perspective of Participants Undergoing CT Colonography and Colonoscopy. Asian Pac J Cancer Prev 2024; 25:529-536. [PMID: 38415539 PMCID: PMC11077122 DOI: 10.31557/apjcp.2024.25.2.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate bowel preparation burden, rectal pain and abdominal discomfort levels and to determine the association between demographic characteristics and those levels among participants undergoing CT colonography and colonoscopy. METHODS A cross-sectional survey was conducted in eligible Thai citizens who consented to participate all four visits of a free colorectal cancer screening protocol. Three levels (mild, moderate and severe) of burden, pain and discomfort were used to ask the perspective of participants at the final visit, one week after undergoing those two procedures. RESULTS Data from 1,271 participants completed for analyses - females 815 (64.1%), males 456 (35.9%). The majority of participants experienced mild burden, pain and discomfort. Association between characteristic groups and burden levels differed regarding own income, chronic disease and laxative. Between characteristic groups and pain and discomfort levels differed regarding own income and chronic disease. Participants without their own income rated severe burden lower than those who had (p<0.001), but those without chronic disease rated moderate burden lower than who had (p=0.003). Participants prepared bowel with spilt-dose of PEG rated moderate burden higher than those who prepared with NaP (p<0.001). Participants undergoing CT colonography without their own income and presenting no chronic disease faced severe rectal pain lower than those who had (p<0.001 and p=0.04). Participants without their own income rated moderate and severe abdominal discomfort lower than those who had (p<0.01 and p=0.008). Participants undergoing colonoscopy without their own income and no chronic diseases faced severe rectal pain lower than those who had (p<0.001 and p=0.007). Participants without their own income and no chronic disease rated severe abdominal discomfort lower than those who had (p<0.001 and p=0.005). CONCLUSION Evaluating the perspectives of customers alongside quality improvement and innovation to reduce unpleasant experiences remains needed in CT colonography and colonoscopy to promote CRC screening.
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25
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Sroczynski G, Hallsson LR, Mühlberger N, Jahn B, Rehms R, Hoffmann S, Crispin A, Lindoerfer D, Mansmann U, Siebert U. Long-term benefits and harms of early colorectal cancer screening in German individuals with familial cancer risk. Int J Cancer 2024; 154:516-529. [PMID: 37795630 DOI: 10.1002/ijc.34747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/04/2023] [Accepted: 08/21/2023] [Indexed: 10/06/2023]
Abstract
Individuals with a family history of colorectal cancer (CRC) may benefit from early screening with colonoscopy or immunologic fecal occult blood testing (iFOBT). We systematically evaluated the benefit-harm trade-offs of various screening strategies differing by screening test (colonoscopy or iFOBT), interval (iFOBT: annual/biennial; colonoscopy: 10-yearly) and age at start (30, 35, 40, 45, 50 and 55 years) and end of screening (65, 70 and 75 years) offered to individuals identified with familial CRC risk in Germany. A Markov-state-transition model was developed and used to estimate health benefits (CRC-related deaths avoided, life-years gained [LYG]), potential harms (eg, associated with additional colonoscopies) and incremental harm-benefit ratios (IHBR) for each strategy. Both benefits and harms increased with earlier start and shorter intervals of screening. When screening started before age 50, 32-36 CRC-related deaths per 1000 persons were avoided with colonoscopy and 29-34 with iFOBT screening, compared to 29-31 (colonoscopy) and 28-30 (iFOBT) CRC-related deaths per 1000 persons when starting age 50 or older, respectively. For iFOBT screening, the IHBRs expressed as additional colonoscopies per LYG were one (biennial, age 45-65 vs no screening), four (biennial, age 35-65), six (biennial, age 30-70) and 34 (annual, age 30-54; biennial, age 55-75). Corresponding IHBRs for 10-yearly colonoscopy were four (age 55-65), 10 (age 45-65), 15 (age 35-65) and 29 (age 30-70). Offering screening with colonoscopy or iFOBT to individuals with familial CRC risk before age 50 is expected to be beneficial. Depending on the accepted IHBR threshold, 10-yearly colonoscopy or alternatively biennial iFOBT from age 30 to 70 should be recommended for this target group.
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Affiliation(s)
- Gaby Sroczynski
- Department of Public Health, Health Services Research, and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria
| | - Lára R Hallsson
- Department of Public Health, Health Services Research, and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria
| | - Nikolai Mühlberger
- Department of Public Health, Health Services Research, and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria
| | - Beate Jahn
- Department of Public Health, Health Services Research, and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria
- Division of Health Technology Assessment, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Raphael Rehms
- Department of Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians Universität, Munich, Germany
| | - Sabine Hoffmann
- Department of Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians Universität, Munich, Germany
| | - Alexander Crispin
- Department of Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians Universität, Munich, Germany
| | - Doris Lindoerfer
- Department of Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians Universität, Munich, Germany
- Chronobiology and Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Ulrich Mansmann
- Department of Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians Universität, Munich, Germany
| | - Uwe Siebert
- Department of Public Health, Health Services Research, and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria
- Division of Health Technology Assessment, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Health Policy & Management, Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Sidhu R, Turnbull D, Haboubi H, Leeds JS, Healey C, Hebbar S, Collins P, Jones W, Peerally MF, Brogden S, Neilson LJ, Nayar M, Gath J, Foulkes G, Trudgill NJ, Penman I. British Society of Gastroenterology guidelines on sedation in gastrointestinal endoscopy. Gut 2024; 73:219-245. [PMID: 37816587 PMCID: PMC10850688 DOI: 10.1136/gutjnl-2023-330396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/06/2023] [Indexed: 10/12/2023]
Abstract
Over 2.5 million gastrointestinal endoscopic procedures are carried out in the United Kingdom (UK) every year. Procedures are carried out with local anaesthetic r with sedation. Sedation is commonly used for gastrointestinal endoscopy, but the type and amount of sedation administered is influenced by the complexity and nature of the procedure and patient factors. The elective and emergency nature of endoscopy procedures and local resources also have a significant impact on the delivery of sedation. In the UK, the vast majority of sedated procedures are carried out using benzodiazepines, with or without opiates, whereas deeper sedation using propofol or general anaesthetic requires the involvement of an anaesthetic team. Patients undergoing gastrointestinal endoscopy need to have good understanding of the options for sedation, including the option for no sedation and alternatives, balancing the intended aims of the procedure and reducing the risk of complications. These guidelines were commissioned by the British Society of Gastroenterology (BSG) Endoscopy Committee with input from major stakeholders, to provide a detailed update, incorporating recent advances in sedation for gastrointestinal endoscopy.This guideline covers aspects from pre-assessment of the elective 'well' patient to patients with significant comorbidity requiring emergency procedures. Types of sedation are discussed, procedure and room requirements and the recovery period, providing guidance to enhance safety and minimise complications. These guidelines are intended to inform practising clinicians and all staff involved in the delivery of gastrointestinal endoscopy with an expectation that this guideline will be revised in 5-years' time.
