Visual distraction alone for the improvement of colonoscopy-related pain and satisfaction

Umezawa, Shotaro; Higurashi, Takuma; Uchiyama, S.; Shimizu, Eiji; Ohkubo, Hidenori; Endo, Hideki; Nonaka, Takashi; Nakajima, Atsushi

doi:10.3748/wjg.v21.i15.4707

Cited by 49 publications

(46 citation statements)

References 28 publications

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“…The intervention had no effect on the discharge SOFA score (F = 0.021; P = .85). ICU length of stay did not differ significantly (t = 0.469; P = .64) between the 2 groups, even though the mean length of stay was almost 2 days shorter in the intervention group (mean, 7.6; SD, 13.8) than in the control group (mean, 9.4; SD, 14).…”

Section: Secondary Outcomesmentioning

confidence: 89%

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Effects of an Integrative Nursing Intervention on Pain in Critically Ill Patients: A Pilot Clinical Trial

Papathanassoglou¹,

Hadjibalassi²,

Miltiadous³

et al. 2018

Am J Crit Care

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Background Pain, a persistent problem in critically ill patients, adversely affects outcomes. Despite recommendations, no evidence-based nonpharmacological approaches for pain treatment in critically ill patients have been developed. Objectives To investigate the effects of a multimodal integrative intervention on the incidence of pain and on secondary outcomes: intensity of pain, hemodynamic indices (systolic and mean arterial pressure, heart rate), anxiety, fear, relaxation, optimism, and sleep quality. Methods A randomized, controlled, double-blinded repeated-measures trial with predetermined eligibility criteria was conducted. The intervention included relaxation, guided imagery, moderate pressure massage, and listening to music. The primary outcome was incidence of pain (score on Critical Care Pain Observation Tool > 2). Other outcomes included pain ratings, hemodynamic measurements, self-reported psychological outcomes, and quality of sleep. Repeated-measures models with adjustments (baseline levels, confounders) were used. Results Among the 60 randomized critically ill adults in the sample, the intervention group experienced significant decreases in the incidence (P = .003) and ratings of pain (P < .001). Adjusted models revealed a significant trend for lower incidence (P = .002) and ratings (P < .001) of pain, systolic arterial pressure (P < .001), anxiety (P = .01), and improved quality of sleep (P = .02). Conclusion A multimodal integrative intervention may be effective in decreasing pain and improving painrelated outcomes in critically ill patients. (American Journal of Critical Care. 2018; 27:172-185) EFFECTS OF Unrelieved pain is common among ICU patients and may compromise outcomes, by contributing to unstable hemodynamic parameters, hypercatabolism, hyperglycemia, infections, delirium, and posttraumatic stress. 2 Pain in ICU patients may also be part of a vicious circle implicating anxiety 3 and insomnia. 4 Moreover, pain has been linked to the post-ICU syndrome 5 and may become chronic in survivors, a situation associated with poor quality of life and poor psychological and physiological outcomes. 6Management of pain in patients with a critical illness is challenging.7 Opioids, the drug class of choice, are associated with marked side effects, including respiratory depression, hypotension, decreased gastrointestinal motility, delirium, and higher costs due to increased use of resources and prolonged stay in the ICU.8 Nociception, the perception of painful stimuli, entails a complex interaction among sensory, affective, and social components.9 Moreover, anxiety, fear, and negative expectations are common in critically ill patients and may contribute to heightened perception of pain.10 Thus, the multifactorial nature of ICU pain calls for approaches that address both physiological and psychosocial responses to pain. Current guidelines highlight the need to test and implement nonpharmacological strategies for pain treatment in critically ill patients.2 Interventions that elicit a relaxation ...

