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The Anatolian Journal of Cardiology

[Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(9): 684-688 | DOI: 10.5152/AnatolJCardiol.2015.6514  

Feasibility and clinical benefit of cognitive–behavioral intervention for preparing patients for transesophageal echocardiography

Paulina Wejner-mik, Maria Sobczak, Dawid Miskowiec, Katarzyna Wdowiak-okrojek, Jaroslaw D. Kasprzak, Piotr Lipiec
Department Of Cardiology, Medical University Of Lodz, Lodz- Poland

Objective: Despite premedication, anxiety in patients undergoing transesophageal echocardiography (TEE) is prevalent, often causing adverse physiological and psychological effects and contributing to decreased patient compliance. We aimed to evaluate the feasibility of cognitive–behavioral intervention (CBI) in patients undergoing TEE and to assess its impact on the severity of anxiety, patient’s and physician’s comfort, and administered dose of sedatives.
Methods: Our study was designed as a prospective, single-center, single-blinded, case-controlled pilot study. The study group comprised 49 patients (26 men, 66±8 years old) referred for TEE. Before the examination, 26 randomly selected patients underwent CBI. Sedatives were administered, if necessary. After the examination, patient anxiety and patient’s and physician’s comfort were evaluated using dedicated questionnaires and scores. Intergroup comparison was performed using Student’s t-test for independent variables and Mann–Whitney U test and Pearson’s chi-square test or Fisher’s exact test for categorical variables.
Results: The mean level of pre-TEE distress and anxiety were significantly lower in patients receiving CBI than in those without intervention (p=0.022). Furthermore, the application of CBI significantly reduced patient’s discomfort (p<0.001) and resulted in increased comfort of physician (p<0.001) during TEE. The need of sedative administration (31% vs. 91%, p<0.001) and its mean dose was significantly lower in patients receiving CBI (1.6±0.5 mg vs. 2.7±1.6 mg midazolam, p=0.009).
Conclusions: CBI is feasible in patients undergoing TEE. It decreases patient’s anxiety and discomfort and increases physician’s comfort. It also results in reduced use of sedatives during the examination. (Anatol J Cardiol 2016; 16 684-8)

Keywords: transesophageal echocardiography, anxiety, cognitive therapy, relaxation therapy, conscious sedation, sedatives


Paulina Wejner-mik, Maria Sobczak, Dawid Miskowiec, Katarzyna Wdowiak-okrojek, Jaroslaw D. Kasprzak, Piotr Lipiec. Feasibility and clinical benefit of cognitive–behavioral intervention for preparing patients for transesophageal echocardiography. Anatol J Cardiol. 2016; 16(9): 684-688

Sorumlu Yazar: Dawid Miskowiec, Poland


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