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Affiliation(s)
- Reena Sidhu
- Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield, UK
- Department of Infection, Immunity & Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - David Turnbull
- Department of Anaesthetics, Royal Hallamshire Hospital, Sheffield, UK
| | - Hasan Haboubi
- Department of Gastroenterology, University Hospital Llandough, Llandough, South Glamorgan, UK
- Institute of Life Sciences, Swansea University, Swansea, UK
| | - John S Leeds
- Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK
- Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
| | - Chris Healey
- Airedale NHS Foundation Trust, Keighley, West Yorkshire, UK
| | - Srisha Hebbar
- Department of Gastroenterology, University Hospital of North Midlands, Stoke-on-Trent, Staffordshire, UK
| | - Paul Collins
- Department of Gastroenterology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Wendy Jones
- Specialist Pharmacist Breastfeeding and Medication, Portsmouth, UK
| | - Mohammad Farhad Peerally
- Digestive Diseases Unit, Kettering General Hospital; Kettering, Kettering, Northamptonshire, UK
- Department of Population Health Sciences, College of Life Science, University of Leicester, Leicester, UK
| | - Sara Brogden
- Department of Gastroenterology, University College London, UK, London, London, UK
| | - Laura J Neilson
- Department of Gastroenterology, South Tyneside District Hospital, South Shields, Tyne and Wear, UK
| | - Manu Nayar
- Hepato-Pancreato-Biliary Unit, Freeman Hospital, Newcastle upon Tyne, UK
- Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK
| | - Jacqui Gath
- Patient Representative on Guideline Development Group and member of Independent Cancer Patients' Voice, Sheffield, UK
| | - Graham Foulkes
- Patient Representative on Guideline Development Group, Manchester, UK
| | - Nigel J Trudgill
- Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
| | - Ian Penman
- Centre for Liver and Digestive Disorders, Royal Infirmary Edinburgh, Edinburgh, Midlothian, UK
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27
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Mutlu S, Yılmaz E, Şahin ST. The effect of position change and abdominal massage on anxiety, pain and distension after colonoscopy: A randomized clinical trial. Explore (NY) 2024; 20:89-94. [PMID: 37391282 DOI: 10.1016/j.explore.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/02/2023]
Abstract
CONTEXT Pain, abdominal distention, and anxiety are major risk factors encountered after colonoscopy. Complementary and alternative treatments, such as abdominal massage and position change, are used to reduce the associated risk factors. OBJECTIVE To determine the effect of position change and abdominal massage on anxiety, pain, and distension after colonoscopy. DESIGN A randomized three-group experimental trial. SETTING AND PARTICIPANTS This study was conducted with 123 patients who underwent colonoscopy at the endoscopy unit of a hospital located in western Turkey. METHODS Three groups were formed: two interventional (abdominal massage and position change) and one control, each including 41 patients. Data were gathered using a personal information form, pre- and post-colonoscopy measurement form, the Visual Analog Scale (VAS), and the Spielberger State-Trait Anxiety Inventory. Pain and comfort levels, abdominal circumference values, and vital signs of the patients were measured at four evaluation times. RESULTS In the abdominal massage group, the VAS pain scores and abdominal circumference measurements decreased the most and the VAS comfort scores increased the most 15 min after the patients were taken to the recovery room (p<0.05). Furthermore, bowel sounds were heard, and bloating was relieved in all patients in both intervention groups 15 min after they were taken to the recovery room. CONCLUSIONS Abdominal massage and position change can be considered effective interventions for relieving bloating and facilitating flatulence after colonoscopy. Moreover, abdominal massage can be a powerful method for reducing pain and abdominal circumference and increasing patient comfort.
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Affiliation(s)
- Senan Mutlu
- Faculty of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Manisa, Turkey; Faculty of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Uncubozköy Sağlık Yerleşkesi (İİBF Eski Binası) Yunusemre, Manisa 45030, Turkey
| | - Emel Yılmaz
- Faculty of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Manisa, Turkey.
| | - Semra Tutcu Şahin
- Faculty of Medical School, Department of General Surgery, Manisa Celal Bayar University, Manisa, Turkey; Faculty of Medical School, Department of General Surgery, Manisa Celal Bayar University, Uncubozköy Mah., Mimar Sinan Bulvarı No:189Yunusemre, Manisa 45030, Turkey
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Xu JB. Correlation between fasting time and bleeding, infection, and perforation after high-frequency electroresection of polyps under colonoscopy. Shijie Huaren Xiaohua Zazhi 2023; 31:973-980. [DOI: 10.11569/wcjd.v31.i23.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/14/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Endoscopic mucosal resection (EMR) is a common method for treating colorectal polyps. The duration of fasting after the operation has been the focus of clinical attention. However, there is currently a lack of research on the correlation between fasting duration and the occurrence of bleeding, infection, and perforation.
AIM To explore the relationship between fasting time and bleeding, infection, and perforation after colonoscopic electro-resection of polyps to provide guidance on fasting strategies for postoperative patients.
METHODS In a cohort of 14857 colorectal polyp patients admitted to the Second People's Hospital of Luqiao District from 2000 to 2023, a case-control study design with matching propensity scores was used to evaluate the risk of bleeding and perforation after polypectomy in adults aged 40 years and older; 3505 patients with short-term postoperative fasting and 9669 patients with prolonged postoperative fasting met the study criteria. A total of 2560 patients in each group were matched for further analysis. The postoperative fasting time of the experimental group was 2 h, and the postoperative fasting time of the control group was 24 h. The liquid food was gradually replaced with semi-liquid food and ordinary food according to the size of the incision and the effect of the operation. The postoperative follow-up duration was 1 mo, and the incidence of postoperative bleeding, infection, and perforation in both groups was recorded.
RESULTS In the short fasting group, the rates of bleeding, infection, and perforation were 0.64%, 0.07%, and 0.07%, respectively. In the long fasting group, the rates of bleeding, infection, and perforation were 0.40%, 0.04%, and 0.04%, respectively. There was no significant difference between the two groups in terms of the rates of bleeding, infection, and perforation.
CONCLUSION Based on these results, it can be preliminarily concluded that the duration of postoperative fasting may not have a significant effect on the incidence of bleeding, infection, and perforation after colonoscopic high-frequency electroresection of polyps. For choosing fasting time, strategies can be developed according to the specific situation and actual needs of the patient. However, it is important to note that this is only a retrospective study and more clinical studies are needed to further validate our findings and explore other possible influencing factors.
