Psychology Service, VA Connecticut Healthcare System, West Haven, CT.
Psychology Service, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT.
Urology. 2020 Mar;137:26-32. doi: 10.1016/j.urology.2019.12.024. Epub 2019 Dec 29.
To improve the tolerability of transrectal ultrasound guided prostate biopsy through use of diaphragmatic breathing.
Forty-seven patients, aged 52-79 years, who were scheduled for a transrectal ultrasound guided prostate biopsy with or without MRI guidance, were recruited at a single Veterans Affairs medical center for the diagnosis or evaluation of prostate cancer. Patients either met with a health psychologist for a 1-time, diaphragmatic breathing intervention immediately prior to their biopsy, or received usual care. All biopsies were performed using local anesthetic without sedation or anxiolytic therapy. The primary outcome was the difference in self-reported procedural situational anxiety as measured with the State Trait Anxiety Inventory, assessed both pre- and post-transrectal ultrasound guided prostate biopsy. We also examined secondary outcomes including physiological parameters (heart rate and blood pressure).
There were no significant differences in preprocedural anxiety or physiological parameters between patients who received the intervention and those who received usual care. Patients who received the intervention had a significantly larger decrease in situational anxiety from pre- to postprocedure (M = 14.15, SD = 6.64) compared with those who received usual care (M = 3.45, SD = 9.97); t (38) = -4.0, P <.000; d = 1.26. Patients who received the intervention had a significantly larger decrease in heart rate (bpm) from pre- to postprocedure (M = 10.63, SD = 12.21) compared with those who received usual care (M = 0.07, SD = 9.25); t (31) = 2.75 P = 0.010; d = 0.97.
A guided diaphragmatic breathing intervention reduced procedural anxiety during prostate biopsy and improved patient experience.
通过膈式呼吸提高经直肠超声引导前列腺活检的耐受性。
在一家退伍军人事务医疗中心，招募了 47 名年龄在 52-79 岁之间的患者，他们计划进行经直肠超声引导前列腺活检，或联合 MRI 引导。患者在接受活检前，与一名健康心理学家进行了一次膈式呼吸干预，或者接受常规护理。所有活检均在局部麻醉下进行，无需镇静或焦虑治疗。主要结局是通过状态特质焦虑量表（State Trait Anxiety Inventory）评估的经直肠超声引导前列腺活检前后的自我报告程序情境焦虑差异。我们还检查了包括生理参数（心率和血压）在内的次要结局。
接受干预和接受常规护理的患者在术前焦虑或生理参数方面没有显著差异。与接受常规护理的患者相比，接受干预的患者在从术前到术后的情境焦虑方面显著降低（M=14.15，SD=6.64），而接受常规护理的患者为 M=3.45，SD=9.97；t（38）=-4.0，P<.000；d=1.26。与接受常规护理的患者相比，接受干预的患者在从术前到术后的心率（bpm）方面显著降低（M=10.63，SD=12.21），而接受常规护理的患者为 M=0.07，SD=9.25；t（31）=2.75，P=0.010；d=0.97。
引导膈式呼吸干预可降低前列腺活检过程中的程序焦虑，并改善患者体验。
