RESEARCH FINDINGS USING GUIDED
IMAGERY FOR
COLONOSCOPY
July, 2006
The
value of colonoscopy
Nearly
14.2 million colonoscopies are performed yearly in the
United States in 2002 (Seeff, Manninen, et al, 2004). The
majority of colonoscopies are done to detect colon cancer,
the second leading cause of cancer death in the U.S.
There are about 130,000 new cases and 57,000 deaths from
colon cancer annually (Landis, Murray et al, 1999).
According to the American Cancer Society, early detection
can increase survival in colon cancer by 90%, but only 37%
of colon cancers are detected early (Hoffmann,
2000).
Problems
with colonoscopy
Many
patients avoid recommended sigmoidoscopies and
colonoscopies out of fear of the procedure itself, or fear
of what the procedure will find. Sometimes people simply
don’t know about its potential benefits. Studies show that
pre-colonoscopic anxiety is a significant problem.
Providing people with information about the procedure can
reduce anxiety and improve acceptance of the procedure
(Bebbenslleben and Rohde, 1990; Luck, Pearson et al, 1999).
Distress due to intestinal cramping can make colonoscopy
much harder for both patient and medical team. Severe
anxiety sometimes prevents completion of the examination.
But using intravenous (I.V.) sedation may cause hypoxia
(low oxygen) and hypotension (low blood pressure) in some
patients.
The
role of relaxation and imagery
Many
studies have shown that relaxation with guided imagery,
hypnosis, and/or music can reduce patient discomfort, raise
patient tolerance of and satisfaction with the procedure,
and reduce need for sedation in colonoscopies, endoscopies,
and some vascular procedures (Bampton and Draper, 1997;
Cadranel, Benhamou, et al, 1994;
Harikumar, Rai, et al, 2006; Lang, Benotsch, et al, 2000;
Lee, Chan, et al, 2002; Salmore and Nelson, 2000).
Reduced sedation during colonoscopy decreases
complications, cuts the need for expensive monitoring, and
allows patients and caregivers to quickly return to their
daily lives (Cataldo, 1996). Increased satisfaction improves
willingness to have future procedures, if needed.
Conclusion
Guided
imagery is a safe, effective, and can increase patient
compliance and satisfaction with colonoscopy, a procedure
with known cost-effectiveness and outcome benefits. Guided
imagery can reduce need for sedation, leading to direct
cost savings and reduced chance of complications.
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