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Affiliation(s)
- Jun-Bin Xu
- Department of Gastroenterology, The Second People's Hospital of Luqiao District, Taizhou 318058, Zhejiang Province, China
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Fuccio L, Rees CJ, Frazzoni L, Neilson L, Radaelli F, Sharp L, Hassan C, Spada C. Patient-reported experience of colonoscopy in Italy: a multicentre prospective observational study. Gut 2023; 72:2227-2230. [PMID: 37536714 DOI: 10.1136/gutjnl-2023-330415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Affiliation(s)
- Lorenzo Fuccio
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy
| | - Colin J Rees
- Gastroenterology, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Leonardo Frazzoni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy
| | | | | | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Cristiano Spada
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy
- Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Rome, Italy
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Aksu Ç. Effects of Music on Anxiety, Pain, and Comfort in Patients Undergoing Upper Endoscopy: A Randomized Clinical Trial. Gastroenterol Nurs 2023; 46:428-435. [PMID: 37678807 DOI: 10.1097/sga.0000000000000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 07/20/2023] [Indexed: 09/09/2023] Open
Abstract
Although upper gastrointestinal endoscopy is an important diagnostic procedure in the detection of diseases, it can cause discomfort and anxiety in patients. This study is a randomized controlled trial conducted to determine the effects of listening to music on the anxiety, pain, and comfort levels of patients undergoing upper gastrointestinal endoscopy. The patients were randomly divided into the intervention group ( n = 40), who listened to music for 45 minutes before upper gastrointestinal endoscopy, and the control group ( n = 40), which did not receive any intervention other than routine nursing care. It was observed that the pain and anxiety levels of the patients who listened to music before the procedure decreased, and their comfort levels and ease of the procedure increased. In order to reduce the pain and anxiety of patients who will undergo upper gastrointestinal endoscopy, increase the success of the procedure, and facilitate patient-doctor cooperation, encouraging patients to listen to music while awaiting the procedure can be effective.
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Affiliation(s)
- Çiǧdem Aksu
- Çiǧdem Aksu, is Assistant Professor at Department of Nursing, Faculty of Health Science, Gaziantep Islamıc Science and Technology University, Gaziantep, Turkey
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Cakir SK, Evirgen S. Three Distraction Methods for Pain Reduction During Colonoscopy: A Randomized Controlled Trial Evaluating the Effects on Pain and Anxiety. J Perianesth Nurs 2023; 38:e1-e7. [PMID: 37565937 DOI: 10.1016/j.jopan.2023.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE The aim of this study was to compare the effects of distraction methods on pain, anxiety, and satisfaction during a colonoscopy. DESIGN This experimental research was conducted as a single-center, randomized, parallel-group trial. METHODS A total of 120 patients were recruited and randomized into 4 groups (music, stress ball, audiovisual distraction, and control). The data were collected using individual an identification form, observation form, the Visual Analog Scale, and the State-Trait Anxiety Inventory. FINDINGS Pain severity during colonoscopy was found to be lower in the intervention (music and audiovisual distraction) groups compared to the stress ball and control groups (P < .001).There was no statistically significant difference between the pre- and postanxiety levels in the intervention groups compared to the control group. After the colonoscopy, satisfaction levels were significantly higher in the music group compared to the audiovisual, control, and stress ball groups (P < .001). CONCLUSIONS Distraction methods used during colonoscopy were found to reduce pain. Although sedation is widely used during a colonoscopy procedure and is accepted as a general standard, music and VR can be used as effective alternative strategies in reducing pain for colonoscopy patients.
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Affiliation(s)
- Selda Karaveli Cakir
- Nursing Department, Health Science Faculty, Kastamonu University, Kastamonu, Turkey.
| | - Sami Evirgen
- Division of Gastroenterology, Department of Internal Medicine, Kastamonu University, Medical School, Kastamonu, Turkey
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Yu X, Deng H, Xiong Z, Gong P, Ye M, Liu T, Long X, Tian L. A scale to measure the worry level in Gastrointestinal Endoscopy with sedation: Development, reliability, and validity. Int J Clin Health Psychol 2023; 23:100410. [PMID: 37701761 PMCID: PMC10493257 DOI: 10.1016/j.ijchp.2023.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
Objective This study aims to develop a scale to measure the worry level of patients who will undergo gastrointestinal (GI) endoscopy with deep sedation, and to provide scientific references to alleviate their worries. Method Based on literature review, panel discussion, patient interview and expert consultation, we developed the first version of the scale. After two pre-investigations, the formal version of the scale was formed, and the reliability and validity were tested on 1389 respondents. Reliability was assessed by Cronbach's alpha. Construct validity was tested by confirmatory factor analysis (CFA) and the Spearman correlations analysis. Results The scale was composed of four dimensions: financial and time costs, sedation, examination, and psychology. It has 15 items. Reliability and validity were acceptable. The Cronbach's alpha of the whole scale was 0.959 and all the factor loadings were > 0.50. The Spearman correlations of the inter-dimensions ranged from 0.614 to 0.836, and the correlation coefficients between the dimensions and the total score were 0.795 to 0.957. The correlation coefficient between the total scale score and the APAIS was 0.833. Conclusions This scale has good validity and reliability, which is useful for physicians and medical institutions to take appropriate measures to reduce patients' worries.
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Affiliation(s)
- Xiaoyu Yu
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Haijun Deng
- School of Mathematics and Statistics, Guizhou University of Finance and Economics in Guizhou, China
| | - Ziyi Xiong
- Central South University in Changsha, China
| | - Pan Gong
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Mingmei Ye
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Tao Liu
- Central South University in Changsha, China
| | - Xiuyan Long
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
| | - Li Tian
- Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan 410013, China
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Zhang C, Liu L, Li J, Lv Y, Wu D, Xu S, Cao C, Zhao L, Liu Y, Ma X, Yang X, Du B. Effect of flexible sigmoidoscopy-based screening on colorectal cancer incidence and mortality: an updated systematic review and meta-analysis of randomized controlled trials. Expert Rev Anticancer Ther 2023; 23:1217-1227. [PMID: 37542427 DOI: 10.1080/14737140.2023.2245564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Our objective was to estimate the effect of flexible sigmoidoscopy (FS)-based screening on colorectal cancer (CRC) incidence and mortality by conducting an updated meta-analysis of randomized controlled trials (RCTs). METHODS PubMed, Web of Science, Embase, and Cochrane Library searched for RCTs from database inception to December 2022. The methodological quality of the RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. RevMan 5.4 was used for this meta-analysis. RESULTS Four RCTs involving 457, 871 patients were included. This meta-analysis revealed that FS-based screening was associated with a 20% relative risk reduction in CRC incidence [RR = 0.80; 95% CI (0.75, 0.86); P < 0.00001], and a 24% reduction in CRC mortality [RR = 0.76; 95% CI (0.70, 0.82); P < 0.00001]. In addition, this meta-analysis revealed that FS-based screening reduced the incidence[RR = 0.68; 95% CI (0.60, 0.77); P < 0.00001] and mortality[RR = 0.64; 95% CI (0.49, 0.83); P = 0.0007] of distal CRC, but had no significant effect on proximal colon cancer. CONCLUSION FS-based screening appeared to be effective in reducing distal CRC incidence and mortality in patients at average risk compared to no intervention, but had no significant effect on proximal colon cancer.
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Affiliation(s)
- Chengren Zhang
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
| | - Lili Liu
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jingjing Li
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
| | - Yaochun Lv
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
| | - Dewang Wu
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
| | - Shiyun Xu
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
| | - Cong Cao
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
| | - Lixia Zhao
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
- The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Yijun Liu
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
- The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiaolong Ma
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
- The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Xiongfei Yang
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
| | - Binbin Du
- Department of Anorectal Surgery, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
- General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
- Clinical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu, China
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Kwong FL, Davenport C, Sundar S. Evaluating the Harms of Cancer Testing-A Systematic Review of the Adverse Psychological Correlates of Testing for Cancer and the Effectiveness of Interventions to Mitigate These. Cancers (Basel) 2023; 15:3335. [PMID: 37444445 DOI: 10.3390/cancers15133335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Several studies have described the psychological harms of testing for cancer. However, most were conducted in asymptomatic subjects and in cancers with a well-established screening programme. We sought to establish cancers in which the literature is deficient, and identify variables associated with psychological morbidity and interventions to mitigate their effect. (2) Methods: Electronic bibliographic databases were searched up to December 2020. We included quantitative studies reporting on variables associated with psychological morbidity associated with cancer testing and primary studies describing interventions to mitigate these. (3) Results: Twenty-six studies described individual, testing-related, and organisational variables. Thirteen randomised controlled trials on interventions were included, and these were categorised into five groups, namely the use of information aids, music therapy, the use of real-time videos, patient navigators and one-stop clinics, and pharmacological or homeopathic therapies. (4) Conclusions: The contribution of some factors to anxiety in cancer testing and their specificity of effect remains inconclusive and warrants further research in homogenous populations and testing contexts. Targeting young, unemployed patients with low levels of educational attainment may offer a means to mitigate anxiety. A limited body of research suggests that one-stop clinics and patient navigators may be beneficial in patients attending for diagnostic cancer testing.
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Affiliation(s)
- Fong Lien Kwong
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Clare Davenport
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Sudha Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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Mammen JR, Speck RM, Stebbins GM, Müller MLTM, Yang PT, Campbell M, Cosman J, Crawford JE, Dam T, Hellsten J, Jensen-Roberts S, Kostrzebski M, Simuni T, Barowicz KW, Cedarbaum JM, Dorsey ER, Stephenson D, Adams JL. Mapping Relevance of Digital Measures to Meaningful Symptoms and Impacts in Early Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2023:JPD225122. [PMID: 37212073 DOI: 10.3233/jpd-225122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Adoption of new digital measures for clinical trials and practice has been hindered by lack of actionable qualitative data demonstrating relevance of these metrics to people with Parkinson's disease. OBJECTIVE This study evaluated of relevance of WATCH-PD digital measures to meaningful symptoms and impacts of early Parkinson's disease from the patient perspective. METHODS Participants with early Parkinson's disease (N = 40) completed surveys and 1:1 online-interviews. Interviews combined: 1) symptom mapping to delineate meaningful symptoms/impacts of disease, 2) cognitive interviewing to assess content validity of digital measures, and 3) mapping of digital measures back to personal symptoms to assess relevance from the patient perspective. Content analysis and descriptive techniques were used to analyze data. RESULTS Participants perceived mapping as deeply engaging, with 39/40 reporting improved ability to communicate important symptoms and relevance of measures. Most measures (9/10) were rated relevant by both cognitive interviewing (70-92.5%) and mapping (80-100%). Two measures related to actively bothersome symptoms for more than 80% of participants (Tremor, Shape rotation). Tasks were generally deemed relevant if they met three participant context criteria: 1) understanding what the task measured, 2) believing it targeted an important symptom of PD (past, present, or future), and 3) believing the task was a good test of that important symptom. Participants did not require that a task relate to active symptoms or "real" life to be relevant. CONCLUSION Digital measures of tremor and hand dexterity were rated most relevant in early PD. Use of mapping enabled precise quantification of qualitative data for more rigorous evaluation of new measures.
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Affiliation(s)
| | | | - Glenn M Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | | | - Phillip T Yang
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Campbell
- Center for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, MD, USA
| | | | | | | | | | - Stella Jensen-Roberts
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Melissa Kostrzebski
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neurology, University of Rochester, Medical Center, Rochester, NY, USA
| | - Tanya Simuni
- Northwestern University Feinberg School of Medicine, Chicago IL, USA
| | | | - Jesse M Cedarbaum
- Coeruleus Clinical Sciences LLC, Woodbridge, CT, USA
- Yale Medical School, New Haven, CT, USA
| | - E Ray Dorsey
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neurology, University of Rochester, Medical Center, Rochester, NY, USA
| | | | - Jamie L Adams
- Center for Health + Technology, University of Rochester Medical Center, Rochester, NY, USA
- Department of Neurology, University of Rochester, Medical Center, Rochester, NY, USA
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Wang X, Zhang M, Sun H, Zhang R, Zhu Y, Zhang Z, Shi R. Dexmedetomidine-Oxycodone combination for conscious sedation during colonoscopy in obese patients: A randomized controlled trial. Heliyon 2023; 9:e16370. [PMID: 37251861 PMCID: PMC10209023 DOI: 10.1016/j.heliyon.2023.e16370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Background Obesity is a risk factor for sedation-related respiratory depression during colonoscopy. In a colonoscopy, propofol is frequently used because of its strong sedative and hypnotic properties. However, propofol is associated with marked respiratory depression. The objective of this trial was to investigate the effectiveness and safety of dexmedetomidine plus oxycodone for conscious sedation during colonoscopy in obese patients. Methods A total of 120 patients had colonoscopies, and they were divided into two groups at random: Dexmedetomidine and oxycodone were used to sedate group Dex + oxy; while group Pro + oxy received anesthesia with propofol plus oxycodone. Parameters including blood pressure, heart rate, respiration, blood oxygen saturation, injection pain, and recovery time were recorded for both groups. Results The incidence of hypoxemia was significantly reduced in group Dex + oxy compared with group Pro + oxy (4.9% vs 20.3%, P = 0.011). Blood pressure was lower, and heart rate was higher in group Pro + oxy compared with group Dex + oxy (P < 0.05). In addition, group Dex + oxy showed a significantly shorter caecal insertion time, recovery time to orientation, and recovery time to walking than group Pro + oxy (P < 0.05). Endoscopist satisfaction scores were significantly higher in group Dex + oxy compared with group Pro + oxy (P = 0.042). Conclusion For obese patients, dexmedetomidine plus oxycodone effectively sedate them with few adverse effects, while also reducing colonoscopy operation difficulty by allowing obese patients to reposition. Thus, dexmedetomidine plus oxycodone could be used safely as a conscious sedation method for colonoscopy in obese patients. Trial registration The protocol was registered at www.chictr.org.cn (ChiCTR1800017283, July 21, 2018).
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Affiliation(s)
- Xinran Wang
- Shanghai Tenth People's Hospital of Tongji University, Tongji University School of Medicine, Shanghai, China
| | - Manman Zhang
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou, China
| | - Han Sun
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou, China
| | - Rui Zhang
- Department of Gastroenterology, Suqian Hospital of Nanjing Drum Tower Hospital Group, Suqian, China
| | - Yangzi Zhu
- Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou, China
| | - Zhen Zhang
- Department of Anesthesiology, Suqian Hospital of Nanjing Drum Tower Hospital Group, Suqian, China
| | - Rongxia Shi
- Department of Endoscopy Center, Xuzhou Central Hospital, Xuzhou, China
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Guo F, Sun DF, Feng Y, Yang L, Li JL, Sun ZL. Efficacy and safety of propofol target-controlled infusion combined with butorphanol for sedated colonoscopy. World J Clin Cases 2023; 11:610-620. [PMID: 36793626 PMCID: PMC9923854 DOI: 10.12998/wjcc.v11.i3.610] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/19/2022] [Accepted: 01/05/2023] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Propofol is a short-acting, rapid-recovering anesthetic widely used in sedated colonoscopy for the early detection, diagnosis and treatment of colon diseases. However, the use of propofol alone may require high doses to achieve the induction of anesthesia in sedated colonoscopy, which has been associated with anesthesia-related adverse events (AEs), including hypoxemia, sinus bradycardia, and hypotension. Therefore, propofol co-administrated with other anesthetics has been proposed to reduce the required dose of propofol, enhance the efficacy, and improve the satisfaction of patients receiving colonoscopy under sedation.
