Lembo T, Fitzgerald L, Matin K, Woo K, Mayer E A, Naliboff B D
Beth Israel Deaconess Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA.
Am J Gastroenterol. 1998 Jul;93(7):1113-6. doi: 10.1111/j.1572-0241.1998.00339.x.
Despite current recommendations calling for regular screening flexible sigmoidoscopies over the age of 50, only a small percentage of the population have regular examinations. Improving patient tolerance of flexible sigmoidoscopies could therefore increase patient compliance with these recommended guidelines. The aim of this study was to determine whether audio and visual stimulation reduces discomfort during flexible sigmoidoscopy and whether the effects of the stimulation are secondary to distraction.
A total of 37 patients undergoing routine screening flexible sigmoidoscopy were randomized to receive no intervention, audio stimulation alone, or audio and visual stimulation. Patient discomfort ratings and affect states were measured prior to and immediately following flexible sigmoidoscopy using a visual analogue scale and the Stress Symptom Ratings (SSR) ratings.
Patients receiving audio and visual intervention had lower abdominal discomfort ratings (7.1 +/- 1.4) than patients receiving audio stimulation (9.5 +/- 1.3) or no intervention (10.8 +/- 1.6) (p < 0.05). Patients receiving audio and visual intervention also had higher arousal (7.3 +/- 0.4) and attention (9.2 +/- 0.2) ratings than patients receiving no intervention (6.1 +/- 0.4 and 6.2 +/- 0.7, respectively) (p < 0.05). Anxiety and anger ratings, on the other hand, were significantly lower in patients receiving audio and visual intervention (2.5 +/- 0.4, 1.4 +/- 0.3, respectively) than patients receiving no intervention (4.4 +/- 0.6, 3.6 +/- 0.7).
Audio and visual stimulation reduces abdominal discomfort associated with flexible sigmoidoscopy. This effect appears to be due to distraction.
尽管目前的建议呼吁50岁以上人群定期进行乙状结肠镜筛查,但只有一小部分人进行定期检查。因此,提高患者对乙状结肠镜检查的耐受性可能会增加患者对这些推荐指南的依从性。本研究的目的是确定视听刺激是否能减轻乙状结肠镜检查期间的不适,以及刺激的效果是否继发于注意力分散。
共有37例接受常规乙状结肠镜筛查的患者被随机分为不接受干预、仅接受音频刺激或接受视听刺激三组。在乙状结肠镜检查前和检查后立即使用视觉模拟量表和应激症状评分(SSR)对患者的不适评分和情绪状态进行测量。
接受视听干预的患者腹部不适评分(7.1±1.4)低于接受音频刺激的患者(9.5±1.3)或未接受干预的患者(10.8±1.6)(p<0.05)。接受视听干预的患者的唤醒评分(7.3±0.4)和注意力评分(9.2±0.2)也高于未接受干预的患者(分别为6.1±0.4和6.2±0.7)(p<0.05)。另一方面,接受视听干预的患者的焦虑评分和愤怒评分(分别为2.5±0.4、1.4±0.3)显著低于未接受干预的患者(4.4±0.6、3.6±0.7)。
视听刺激可减轻乙状结肠镜检查相关的腹部不适。这种效果似乎是由于注意力分散。