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Abstract
Background/Aims
Patients who undergo endoscopic biopsy suffer anxiety until results are confirmed. This study assesses the effects of written educational material on the anxiety level of patients following endoscopic biopsy.
Methods
This study was a randomized controlled study trial with 83 patients divided into the following three groups: a biopsy group given written educational material prepared by our institution following the biopsy (intervention group, n=28), a biopsy group without written material (biopsy only group, n=25), and a control group without biopsy (control group, n=30). The anxiety level of each patient was evaluated three times using Spielberger's State-Trait Anxiety Inventory (STAI): for baseline at the first visit to our institution, at the day of endoscopy, one day later, and one week after the procedure. We compared baseline characteristics, STAI scores at each visit, and differences in STAI scores among the three groups.
Results
No difference was found in STAI score among groups at baseline and before and after the endoscopic procedure. However, the STAI-state score of the intervention group was slightly lower than biopsy only group one day post-procedure (40.3±7.7 vs. 43.9±7.1, p=0.135). The STAI-state score significantly decreased from pre- to post-procedure only in the intervention group (–2.75±6.1 vs. 0.92±4.0, p＜0.027).
References
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Supplementary Fig. 1.
The written educational material for endoscopic biopsy in our study (Korean version).
Supplementary Fig. 2.
The written educational material for endoscopic biopsy in our study (English version).
Fig. 1.
Flow chart of the study design. Enrolled patients were measured Spielberger's State-Trait Anxiety Inventory (STAI; state, trait) at reservation day for endoscopy, procedure day and follow up day. Only intervention group patients were provided written educational materials after endoscopic biopsy. OPD, outpatient department.
Fig. 2.
Comparison of mean state and trait anxiety levels after using of written educational material. *The Spielberger's State-Trait Anxiety Inventory (STAI)-state score was significantly decreased in the intervention group (control, biopsy only, and intervention group; 0.29±5.3,0.92±4.0, and –2.75±6.1, respectively; p=0.029).
Table 1.
Demographic Characteristics by Group
| Variable | Control (n=30) | Biopsy only (n=25) | Intervention (n=28) | p-value |
|---|---|---|---|---|
| Age (yr) | 44.0±12.0 | 47.4±13.6 | 51.1±13.8 | 0.131 |
| Gender | 0.814 | |||
| Male | 12 (40.0) | 12 (48.0) | 13 (46.4) | |
| Female | 18 (60.0) | 13 (52.0) | 15 (53.6) | |
| Educational level | 0.762 | |||
| Primary school graduate | 1 (3.3) | 2 (8.0) | 2 (7.1) | |
| High school graduate | 5 (16.7) | 5 (20.0) | 5 (17.9) | |
| University graduate | 21 (70.0) | 14 (56.0) | 20 (71.4) | |
| Not checked | 3 (10.0) | 4 (16.0) | 1 (3.6) | |
| Existing conditions | 0.223 | |||
| None | 24 (80.0) | 10 (40.0) | 18 (64.3) | |
| Diabetes mellitus | 0 (0.0) | 1 (4.0) | 1 (3.6) | |
| Hypertension | 2 (6.7) | 3 (12.0) | 2 (7.1) | |
| Thyroid disease | 0 (0.0) | 2 (8.0) | 1 (3.6) | |
| Gastric ulcer | 0 (0.0) | 0 (0.0) | 2 (7.1) | |
| Duodenal ulcer | 0 (0.0) | 1 (4.0) | 1 (3.6) | |
| Gastric cancer | 0 (0.0) | 1 (4.0) | 0 (0.0) | |
| Liver disease | 1 (3.3) | 1 (4.0) | 0 (0.0) | |
| Others | 3 (10.0) | 6 (24.0) | 4 (14.3) | |
| Endoscopy history | 0.451 | |||
| Done | 18 (60.0) | 19 (76.0) | 19 (67.9) | |
| Not done | 12 (40.0) | 6 (24.0) | 9 (32.1) | |
| Current endoscopy | 0.375 | |||
| Gastroscopy | 9 (30.0) | 7 (28.0) | 3 (10.7) | |
| Colonoscopy | 8 (26.7) | 5 (20.0) | 7 (25.0) | |
| Gastroscopy and colonoscopy | 13 (43.3) | 13 (52.0) | 18 (64.3) | |
| Type of biopsy a | 0.394 | |||
| Gastroscopy | 7 (28.0) | 6 (21.4) | ||
| Colonoscopy | − | 5 (20.0) | 14 (50.0) | |
| Gastroscopy and colonoscopy | 13 (52.0) | 8 (28.6) |
Table 2.
State and Trait Anxiety Scores at Baseline, prior to Gastroscopy and Colonoscopy, and One Day Post-procedure by Group
Table 3.
Number of Patients with High State Anxiety Scores at Baseline, prior to Gastroscopy and Colonoscopy, and One Day Post-procedure by Group
Table 4.
Comparisons of Differential in STAI Scores between Pre- and Post-procedure by Group
| Control (n=30) | Biopsy only (n=25) | Intervention (n=28) | p-value | |
|---|---|---|---|---|
| STAI (state anxiety) a | 0.29±5.3 | 0.92±4.0 | −2.75±6.1 | 0.029 |
| STAI (trait anxiety) | −1.06±7.2 | 0.25±3.8 | −0.71±5.2 | 0.707 |
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