AIM To evaluate the efficacy and safety of propofol target-controlled infusion (TCI) in combination with butorphanol for sedation during colonoscopy.
METHODS In this controlled clinical trial, a total of 106 patients, who were scheduled for sedated colonoscopy, were prospectively recruited and assigned into three groups to receive different doses of butorphanol before propofol TCI: Low-dose butorphanol group (5 μg/kg, group B1), high-dose butorphanol group (10 μg/kg, group B2), and control group (normal saline, group C). Anesthesia was achieved by propofol TCI. The primary outcome was the median effective concentration (EC50) of propofol TCI, which was measured using the up-and-down sequential method. The secondary outcomes included AEs in perianesthesia and recovery characteristics.
RESULTS The EC50 of propofol for TCI was 3.03 μg/mL [95% confidence interval (CI): 2.83-3.23 μg/mL] in group B2, 3.41 μg/mL (95%CI: 3.20-3.62 μg/mL) in group B1, and 4.05 μg/mL (95%CI: 3.78-4.34 μg/mL) in group C. The amount of propofol necessary for anesthesia was 132 mg [interquartile range (IQR), 125-144.75 mg] in group B2 and 142 mg (IQR, 135-154 mg) in group B1. Furthermore, the awakening concentration was 1.1 μg/mL (IQR, 0.9-1.2 μg/mL) in group B2 and 1.2 μg/mL (IQR, 1.025-1.5 μg/mL) in group B1. Notably, the propofol TCI plus butorphanol groups (groups B1 and B2) had a lower incidence of anesthesia AEs, when compared to group C. Furthermore, no significant differences were observed in the rates of AEs in perianesthesia, including hypoxemia, sinus bradycardia, hypotension, nausea and vomiting, and vertigo, among group C, group B1 and group B2.
CONCLUSION The combined use with butorphanol reduces the EC50 of propofol TCI for anesthesia. The decrease in propofol might contribute to the reduced anesthesia-related AEs in patients undergoing sedated colonoscopy.
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Affiliation(s)
- Feng Guo
- Department of Anesthesiology, No. 967 Hospital, Joint Logistics Support Force of Chinese People’s Liberation Army, Dalian 116011, Liaoning Province, China
| | - De-Feng Sun
- Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Yan Feng
- Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Lin Yang
- Department of Neuroelectrophysiology, The First Affiliated Hospital of Dalian Medical University, Dalian 11601, Liaoning Province, China
| | - Jing-Lin Li
- Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Zhong-Liang Sun
- Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
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Sun DJ, You YX, He XJ, Li HT, Zeng XP, Li DZ, Wang W. Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: A randomized controlled trial. Medicine (Baltimore) 2022; 101:e32339. [PMID: 36595974 PMCID: PMC9803447 DOI: 10.1097/md.0000000000032339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Colonoscopy is the main kind of way to detect and treat diseases about large intestine, but during the examination and preparation, these 2 processes are able to lead abdominal pain, abdominal distention and other discomfort feel, which will cause patients to refuse the examination and become anxious. Painless and sedative endoscopy may reduce discomfort of patients, but there is a risk of adverse effects. Many studies have shown that playing music during colonoscopy can reduce discomfort and increase acceptance of colonoscopy, but the conclusion remains controversial. The 3 approaches of random, single-blind, controlled method were used to investigate the interventions effects of piano light music on satisfaction, anxiety and pain in patients undergoing colonoscopy. METHODS A total of 216 patients were randomly divided into piano music group (n = 112, piano music played during colonoscopy) and control group (n = 104, no music during colonoscopy) to compare patients satisfaction, anxiety score, pain score, vital signs, endoscopic difficulty score, and willingness to undergo colonoscopy again. RESULTS There were no significant differences in vital signs, pre-colonoscopic state anxiety score, and trait anxiety score before and after colonoscopy, and willingness to undergo colonoscopy again between the 2 groups (P > .05). The difficulty of colonoscopy operation and the score of state anxiety after colonoscopy in the piano group were lower than those in the control group (P < .05), and the satisfaction of colonoscopy process, pain management and overall service satisfaction were better than those of the control group (P < .05), and they were more likely to listen to music in the next examination (P < .001). CONCLUSION The light music played by piano can relieve patients' anxiety, improve the satisfaction of colonoscopy process, pain management and service satisfaction, reduce the difficulty of colonoscopy, which have no obvious adverse reactions. Therefore, it is worthy of promotion.
