Audio and visual stimulation reduces patient discomfort during screening flexible sigmoidoscopy.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
Audio and visual stimulation reduces abdominal discomfort associated with flexible sigmoidoscopy. This effect appears to be due to distraction.
Beth Israel Deaconess Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA.
T
T
Lembo
L
L
Fitzgerald
K
K
Matin
K
K
Woo
E A
EA
Mayer
B D
BD
Naliboff
D015746:Abdominal Pain / Q000517:prevention & control; D000161:Acoustic Stimulation; D000339:Affect / Q000502:physiology; D000368:Aged; D000786:Anger / Q000502:physiology; D001007:Anxiety / Q000517:prevention & control; D001143:Arousal / Q000502:physiology; D001288:Attention / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D007417:Intestinal Polyps / Q000517:prevention & control; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D010349:Patient Compliance; D010775:Photic Stimulation; D018583:Pliability; D020694:Sigmoidoscopes; D012812:Sigmoidoscopy / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology