title: Education and Visual Information Improves Effectiveness of Ultrasound-Guided Local Injections on Shoulder Pain and Associated Anxiety Level: A Randomized Controlled Study.
abstract: OBJECTIVE
  Local injections are widely used in patients with a painful shoulder. The aim of this study was to evaluate the possible impact of patients' visual information on the effectiveness of ultrasound (US)-guided local injections on anxiety levels and shoulder pain.
  
  
  METHODS
  A total of 151 patients, scheduled for local injection owing to shoulder pain, were randomly assigned into two groups in a consecutive order. Patients in group I (n = 72) were provided information related to US findings and allowed to watch the procedures from the monitor, whereas patients in group II (n = 79) received the injection only without any collaboration. Data were collected from both groups immediately before and after injections through visual analog scale and questionnaire (the State-Trait Anxiety Inventory [STAI] forms 1 and 2).
  
  
  RESULTS
  US-guided local injections provided significant improvement of anxiety and pain in both groups, irrespective of providing visual information. Group I and group II comparisons with respect to the visual analog scale, STAI 1, and STAI 2 yielded significant difference only for postinjection STAI 2 in group I (P = 0.006). Intragroup comparisons revealed significant differences between preinjection and postinjection values (group I: visual analog scale, P = 0.001; STAI form 1, P = 0.001; STAI form 2, P = 0.002; group II: visual analog scale, P = 0.001; STAI form 1, P = 0.002; STAI form 2, P = 0.042). There was no significant difference between the groups in terms of postinjection satisfaction levels from the procedures (P = 0.824).
  
  
  CONCLUSIONS
  Performing US-guided shoulder injections with patient visual information provides positive contributions to coping with pain and anxiety. In particular, the patient collaboration-based US-guided injections have positive consequences on patients' long-standing "trait-anxiety" levels.
authors.affiliation: From the Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Medical School, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey (MK, EC); Department of Physical Medicine and Rehabilitation, Medical School, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey (NC, IC); Department of Physical Medicine and Rehabilitation, Dıcle University Medical School, Diyarbakır, Turkey (IB); Department of Orthopedics and Traumatology, Medical School, Karadeniz Technical University, Trabzon, Turkey (SK, MAO); Department of Physical and Rehabilitation Medicine, Erzincan University Medical School, Erzincan, Turkey (AK); and Department of Physiology, Medical School, Karadeniz Technical University, Trabzon, Turkey (AA).
authors.forename: Murat
authors.initials: M
authors.lastname: Karkucak
authors.forename: Nurce
authors.initials: N
authors.lastname: Cilesizoglu
authors.forename: Erhan
authors.initials: E
authors.lastname: Capkin
authors.forename: Ipek
authors.initials: I
authors.lastname: Can
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Batmaz
authors.forename: Servet
authors.initials: S
authors.lastname: Kerimoglu
authors.forename: Mustafa Avni
authors.initials: MA
authors.lastname: Onder
authors.forename: Adem
authors.initials: A
authors.lastname: Karaca
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayar
mesh_terms: D001007:Anxiety / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011446:Prospective Studies; D020069:Shoulder Pain / Q000188:drug therapy*; D018084:Ultrasonography, Interventional / Q000295:instrumentation*; D064232:Visual Analog Scale