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Affiliation(s)
- Dong-Jie Sun
- Department of Digestive Diseases, Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Yi-Xiang You
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Jian He
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Hai-Tao Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Xiang-Peng Zeng
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Da-Zhou Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Wen Wang
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
- * Correspondence: Wen Wang, Department of Digestive Diseases, The Fuzong Clinical Medical College, Fujian Medical University, 156 North Road of West No.2 Ring, Fuzhou 350025, China (e-mails: )
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Endoscopy demand among county people in southeast China: A cross-sectional study. LAPAROSCOPIC, ENDOSCOPIC AND ROBOTIC SURGERY 2022. [DOI: 10.1016/j.lers.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Collatuzzo G, Boffetta P, Radaelli F, Cadoni S, Hassan C, Frazzoni L, Anderloni A, Laterza L, La Marca M, Rogai F, Binda C, Montale A, Soriani P, Fabbri C, Sacco M, Gallittu P, Mura D, Trovato C, Vitale G, Mussetto A, Musso A, Conti CB, Manno M, Repici A, Zagari RM, Farioli A, Fuccio L. Incidence, risk and protective factors of symptoms after colonoscopy. Dig Liver Dis 2022; 54:1698-1705. [PMID: 36154988 DOI: 10.1016/j.dld.2022.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Few studies focused on minor adverse events which may develop after colonoscopy. AIMS To investigate the incidence and factors associated to post-colonoscopy symptoms. METHODS This is a prospective study conducted in 10 Italian hospitals. The main outcome was a cumulative score combining 10 gastrointestinal (GI) symptoms occurring the week following colonoscopy. The analyses were conducted via multivariate logistic regression. RESULTS Of 793 subjects included in the analysis, 361 (45.5%) complained the new onset of at least one GI symptom after the exam; one symptom was reported by 202 (25.5%), two or more symptoms by 159 (20.1%). Newly developed symptoms more frequently reported were epigastric/abdominal bloating (32.2%), pain (17.3%), and dyspeptic symptoms (17.9%). Symptoms were associated with female sex (odds ratio [OR]=2.54), increasing number of symptoms developed during bowel preparation intake (OR=1.35) and somatic symptoms (OR=1.27). An inverse association was observed with better mood (OR=0.74). A high-risk profile was identified, represented by women with bad mood and somatic symptoms (OR=8.81). CONCLUSION About half of the patients develop de novo GI symptoms following colonoscopy. Improving bowel preparation tolerability may reduce the incidence of post-colonoscopy symptoms, especially in more vulnerable patients.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, United States
| | | | - Sergio Cadoni
- Digestive Endoscopy Unit, Centro Traumatologico-Ortopedico Hospital, Iglesias, Italy
| | - Cesare Hassan
- Division of Gastroenterology and Digestive Endoscopy, Department of Gastroenterology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Leonardo Frazzoni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Bologna, Italy
| | - Andrea Anderloni
- Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center, Milan, Italy
| | - Liboria Laterza
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Endoscopy Service, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Marina La Marca
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Bologna, Italy
| | - Francesca Rogai
- IBD Unit, Gastroenterology Department, Careggi Hospital, University of Florence, Viale San Luca, 50134, Florence, Italy
| | - Cecilia Binda
- Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, Italy
| | - Amedeo Montale
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Bologna, Italy
| | - Paola Soriani
- UOSD Gastroenterologia ed Endoscopia Digestiva, Azienda USL di Modena, Italy
| | - Carlo Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, Italy
| | - Marco Sacco
- Città della Salute e della Scienza, Turin, Italy
| | - Paolo Gallittu
- Digestive Endoscopy Unit, Centro Traumatologico-Ortopedico Hospital, Iglesias, Italy
| | - Donatella Mura
- Digestive Endoscopy Unit, Centro Traumatologico-Ortopedico Hospital, Iglesias, Italy
| | - Cristina Trovato
- Division of Endoscopy, Istituto di Ricovero e Cura a Carattere Scientifico, European Institute of Oncology, Milan, Italy
| | | | | | | | - Clara Benedetta Conti
- Gastroenterology Unit, Valduce Hospital, Como, Italy; Interventional Endoscopy ASST Monza, Monza, Italy
| | - Mauro Manno
- UOSD Gastroenterologia ed Endoscopia Digestiva, Azienda USL di Modena, Italy
| | - Alessandro Repici
- Division of Gastroenterology and Digestive Endoscopy, Department of Gastroenterology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Rocco Maurizio Zagari
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Bologna, Italy
| | - Andrea Farioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Lorenzo Fuccio
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna, Bologna, Italy.
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Shahrbabaki PM, Asadi NB, Dehesh T, Nouhi E. The Effect of a Pre-Colonoscopy Education Program on Fear and Anxiety of Patients: A Randomized Clinical Trial Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2022; 27:554-559. [PMID: 36712299 PMCID: PMC9881560 DOI: 10.4103/ijnmr.ijnmr_96_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 01/31/2023]
Abstract
Background Due to the increasing prevalence of intestinal diseases, colonoscopy is considered a safe and fast diagnostic and treatment method for these patients. According to studies, most patients waiting for a colonoscopy experience fear and anxiety. This study aimed to investigate the effect of a pre-colonoscopy education program on the fear and anxiety of patients undergoing colonoscopy. Materials and Methods This randomized clinical trial study was conducted on patients undergoing colonoscopy in hospitals in southeast Iran. A total of 90 participants were selected by convenient sampling and randomly assigned to two groups control (n = 45) and intervention (n = 45). The patients in the intervention group received nursing interventions before colonoscopy, while the patients in the control group received only routine care. The data were collected using a researcher-made fear of colonoscopy scale, its Cronbach's alpha coefficient (0.92), and the Spielberger State-Trait Anxiety Inventory. The data were analyzed with a Chi-square t-test and pair t-test. Results The data showed that anxiety and fear of colonoscopy in the patients in the intervention group significantly decreased compared to the patients in the control group (p < 0.001). Conclusions Using non-pharmacological methods before colonoscopy can reduce the fear and anxiety in patients who are candidates for this procedure and similar invasive procedures. The intervention performed in this study can be used together with other methods to control patients' fear and anxiety. Especially for nurses, It is recommended to do pre-colonoscopy education programs for these clients.
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Affiliation(s)
- Parvin Mangolian Shahrbabaki
- Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran,Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Tania Dehesh
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Esmat Nouhi
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran,Address for correspondence: Dr. Esmat Nouhi, Haft-Bagh Highway, Medical Surgical Nursing, Faculty of Nursing and Midwifery, P. O. Box: 7716913555, Kerman University of Medical Sciences, Kerman, Iran. E-mail: /
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Zhu X, Weiser E, Griffin JM, Limburg PJ, Finney Rutten LJ. Factors Influencing Colorectal Cancer Screening Decision-Making Among Average-Risk US Adults. Prev Med Rep 2022; 30:102047. [DOI: 10.1016/j.pmedr.2022.102047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
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Determinants of symptom burden related to bowel preparation for colonoscopy. Dig Liver Dis 2022; 54:1554-1560. [PMID: 35778229 DOI: 10.1016/j.dld.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/11/2022] [Accepted: 06/07/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Symptoms developing during bowel preparation are major concerns among subjects who refuse the procedure. AIMS We aimed to explore the determinants of symptoms occurring during preparation among patients undergoing elective colonoscopy. METHODS This is a prospective multicenter study conducted in 10 Italian hospitals. A multidimensional approach collecting socio-demographic, clinical, psychological and occupational information before colonoscopy through validated instruments was used. Outcome was a four-category cumulative score based on symptoms occurring during preparation, according to the Mayo Clinic Bowel Prep Tolerability Questionnaire, weighted by intensity. Missing values were addressed through multiple imputation. Odds ratios (OR) and 95% confidence intervals (CI) were estimated through multivariate logistic regression models. RESULTS 1137 subjects were enrolled. Severe symptoms were associated with female sex (OR=3.64, 95%CI 1.94-6.83), heavier working hours (OR=1.13, 95% CI=1.01-1.25), previous gastrointestinal symptoms (OR=7.81, 95% CI 2.36-25.8 for high score), somatic symptoms (OR=2.19, 95% CI=1.06-4.49 for multiple symptoms), day-before regimen (OR=2.71, 95%CI 1.28-5.73). On the other hand, age ≥60 years (OR=0.10, 95% CI 0.02-0.44) and good mood (p=0.042) were protective factors. A high-risk profile was identified, including women with low mood and somatic symptoms (OR=15.5, 95%CI 4.56-52.7). CONCLUSIONS We identified previously unreported determinants of symptoms burdening bowel preparation and identified a particularly vulnerable phenotype. Symptoms during preparation especially impact heavier working activity.
