Yue Qian-Qian, Feng Ge-Hui, Peng Tong, Tang Tian, Sun Ying-Xue, Meng Xin-Ru, Huang Li-Li, Zhao Ke-Hao, Huang Hui-Lin, Zeng Ying
Department of International and Humanistic Nursing, Hunan Science Popularization Education Base, School of Nursing, Hengyang Medical School, University of South China, Hengyang, China.
Hunan Province Key Laboratory of Tumor Cellular & Molecular Pathology, Cancer Research Institute, Hengyang Medical School, University of South China, Hengyang, China.
BMC Psychol. 2025 Feb 27;13(1):169. doi: 10.1186/s40359-025-02463-z.
Anxiety in patients undergoing colonoscopy may also result in adverse effects, including altered vital signs such as elevated heart rate and blood pressure, exacerbation of symptoms like bloating and gastrointestinal discomfort, a decline in cooperation and satisfaction, and even colonoscopy failure. However, limited studies have explored the level of anxiety, factors that influence it, and its specific causes.
A cross-sectional study was conducted, recruiting 825 patients undergoing colonoscopy in Hunan Province between January and July 2023 using stratified sampling. The Spielberger State-Trait Anxiety Inventory (STAI), a self-designed demographic characteristics questionnaire, and a colonoscopy patient anxiety influencing factor questionnaire were used. The data were analyzed in SPSS (version 26) using Mann-Whitney U, Kruskal-Wallis, and multiple regression analysis tests.
The final study included 825 participants, of whom 19.8% exhibited mild anxiety, 37.0% exhibited moderate anxiety, and 43.2% exhibited severe anxiety. The results indicated that insomnia (β=-0.080, p = 0.013), no comorbidities (β=-0.147, p < 0.001), not smoking or drinking (β=-0.158, p < 0.001), and poor health (moderate: β=-0.183, p < 0.001; poor: β=-0.164, p < 0.001) were negatively associated with anxiety levels. In contrast, marital status (β = 0.177, p < 0.001), education level (β = 0.204, p < 0.001), age (β = 0.114, p = 0.007), medical insurance (Basic Medical Insurance for Urban Residents β = 0.204, p < 0.001; Commercial medical insurance: β = 0.112, p < 0.001), care provided by relatives (β = 0.102, p = 0.002), diarrhoea (β = 0.089, p = 0.005), occupation (farmers: β = 0.099, p = 0.009; self-employed: β = 0.082, p = 0.014), and paternal upbringing (β = 0.067, p = 0.034) were positively correlated with anxiety. Several factors had a greater impact on the anxiety level of the patients: education level (β = 0.204), health status (moderate: β=-0.183; not good: β=-0.164), and marital status (β = 0.177). It probably because higher education levels may increase awareness of potential risks associated with colonoscopy, contributing to greater anxiety. The five common reasons for anxiety included the presence of bloody faeces, enemas, need for further treatment, lack of timely feedback from the physician, lack of an accurate diagnosis.
The level of anxiety experienced by patients during the colonoscopy phase was more severe and should be alleviated with targeted interventions based on the cause of anxiety, such as pre-procedural counseling, patient education materials, and enhanced communication with healthcare providers.
接受结肠镜检查的患者出现焦虑情绪也可能导致不良反应，包括生命体征改变，如心率和血压升高，腹胀和胃肠道不适等症状加重，合作度和满意度下降，甚至导致结肠镜检查失败。然而，针对焦虑水平、影响因素及其具体成因的研究有限。
采用分层抽样法进行横断面研究，于2023年1月至7月招募了湖南省825例接受结肠镜检查的患者。使用斯皮尔伯格状态-特质焦虑量表（STAI）、自行设计的人口统计学特征问卷以及结肠镜检查患者焦虑影响因素问卷。数据在SPSS（26版）中使用曼-惠特尼U检验、克鲁斯卡尔-沃利斯检验和多元回归分析进行分析。
最终纳入研究的有825名参与者，其中19.8%表现为轻度焦虑，37.0%表现为中度焦虑，43.2%表现为重度焦虑。结果表明，失眠（β=-0.080，p = 0.013）、无合并症（β=-0.147，p < 0.001）、不吸烟不饮酒（β=-0.158，p < 0.001）以及健康状况差（中度：β=-0.183，p < 0.001；差：β=-0.164，p < 0.001）与焦虑水平呈负相关。相反，婚姻状况（β = 0.177，p < 0.001）、教育程度（β = 0.204，p < 0.001）、年龄（β = 0.114，p = 0.007）、医疗保险（城镇居民基本医疗保险β = 0.204，p < 0.001；商业医疗保险：β = 0.112，p < 0.001）、亲属照顾（β = 0.102，p = 0.002）、腹泻（β = 0.089，p = 0.005）、职业（农民：β = 0.099，p = 0.009；个体经营者：β = 0.082，p = 0.014）以及父亲的养育方式（β = 0.067，p = 0.034）与焦虑呈正相关。有几个因素对患者的焦虑水平影响更大：教育程度（β = 0.204）、健康状况（中度：β=-0.183；不佳：β=-0.164）以及婚姻状况（β = 0.177）。这可能是因为较高的教育水平可能会增加对结肠镜检查潜在风险的认知，从而导致更大的焦虑。焦虑的五个常见原因包括出现便血、灌肠、需要进一步治疗、医生缺乏及时反馈以及缺乏准确诊断。
患者在结肠镜检查阶段的焦虑程度较为严重，应根据焦虑原因进行针对性干预，如术前咨询、患者教育资料以及加强与医护人员的沟通，以缓解焦虑。
