RESEARCH FINDINGS USING GUIDED
IMAGERY FOR
ENDOSCOPY
August, 2006
The
value of endoscopy
Endoscopy
is the visual examination of the esophagus, stomach and the
duodenum (the first part of the small intestine) using a
lighted, thin flexible tube (an "endoscope"]. Nearly 5.7
million inpatient and outpatient gastrointestinal
endoscopies are performed yearly in the United States (Hall
and Lawrence, 1998; Fastats, 2006).
Endoscopy is a valuable, safe procedure to investigate
various problems, such as trouble swallowing, nausea,
vomiting, reflux, bleeding, indigestion, abdominal pain, or
chest pain. It is the best way of diagnosing many problems
in the digestive tract, including ulcers, cancer, bleeding,
and hernias. It also makes it possible for some people to
avoid surgery for abnormal vessels, ulcers, narrowing of
passageways, polyps, and some tumors (Ravenscroft and Swan,
1984).
Problems
with endoscopy
Many
patients avoid recommended endoscopies out of fear of the
procedure, or of what the procedure will find. Studies show
that pre-endoscopic anxiety is a significant problem and
that providing information about the procedure can reduce
anxiety and improve acceptance of the procedure
(Bebbensleben and Rohde, 1990; Luck, Pearson et al, 1999).
Distress due to gagging and intestinal cramping can make
endoscopy much harder for both patient and provider and
sometimes prevents completion of the examination.
Intravenous sedation may cause low oxygen and low blood
pressure in some patients (Ravenscroft and Swan, 1984).
The role of relaxation and imagery
Many
studies have shown that relaxation with distraction, guided
imagery, hypnosis, cognitive behavioral changes, deep
breathing, and/or music can reduce patient discomfort,
lower anxiety, and raise patient tolerance of and
satisfaction with the procedure. They can also reduce need
for sedation in endoscopies and other procedures (Bampton
and Draper, 1997; Cataldo, 1996; Diette, Lechtzin, et al,
2003; Gattuso, Litt and Fitzgerald, 1992; Lang, Benotsch,
et al, 2001; Maguire, Walsh, and Little, 2004; Salmore and
Nelson, 2000; Zimmerman, 1998).
Procedures also tended to go more smoothly and require less
time (Zimmerman; Lang, Benotsch, et al.). Reduced sedation
decreases complications and cuts the need for expensive
monitoring. It also allows patients and caregivers to
quickly return to their daily lives (Cataldo).
Increased
satisfaction improves willingness to have future
procedures, if necessary.
Conclusion
Guided imagery is a safe and
effective method that can increase patient compliance and
satisfaction with endoscopy. Guided Imagery can reduce the
need for sedation, leading to direct cost savings and
reduced chance of complications.
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