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Wang Y, Xu F, Zhao S, Han L, Huang S, Zhu H, Ding Y, Ma L, Zhao W, Zhang T, Chen X. Procedural analgesic interventions in China: a national survey of 2198 hospitals. BMC Anesthesiol 2022; 22:250. [PMID: 35933333 PMCID: PMC9356406 DOI: 10.1186/s12871-022-01783-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background Humane treatment requires the provision of appropriate sedation and analgesia during medical diagnosis and treatment. However, limited information is available about the status of procedural analgesic interventions in Chinese hospitals. Therefore, a nationwide survey was established to identify challenges and propose potential improvement strategies. Methods Forty-three members of the Pain Group of Chinese Society of Anesthesiology established and reviewed the questionnaire, which included (1) general information on the hospitals, (2) the sedation/analgesia rate in gastrointestinal endoscopy, labor, flexible bronchoscopy, hysteroscopy in China, (3) staff assignments, (4) drug use for procedural analgesic interventions, and (5) difficulties in procedural analgesic interventions. The data were obtained using an online questionnaire sent to the chief anesthesiologists of Chinese hospitals above Grade II or members of the Pain Group of Chinese Society of Anesthesiology. Results Valid and complete questionnaires were received from 2198 (44.0%) hospitals, of which 64.5% were Grade III. The overall sedation/analgesia rates were as follows: gastroscopy (50.6%), colonoscopy (53.7%), ERCP (65.9%), induced abortion (67.5%), labor (42.3%), hysteroscopy (67.0%) and fiber bronchoscopy (52.6%). Compared with Grade II hospitals, Grade III hospitals had a higher proportion of procedural analgesic interventions services except for induced abortion. On average (median [IQR]), each anesthesiologist performed 5.7 [2.3—11.4] cases per day, with 7.3 [3.2—13.6] performed in Grade III hospitals and 3.4 [1.8—6.8] performed in Grade II hospitals (z = -7.065, p < 0.001). Conclusions Chinese anesthesiologists have made great efforts to achieve procedural analgesic interventions, as evidenced by the increased rate. The uneven health care provided by hospitals at different levels and in different regions and the lack of anesthesiologists are the main barriers to optimal procedural analgesic interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12871-022-01783-6.
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Affiliation(s)
- Yafeng Wang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Feng Xu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shuai Zhao
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Linlin Han
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shiqian Huang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hongyu Zhu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yuanyuan Ding
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Lulin Ma
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wenjing Zhao
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tianhao Zhang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiangdong Chen
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Jung YS, Jee Y, Im E, Kim MH, Moon CM. Bowel Preparation and Subsequent Colonoscopy Is Associated with the Risk of Atrial Fibrillation: A Population-Based Case-Crossover Study. J Pers Med 2022; 12:jpm12081207. [PMID: 35893301 PMCID: PMC9331767 DOI: 10.3390/jpm12081207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/19/2022] [Indexed: 12/09/2022] Open
Abstract
This study aimed to clarify the association of the risk of atrial fibrillation (AF) with bowel preparation and subsequent colonoscopy through population-based case-crossover analysis. Patients who developed new-onset AF after undergoing colonoscopy following bowel preparation were included. For each patient, one hazard period and four control periods were matched at specified time windows. Among 189,613 patients with AF, 84 patients (mean age: 72.4 years) finally met the inclusion criteria. Most patients used polyethylene glycol (PEG)-based solutions (2 L PEG + ascorbic acid (n = 56), 4 L PEG (n = 21)) as purgatives and had hypertension (n = 75). A significant association of bowel preparation and colonoscopy with AF occurrence was found in all time windows. The proportion of patients with bowel preparation and colonoscopy was higher during the hazard period than during the control periods. In the 1-, 2-, 4-, 8-, and 12-week time windows, the proportions were 11.9% vs. 4.2%, 13.1% vs. 4.8%, 16.7% vs. 6.3%, 28.6% vs. 11.9%, and 29.8% vs. 14.0%, and the odd ratios (ORs) were 3.11, 3.01, 3.00, 2.96, and 2.61, respectively. Bowel preparation and undergoing colonoscopy was associated with the risk of AF and this examination need to be performed with caution especially in elderly patients with hypertension.
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Affiliation(s)
- Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Yongho Jee
- Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul 07804, Korea;
| | - Eui Im
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin 16995, Korea;
| | - Min-ho Kim
- Informatization Department, Ewha Womans University Seoul Hospital, Seoul 07804, Korea;
| | - Chang Mo Moon
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Korea
- Inflammation-Cancer Microenvironment Research Center, College of Medicine, Ewha Womans University, Seoul 07804, Korea
- Correspondence:
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Lin W, Huang W, Mei C, Zhong C, Zhu L, Liu P, Yuan S, Liu Z, Wang Y. Pre-Procedural Anxiety and Associated Factors Among Women Seeking for Cervical Cancer Screening Services in Shenzhen, China: Does Past Screening Experience Matter? Front Oncol 2022; 12:857138. [PMID: 35875131 PMCID: PMC9296811 DOI: 10.3389/fonc.2022.857138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background Research gaps exist in addressing the psychological harm related to the cervical cancer screening. Anxiety is the most common distress driven by the screening procedures, which may be affected by past screening experience (PSE) but with uncertainty. This study aimed to evaluate the pre-procedural anxiety in cervical cancer screening and to identify the influence attributed to PSE. Methods A cross-sectional survey targeted women seeking for cervical cancer screening services was conducted from June 5th to December 31st, 2020 in Shenzhen. The 20-item state anxiety scale of the State-Trait Anxiety Inventory (STAI-S) was applied to measure pre-procedural anxiety, in which a score of 40 or higher was regarded with anxiety symptom. Logistic regression models were established to explore potential associated factors of pre-procedural anxiety both for women with and without PSE. Results Overall, 3,651 women were enrolled, in which 36.1% had never been screened and the remaining 63.9% had been screened at least once before. Women without PSE demonstrated more prevalent pre-procedural anxiety (74.5% vs. 67.8%, P <0.001) than their experienced counterparts. Among women without PSE, having heard of cervical cancer screening was associated with a lower likelihood of pre-procedural anxiety (OR: 0.37, 95%CI: 0.25~0.56). Among experienced women, participating three or more times screening was negatively associated with anxiety symptom (OR: 0.67, 95%CI: 0.53~0.84), however, both receiving screening within three years (OR: 1.58, 95%CI: 1.27~1.97) and unknowing previous screening results (OR: 1.42, 95%CI: 1.11~1.82) increased the susceptibility of pre-procedural anxiety. Conclusions Women participating in cervical cancer screening commonly present pre-procedural anxiety. The association between PSE and pre-procedural anxiety may be influenced by past screening times, interval, and results. Psychological counseling according to women’s PSE before cervical cancer screening is warranted of necessity.
