Coping with a stressful sigmoidoscopy: Evaluation of cognitive and relaxation preparations

Abstract

Sigmoidoscopy involves the insertion of a small scope into the anal cavity to inspect for abnormalities in the colon. Although the procedure is not believed to be painful, it is often noxious for patients because it produces embarassment and discomfort. We examined the effectiveness of two brief interventions designed to enhance coping: self-instructional training and relaxation. In the self-instructional conditions patients were given brief training to focus their attention on either their own (internal) or the doctor's (external) ability to regulate the situation. A third (control) group received attention but did not experience self-instructional training. Half of each of these three groups also received relaxation training, while the other half did not. Planned comparisons demonstrated that subjects in the self-instructional strategies rated themselves as less anxious, had fewer body movements during the exam, and emitted fewer verbalization than those in an attention control group. Patients in the external condition estimated that the exam took less time but tended to have elevated heart rates during the procedure. Those experiencing relaxation training tended to overestimate the duration of the exam, but made fewer requests to stop the exam and rated themselves as less anxious than patients who did not receive relaxation training.

Assessment of discomfort in advanced Alzheimer patients

“…Following the model of Davis and Calhoon's (1989) observation times of 5 min for rating an infant during an aversive procedure, during routine care, and at recovery, 5 min was selected as the duration for the observations. Five minutes also is consistent with research for observing the effect of a coping strategy on the response to procedures (Fuller, Endress, &Johnson, 1978;Kaplan, Atkins, & Lenhard, 1982;Wells, 1990). The 1-hr time frame, used by Spielberger and colleagues (1983) for contrasting the stability of scales to measure both state and trait anxiety, was used for the retest reliability examination.…”

“…Practical considerations typically would not allow for that level of data collection, even for research. Based on the body of research in the area of managing subjects' responses to aversive procedures (e.g., Fuller et al, 1978;Kaplan et al, 1982;Wells, 1990), wide-reaching inferences for changing practice have been drawn from 5-min observations. For clinical purposes, a 5-min observation appears adequate to identify discomfort while ruling out transitory and meaningless gestures or postures.…”

A nurse- and peer-led support program to assist women in gynaecological oncology receiving curative radiotherapy, the PeNTAGOn study (Peer and nurse support trial to assist women in gynaecological oncology): study protocol for a randomised controlled trial

“…The prompt sheet also assesses global distress using the Distress Thermometer [40]. Anxious patients will be trained to use the strategy of controlled breathing with positive self-talk, an effective self-care activity to reduce treatment-related anxiety [41]. The prompt sheet will aid a discussion of the woman’s supportive care needs and possible MDC referrals.…”

Comparison of Effectiveness of Paper Handout vs. Video Media in Reducing Level of Anxiety in Patients Scheduled for Upper GI Endoscopy

“…Additionally, it may also reduce the cost [1,15] and adverse events associated with sedation [1] . There are a variety of choices to reduce pre-procedural anxiety, namely psychological intervention [16,17,18,19] , educational materials including video media [1,2,3,4] , hypnosis, acupuncture and nitrous oxide analgesia [1] . The video media and paper handouts as educational tools are simple and easy ways to achieve this.…”