Randomised controlled trial of the effect of standard and detailed risk disclosure prior to bronchoscopy on peri-procedure anxiety and satisfaction

Abstract

Background: Deciding what risks to disclose before a procedure is often challenging for clinicians. Consecutive patients undergoing elective fibreoptic bronchoscopy were randomised to receive simple or more detailed written information about the risks of the procedure and the effects on anxiety and satisfaction levels were compared. Methods: A 100 mm anxiety visual analogue scale (VAS) and a modified Amsterdam preoperative anxiety (scored 4-20) scale (APAIS) were completed before and after reading the designated information leaflet. Following bronchoscopy, subjects completed a satisfaction questionnaire. Results: Of 142 consecutive patients, 122 (86%) (mean age 57.8 years, 53% male) completed the study. Baseline demographic, clinical and anxiety measures were similar in the two groups. Those who received more detailed risk information had significantly greater increase in anxiety levels than those who received simple information on both the VAS (mean 14.0 (95% CI 10.1 to 17.9) vs 2.5 (95% CI 21.4 to 6.4), p,0.001) and the APAIS (1.73 (95% CI 1.19 to 2.26) vs 0.57 (95% CI 0.05 to 1.10), p,0.001). Almost twice as many of those receiving detailed risk information reported that they felt they had received too much information about complications or that the information they had received about bronchoscopy had been worrying. Conclusions: Provision of more detailed risk information before bronchoscopy may come at the cost of a small but significant increase in anxiety.

Effect of Verbal Empathy and Touch on Anxiety Relief in Patients Undergoing Flexible Bronchoscopy: Can Empathy Reduce Patients' Anxiety?

“…There was an effect of verbal empathy accompanied by intentional touch in participants with baseline anxiety on the VAS of ≥60 mm, and verbal empathy with touch as well as verbal empathy without touch reduced anxiety in participants with baseline anxiety on the VAS of ≥70 mm. This observation can be understood in the context of previous studies suggesting that patients with higher preintervention anxiety levels are more vulnerable to the aggravation of anxiety, or more susceptible to anxiety relief by intervention [17, 27,28]. …”

“…We used a visual analog scale (VAS) to measure the level of patients' anxiety based on the previous studies evaluating anxiety of patients [9,15,17]. The results of the VAS were assessed by a technician who was blinded to group assignment.…”

“…A previous study assessing peribronchoscopy anxiety and satisfaction defined a change of 8 mm on the VAS as clinically significant, assuming that a clinically significant change in a health-related quality of life tool is equivalent to 8% of the theoretical range of the tool [17]. Sample size calculations were based on the primary outcome, the difference in the VAS change, which should be 8 mm between the intervention and control groups.…”

Sedation with midazolam in flexible bronchoscopy – A prospective study

“…Com efeito, o receio antes do procedimento é praticamente universal 10 . Isto pode ser influenciado por vários fatores, como o nível de informação disponibilizada 15 ou forma de abordagem (escrita vs verbal).…”

The effect of multimedia information on anxiety levels of patients undergoing magnetic resonance imaging

“…Anksiyete, kolonoskopi, gastroskopi, bronkoskopi, invaziv kardiyak girişimler, miyokard perfuzyon sintigrafisi ve manyetik rezonans görüntüleme (MRG) gibi birçok medikal ve cerrahi prosedür sirasinda sik görülebilen bir durumdur [1][2][3][4][5][6][7][8][9].…”