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Affiliation(s)
- Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Weikang Huang
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Chaofan Mei
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Chuyan Zhong
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Leilei Zhu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- Department of Gynecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Peiyi Liu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- Research Institute of Maternity and Child Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shixin Yuan
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- Research Institute of Maternity and Child Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Zhihua Liu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- Department of Gynecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- Research Institute of Maternity and Child Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
- *Correspondence: Yueyun Wang,
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Jain A, Jain R, Nugent Z, Solati Z, Davidson D, Shafer LA, Restall G, Reynolds K, Singh H. Improving Colonoscopy Bowel Preparation and Reducing Patient Anxiety Through Recently Developed Online Information Resource: A Cross-sectional Study. J Can Assoc Gastroenterol 2022; 5:161-168. [PMID: 35919762 PMCID: PMC9340630 DOI: 10.1093/jcag/gwab047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction Invasive medical procedures such as colonoscopies can cause psychological distress and anxiety. Mycolonoscopy.ca is a multilanguage website that provides online written and video information (individual items reported in prior publications to be highly rated by patients) regarding preparation and what to expect before, during, and after colonoscopy. Information about how to access the website is included with all colonoscopy appointment materials in Winnipeg, Manitoba. We evaluated the use of mycolonoscopy.ca among patients undergoing colonoscopy and examined the association between visitation to the website and patient outcomes. Methods A paper-based survey was distributed to patients attending their colonoscopy appointments between 11/2019 and 3/2020. Logistic regression analyses were performed to determine the factors associated with website visitation, procedural worry, and bowel preparation scores. Results Five hundred and ninety-three surveys were distributed, of which 506 were completed. 17.4% of participants had visited the website before their colonoscopy. Visitors to mycolonoscopy.ca were more likely to consume a split-dose bowel preparation (63.9%) compared with non-visitors (52.5%) (P = 0.006). 31.3% of website visitors were very/extremely worried about their colonoscopy compared with 17.9% of non-visitors. 76.6% of individuals agreed/strongly agreed that visiting the website helped them prepare for their colonoscopy and 69.7% who visited the website agreed/strongly agreed that it helped to reduce their stress/anxiety for the procedure. In multivariable analyses, visitation to website was associated with higher adequate bowel preparation (OR:10.55; 95% CI:1.35 to 82.4). Conclusion Use of an informative online platform such as mycolonoscopy.ca can help to improve patient education before colonoscopy, reduce worry surrounding the procedure, and improve bowel preparation.
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Affiliation(s)
- Avni Jain
- Department of Internal Medicine, Section of Gastroenterology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruchi Jain
- Department of Internal Medicine, Section of Gastroenterology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Zoann Nugent
- Department of Internal Medicine, Section of Gastroenterology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Zahra Solati
- Department of Internal Medicine, Section of Gastroenterology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dylan Davidson
- Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Leigh Anne Shafer
- Department of Internal Medicine, Section of Gastroenterology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gayle Restall
- Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harminder Singh
- Department of Internal Medicine, Section of Gastroenterology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Broder E, Davies A, Alrubaiy L. Using Information Videos to Improve Patient Satisfaction in Endoscopy: A Prospective Service Improvement Project. Cureus 2022; 14:e24108. [PMID: 35518531 PMCID: PMC9065946 DOI: 10.7759/cureus.24108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Endoscopy is a rapidly developing discipline with new techniques and procedures being introduced each year. The consenting process is central to patient perception; using information videos as additional tools to aid consent and improve the quality of care in endoscopy is not well established. Our aim was to develop, implement and validate the use of patient educational videos to improve patients’ satisfaction and experience in endoscopy. Methods and analysis: This was a prospective service quality improvement study. Eligible patients were invited to watch the educational videos in addition to standard practice. We compared this group with a matched cohort of patients who were receiving standard care of postal information leaflets. Patient satisfaction was measured through the validated Gastrointestinal Endoscopy Satisfaction Questionnaire (GESQ). Results: Patients in the intervention group scored four questions relating to pre-procedural information significantly higher than the control (p=0.038). The total mean GESQ score was also higher in the intervention group compared to the control, however this was not statistically significant (p=0.397). The intervention group had significantly lower cancellation rate (4%) compared to the control group (20%), p=0.023. Conclusions: Patients who watched educational videos were more satisfied with pre-procedural information in the consenting period than those who did not. Further research is still needed to determine if they reduce patient anxiety. Meanwhile, it would be appropriate to implement these videos into routine practice as a cost-effective method of improving patient satisfaction.
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Kelly L. Colonoscopy: an evidence-based approach. Nurs Stand 2022; 37:77-82. [PMID: 35257537 DOI: 10.7748/ns.2022.e11901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
Colonoscopy is an invasive, endoscopic procedure undertaken to visualise the inner lumen of the colon and is used for a variety of diagnostic purposes. The procedure is increasingly performed by nurse endoscopists. This article provides an overview of the indications and contraindications for colonoscopy and describes various elements of the procedure, including consent, sedation and bowel preparation within the context of the evidence base. The article also discusses patient care before, during and after the procedure.
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Affiliation(s)
- Lucy Kelly
- endoscopy department, Burnley General Hospital, East Lancashire Hospital NHS Trust, Burnley, Lancashire, England
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50
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Găină MA, Szalontay AS, Ștefănescu G, Bălan GG, Ghiciuc CM, Boloș A, Găină AM, Ștefănescu C. State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain. J Clin Med 2022; 11:1670. [PMID: 35329993 PMCID: PMC8949336 DOI: 10.3390/jcm11061670] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Colonoscopy related fear impairs the current gold standard screening of colorectal cancer. Compared to other minimally invasive procedures for cancer screening, colonoscopy-induced anxiety exceeds the procedure through bowel preparation. Immersive virtual reality's (iVR) role in alleviating the complex stress-pain relationship encountered during medical procedures is directly proportional to the rising affordability of state-of-the-art Head-Mounted-Displays (HMDs). OBJECTIVE to assess the effect of iVR on patients' colonoscopy-induced anxiety and pain. MATERIALS AND METHODS A systematic search was conducted in PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase and Scopus databases up to January 2022. Clinical trials evaluating anxiety as an outcome were included without language restriction. RESULTS Four clinical trials were included: three on the patients' intraprocedural anxiety and one on patient education. Intraprocedural iVR interventions for colonoscopy-induced anxiety and pain revealed a similar effect as conventional sedation, while a statistically significant reduction was reported for non-sedated patients. iVR patient education improved the quality of bowel preparation and reduced patient anxiety before colonoscopy. CONCLUSIONS The current research highlights the need to use high-end HMDs and appropriate interactive iVR software content for colonoscopy-induced anxiety. Methodological frameworks regarding the eligibility of participants, double-blinding and randomization of iVR studies can facilitate the development of iVR implementation for anxiety and pain management.
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Affiliation(s)
- Marcel-Alexandru Găină
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Andreea Silvana Szalontay
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Gabriela Ștefănescu
- Medical Semiology and Gastroenterology, Department of Medicine I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (G.Ș.); (G.G.B.)
- 2nd Gastroenterology Ward, Saint “Spiridon” County Hospital, Independence Bvd. No 1, 700111 Iasi, Romania
| | - Gheorghe Gh Bălan
- Medical Semiology and Gastroenterology, Department of Medicine I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (G.Ș.); (G.G.B.)
- 2nd Gastroenterology Ward, Saint “Spiridon” County Hospital, Independence Bvd. No 1, 700111 Iasi, Romania
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Department of Morpho-Functional Sciences II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania;
| | - Alexandra Boloș
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Alexandra-Maria Găină
- 1st Neurology Ward, Hospital of Neurosurgery “Prof. Dr. Nicolae Oblu” Iasi, 2 Ateneului Street, 700309 Iasi, Romania;
| | - Cristinel Ștefănescu
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania; (A.S.S.); (A.B.); (C.Ș.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
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