건강검진 수검자들의 위내시경 검사 전 불안과 관련된 요인
Factors Related to Pre-Procedural Anxiety for Gastroscopy in Health Check Examinee
0
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
연구배경: 위내시경은 상부 위장 질환의 진단에 유용하지만수검자들은 신체 불편감과 불안을 유발시키는 시술로 인식하고 있다. 이에 본 연구는 위내시경 검사 전 불안과 관련된 요인을 확인하기 위해 수행하였다. 방법: 2009년 3월 9일부터 6월 12일까지 일개 대학병원 건강 검진 센터에서 위내시경을 받은 463명에게 자기기입 설문지를 이용하여 대상자들의 일반적 특성(연령, 성별, 교육 정도, 경제적 수준, 위암의 가족력)및 검사 당시 위장 증상 유무,위장 질환 과거력, 의식진정하 위내시경 시행 여부, 위내시경 경험 유무를 확인하였다. 위내시경 검사 전의 불안 정도는Spielberger의 State-Trait Anxiety Inventory Form Y (STAI-Y)의 국문 번역 도구 중 상태불안을 측정하는 20항목만을 사용하여위내시경 검사 직전에 확인하였다. 결과: 전체 대상자의 위내시경 검사에 대한 검사 전 평균 불안점수는 38.1±10.2점이었고, 이들 중 위내시경 경험이 없으면서 비 의식진정하 위내시경 검사를 받을 대상자들의 평균 불안 점수는 42.1±10.3점으로 가장 높았다. 위내시경 검사 전 불안과 관련된 요인들은 여성(교차비, 3.00; 95% 신뢰구간, 1.94-4.64), 낮은 교육 정도(교차비, 1.68; 95% 신뢰구간, 1.05-2.71),내시경 경험여부(교차비, 0.46; 95% 신뢰구간, 0.24-0.88)였다. 과거 위 내시경 경험이 있는 대상자에서 검사 전 불안은 여성(교차비, 3.20; 95% 신뢰구간, 1.97-5.22), 고졸 이하의 학력(교차비, 1.79; 95% 신뢰구간, 1.06-3.02), 과거 위내시경 검사 시좋은 순응 정도(교차비, 0.35; 95% 신뢰구간, 0.21-0.59)와 관련이 있었다. 결론: 건강검진 수검자들 중 여성이거나, 교육 정도가 낮거나,위내시경 경험이 없는 경우 위내시경 검사 전 불안을 느낀다. 따라서 위내시경 시술자는 위 요인을 가진 수검자들에게 효과적인 중재법으로 검사 전 불안을 줄이기 위해 노력해야 한다.
Abstract
Background: Gastroscopy is the useful method to detect the upper gastrointestinal condition, but examinee have recognized it as the procedure causing the discomfort and anxiety. This study was conducted to identify the factors related to pre-procedural anxiety for gastroscopy . Methods: From 9th March to 12th June 2009, Data were collected from 463 examinee undergone gastroscopy at a health promotion center of a university hospital by self-administered questionnaires about general characteristics (age, sex,education state, economic state, family history of gastric cancer), gastrointestinal symptom, histroy of gastrointestinal disease, sedated gastroscopy and previous experience of gastroscopy. Before gastroscopy procedure, pre-procedural anxiety was assessed using 20-items by Korean version of Spielberger State Triat Anxiety Inventory Form-Y (STAI-Y). Results: The mean score of pre-procedural state anxiety was 38.1 ± 10.2 in all participants. The mean score was the most highest in participants who had no previous experience of gastroscopy and would perform non-sedated gastroscopy as 42.1 ± 10.3. Factors related to pre-procedural anxiety were female (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.94to 4.64), low education state (OR, 1.68; 95% CI, 1.05 to 2.71) and the previous experience of gastroscopy (OR, 0.46; 95% CI,0.24 to 0.88). Among participants who had the previous experienced gastroscopy, female (OR, 3.20; 95% CI, 1.97 to 5.22),low education state (OR, 1.79; 95% CI, 1.06 to 3.02) and the good tolerance at previous gastroscopy (OR, 0.35; 95% CI 0.21to 0.59) were related to pre-procedural anxiety. Conclusion: In health check examinee, female, low education state and the no previous experience of gastroscopy were related to pre-procedural anxiety. Endoscopists should be provide efforts to lower pre-procedural anxiety in those subjects as to increase effectiveness of interventions.
참고문헌 (18)
- Woodliff DM, "The role of upper gastrointestinal endoscopy in primary care", J Fam Pract, 8, pp.715~719 (1979)
- Choi KS, "Screening for gastric cancer in Korea: population-based preferences for endoscopy versus upper gastrointestinal series", Cancer Epidemiol Biomarkers Prev, 18, pp.1390~1398 (2009)
- Parker D, "Human responses to colonoscopy", Gastroenterol Nurs, 15, pp.107~109 (1992)
- Mahajan RJ, "Predictors of patient cooperation during gastrointestinal endoscopy", J Clin Gastroenterol, 24, pp.220~223 (1997)
- Walmsley RS, "Factors affecting patient tolerance of upper gastrointestinal endoscopy", J Clin Gastroenterol, 26, pp.253~255 (1998)
- Campo R, "Identification of factors that influence tolerance of upper gastrointestinal endoscopy", Eur J Gastroenterol Hepatol, 11, pp.201~204 (1999)
- Mulcahy HE, "Factors associated with tolerance to, and discomfort with, unsedated diagnostic gastroscopy", Scand J Gastroenterol, 36, pp.1352~1357 (2001)
- Jones MP, "Patient anxiety and elective gastrointestinal endoscopy", J Clin Gastroenterol, 38, pp.35~40 (2004)
- Lee Sun Young, "Identification of Factors that Influence Conscious Sedation in Gastrointestinal Endoscopy", Journal of Korean Medical Science, 19(4), pp.536~540 (2004), 대한의학회
- 장진수, "상부위장관 내시경 검사 시 피검자의 불안 정도 평가", Clinical Endoscopy, 34(2), pp.65~70 (2007), 대한소화기내시경학회
- Hahn DW, "Korean adaptation of Spielberger's STAI (K-STAI)", Korean J Health Psychol, 1, pp.1~14 (1996)
- Tonnesen H, "Stress response to endoscopy", Scand J Gastroenterol, 34, pp.629~631 (1999)
- Drossman DA, "A preliminary study of patients' concerns related to GI endoscopy", Am J Gastroenterol, 91, pp.287~291 (1996)
- Abuksis G, "A patient education program is cost-eective for preventing failure of endoscopic procedures in a gastroenterology department", Am J Gastroenterol, 96, pp.1786~1790 (2001)
- Chang SJ, "Effect of preparatory audiovisual information with videotape on anxiety of gastroscopy", pp.2001
- Madan A, "Who is willing to undergo endoscopy without sedation: patients, nurses, or the physicians?", South Med J, 97, pp.800~805 (2004)
- Trevisani L, "Upper gastrointestinal endoscopy: are preparatory interventions or conscious sedation effective? A randomized trial", World J Gastroenterol, 10, pp.3313~3317 (2004)
- Fisher NC, "A prospective, randomized controlled trial of sedation vs. no sedation in outpatient diagnostic upper gastrointestinal endoscopy", Endoscopy, 30, pp.21~24 (1998)