A Randomized Controlled Trial of a Modified Cystoscopy Technique using the Peak-End Rule in order to Improve Pain and Anxiety

Hetou, Khalil; Halstuch, Daniel; Lavi, Arnon; Nair, Shiva M.; Gan, Ailsa May Li; Huynh, Melissa; Izawa, Jonathan I.; Chin, Joseph L.; Power, Nicholas

doi:10.1016/j.urology.2021.02.033

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…6 A recent trial applying the peak-end rule to cystoscopy also showed that participants with higher overall pain scores had more pain reduction than those with lower overall pain scores. 14 Consistently, postmenopausal women in our trial had higher maximal real-time pain of the regular course than premenopausal women (Supplemental Table S1, available at http://links.lww.com/PAIN/ B802). The above findings explained why our modification was more effective in postmenopausal women.…”

Section: Discussionsupporting

confidence: 72%

Adding a nonpainful end to reduce pain recollection of Pap smear screening: a randomized controlled trial

Yen

Cheng

Chiu

et al. 2023

Pain

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The pain experienced during Pap tests is a crucial gap in reducing cervical cancer burden. This study sought to investigate whether adding a nonpainful step at the end of Pap tests helps women recall less pain. We conducted a randomized controlled trial on women aged 30 to 70 years at a cervical cancer screening center. A nonpainful step was added at the end of Pap test in the modified Pap group. The outcomes included recalled pain after Pap smear screening, real-time pain, and 1-year willingness to receive further Pap tests. Among 266 subjects in the intention-to-treat analysis, the modified Pap group (n = 133) experienced lower 5-minute recalled pain than the traditional Pap group on a 1 to 5 numeric scale (mean [SD], 1.50 [0.77] vs 2.02 [1.12]; P < 0.001) and a 0 to 10 visual analog scale (2.12 [1.79] vs 3.12 [2.23]; P < 0.001). In exploratory subgroup analyses, the association between the modified Pap test and reduced 5-minute recalled pain was not affected by predicted pain, demographic, or socioeconomic characteristics, but it was more apparent in postmenopausal women. Consistently, the modified Pap test attenuated 1-year recalled pain on both pain scales. Furthermore, the modified Pap test increased 1-year willingness grade to receive further Pap tests (adjusted β [SE], 2.11 [0.27]; P < 0.001). In conclusion, adding a nonpainful step at the end of Pap smear screening reduces on-site and long-term recalled pain and strengthens willingness to undergo subsequent Pap tests regularly. The modified Pap test contributes to cervical cancer screening participation.

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Section: Discussionsupporting

confidence: 72%

Adding a nonpainful end to reduce pain recollection of Pap smear screening: a randomized controlled trial

Yen

Cheng

Chiu

et al. 2023

Pain

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“…Eine weitere interessante Option stellt eine zweiminütige Ruhepause vor dem Zurückziehen des Zystoskops am Ende der Zystoskopie dar, die die Schmerz-und Angstwahrnehmung der Patienten um die Hälfte reduzieren konnte. Dieser von dem Nobelpreisträger und Psychologen Daniel Kahnemann beschrieben Effekt der "peak end rule" beruht darauf, dass in der menschliche Erinnerung eine Erfahrung nicht nach der Gesamtsumme oder dem Durchschnitt jedes Moments beurteilt, sondern vor allem durch die besonders positiv oder negativ wahrgenommenen sowie die abschließenden Momente geprägt wird [19].…”

Section: Narrow Band Imaging (Nbi)unclassified

Zystoskopien in der urologischen Praxis – was muss ich beachten?

Schöne

Uhthoff

Schöne³

2022

Aktuelle Urol

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ZusammenfassungDie Urethrozystoskopie ist ein wichtiges diagnostisches Werkzeug zur Abklärung des unteren Harntraktes. Die Standardzystoskopie (Weißlicht) wird fortwährend weiterentwickelt, moderne Endoskope und Videosysteme stehen zur Verfügung. Unterstützende Verfahren wie die photodynamische Diagnostik (PDD), narrow band imaging (NBI) oder digitale Kontrastverstärkungen verbessern die Detektionsrate von Blasentumoren. Besondere Bedeutung im Praxisalltag haben eine korrekte Indikationsstellung, die sorgfältige Vorbereitung und Aufklärung der Patienten und eine fachliche Expertise bei der Durchführung der Untersuchung, um Beschwerden und Komplikationen zu minimieren und zielführende Befunde zu erheben. Die Hygieneanforderung an Aufbereitung und Infrastruktur werden derzeit im Vergütungssystem nicht adäquat abgebildet. Technische Bildverarbeitung und Systeme mit künstlicher Intelligenz (KI) haben das Potential den Urologen bereits während der Untersuchung zu unterstützen.

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Prospective randomized controlled trial to evaluate effectiveness of virtual reality to decrease anxiety in office-based flexible cystoscopy patients

et al. 2022

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A Randomized Controlled Trial of a Modified Cystoscopy Technique using the Peak-End Rule in order to Improve Pain and Anxiety

Cited by 5 publications

References 19 publications

Adding a nonpainful end to reduce pain recollection of Pap smear screening: a randomized controlled trial

Adding a nonpainful end to reduce pain recollection of Pap smear screening: a randomized controlled trial

Zystoskopien in der urologischen Praxis – was muss ich beachten?

Prospective randomized controlled trial to evaluate effectiveness of virtual reality to decrease anxiety in office-based flexible cystoscopy patients

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