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Section: Secondary Outcomesmentioning

confidence: 89%

“…13 Multiple synergistic mechanisms may be involved, including distraction of attention, diminished transmission of nociceptive signals due to descending impulses from the brain during processing of relaxation cues, downregulation of the affective nociceptive pathway, and perception of social connectedness. [14][15][16][17][18] …”

mentioning

confidence: 99%

Effects of an Integrative Nursing Intervention on Pain in Critically Ill Patients: A Pilot Clinical Trial

Papathanassoglou¹,

Hadjibalassi²,

Miltiadous³

et al. 2018

Am J Crit Care

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“…In a study on patients undergoing FB, those who experienced more pain and choking were less likely to agree to a repeat procedure . Compared with the control patients, patients undergoing colonoscopy with visual or audiovisual distraction were much more likely to agree to a repeat colonoscopy if required . Klaming et al .…”

Section: Discussionmentioning

confidence: 99%

“…reported that playing music during FB improved physiological indicators of anxiety and decreased patient‐perceived anxiety and pain . Several studies conducted in the United States, Europe and China have reported positive effects of visual and/or aural distraction during other invasive procedures including colonoscopy, sigmoidoscopy, interventional radiologic procedures and burn dressing changes .…”

Section: Discussionmentioning

confidence: 99%

The effect of audiovisual distraction on the tolerability of flexible bronchoscopy: a randomized trial

Navidian

Moulaei

Tabas

et al. 2016

Clinical Respiratory J

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“…The study with the largest sample size, 964 patients, undergoing colonoscopy with and without sedation, reported moderate or intense anxiety in 497 patients (51.5%) (12). In a sample of 60 patients undergoing colonoscopy without sedation which employed the same VAS method used in our study to assess anxiety, Umezawa et al found a median VAS value of 51 to 52.5 (13). In another prospective study on 403 patients undergoing colonoscopy, the median value of the VAS was 52 among patients who chose colonoscopy without sedation and 61 in patients who chose colonoscopy under sedation (14).…”

Section: Main Endoscopic Diagnosis Principal (N %)mentioning

confidence: 97%

Prospective study of anxiety in patients undergoing an outpatient colonoscopy

Bensusán¹,

Martín²,

Álvarez³

2016

Rev Esp Enferm Dig

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Background: Undergoing a colonoscopy can cause anxiety in patients and this is something which has not been closely studied.Objective: To determine the frequency and intensity of anxiety prior to a colonoscopy and the factors which are related to the procedure.Methods: This is a prospective study of patients undergoing outpatient colonoscopy in our hospital. Anxiety was assessed using a visual analogue scale of 0 to 100. The severity of anxiety was rated as mild (1-29), moderate (30-79) or severe (80-100).Results: Three hundred and twenty-seven patients completed the study, of whom 154 (47.1%) were men with a median age of 54 years (p25-75: 45-65). Three hundred and nine (94.5%) patients were found to suffer a certain degree of anxiety. The median value on the visual analogue scale was 31 (p25-75: 10-53). Anxiety levels were mild in 136 patients (44%), moderate in 141 (45.6%) and severe in 32 (10.4%). Greater anxiety was associated with female patients (mean 40.38 vs 31.99, p = 0.01) and a poorly tolerated previous colonoscopy (mean 50.67 vs 28.44, p = 0.01) and correlated inversely with age (r = -0.170, p = 0.02).Conclusions: Colonoscopy causes some degree of anxiety in most patients. Being female, younger and having experienced poor tolerance to a previous scan are associated with greater degrees of anxiety. These findings should be taken into account in the implementation of measures to improve the quality and tolerance of colonoscopy.

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Visual distraction alone for the improvement of colonoscopy-related pain and satisfaction

Abstract: Visual distraction alone improves satisfaction in patients undergoing colonoscopy and decreases anxiety and pain during the procedure among patients with a high pre-procedural anxiety score.

Cited by 49 publications

References 28 publications

Effects of an Integrative Nursing Intervention on Pain in Critically Ill Patients: A Pilot Clinical Trial

Effects of an Integrative Nursing Intervention on Pain in Critically Ill Patients: A Pilot Clinical Trial

The effect of audiovisual distraction on the tolerability of flexible bronchoscopy: a randomized trial

Prospective study of anxiety in patients undergoing an outpatient colonoscopy

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