Feasibility and clinical benefit of cognitivebehavioral intervention for preparing patients for transesophageal echocardiographyPaulina 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 cognitivebehavioral intervention (CBI) in patients undergoing TEE and to assess its impact on the severity of anxiety, patients and physicians comfort, and administered dose of sedatives.Keywords: transesophageal echocardiography, anxiety, cognitive therapy, relaxation therapy, conscious sedation, 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 patients and physicians comfort were evaluated using dedicated questionnaires and scores. Intergroup comparison was performed using Students t-test for independent variables and MannWhitney U test and Pearsons chi-square test or Fishers 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 patients 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 patients anxiety and discomfort and increases physicians comfort. It also results in reduced use of sedatives during the examination. (Anatol J Cardiol 2016; 16 684-8)
Paulina Wejner-mik, Maria Sobczak, Dawid Miskowiec, Katarzyna Wdowiak-okrojek, Jaroslaw D. Kasprzak, Piotr Lipiec. Feasibility and clinical benefit of cognitivebehavioral intervention for preparing patients for transesophageal echocardiography. Anatol J Cardiol. 2016; 16(9): 684-688
Sorumlu Yazar: Dawid Miskowiec, Poland