Feasibility and clinical benefit of cognitive–behavioral intervention for preparing patients for transesophageal echocardiography

Abstract

Objective:Despite premedication, anxiety in patients undergoing transesophageal echocardiography (TEE) is prevalent, often causing adverse physiological and psychological effects and contributing to decreased patient compliance. We aimed to evaluate the feasibility of cognitive–behavioral intervention (CBI) in patients undergoing TEE and to assess its impact on the severity of anxiety, patient’s and physician’s comfort, and administered dose of sedatives.Methods:Our study was designed as a prospective, single-center, single-blinded, case-controlled pilot study. The study group comprised 49 patients (26 men, 66±8 years old) referred for TEE. Before the examination, 26 randomly selected patients underwent CBI. Sedatives were administered, if necessary. After the examination, patient anxiety and patient’s and physician’s comfort were evaluated using dedicated questionnaires and scores. Intergroup comparison was performed using Student’s t-test for independent variables and Mann–Whitney U test and Pearson’s chi-square test or Fisher’s exact test for categorical variables.Results:The mean level of pre-TEE distress and anxiety were significantly lower in patients receiving CBI than in those without intervention (p=0.022). Furthermore, the application of CBI significantly reduced patient’s discomfort (p<0.001) and resulted in increased comfort of physician (p<0.001) during TEE. The need of sedative administration (31% vs. 91%, p<0.001) and its mean dose was significantly lower in patients receiving CBI (1.6±0.5 mg vs. 2.7±1.6 mg midazolam, p=0.009).Conclusions:CBI is feasible in patients undergoing TEE. It decreases patient’s anxiety and discomfort and increases physician’s comfort. It also results in reduced use of sedatives during the examination.

Conscious sedation for transcatheter implantation of atrial septal occluders with two- and three-dimensional transoesophageal echocardiography guidance — a feasibility and safety study

“…As we have previously reported in another study, appropriate preparation of patients to the TEE results in lower patient anxiety and discomfort, as well as improves comfort of the physician and reduces the dose of used sedatives [18]. Of note, none of the procedures performed by us were aborted due to lack of patient cooperation.…”

Feasibility and clinical benefit of the cognitive–behavioral intervention for preparing patients for transesophageal echocardiographic study

“…We read with great interest the article in this issue of Anatol J Cardiol entitled "Feasibility and clinical benefit of cognitive-behavioral intervention for preparing patients for transesophageal echocardiography" by Wejner-Mik et al (2), where they reported their experience on impact of cognitive behavior intervention (CBI) on the severity of anxiety, patient and physician comfort, and administered dose of sedatives in a group of patients undergoing TEE. Though subject to several limitations, their experience is certainly a turning point in preparing patients for elective TEE.…”