The influence of various distractions prior to upper gastrointestinal endoscopy: a prospective randomized controlled study

Abstract

Background: Although many patients still have anxiety about upper gastrointestinal (GI) endoscopy, there have been few reports on the influence of distractions for a person who is going to undergo upper GI endoscopy soon. This study was a prospective randomized controlled study investigating the influence of distractions, such as auditive and visual distractions using subjective and objective assessments including autonomic nervous function prior to upper GI endoscopy.

Methods: 206 subjects who underwent upper GI endoscopy as regular health check-ups were divided randomly into 4 groups prior to upper GI endoscopy; group 1 (control group), group 2 (auditive group), group 3 (visual group), and group 4 (combination group). We measured vital signs, autonomic nervous function, profile of mood state (POMS), and the impression for upper GI endoscopy pre- and post-distraction in the 4 groups.

Results: There was no significant difference in vital signs between 5 and 15 min after sitting in group 1, however, several vital signs in all distraction groups improved significantly after distraction (Pulse rate (P): p < 0.001 in group 4; blood pressure: p < 0.05 in group 2, 3, 4) and the rate of decrease in P and diastolic blood pressure was highest in group 4 (p < 0.001). Several scores of POMS and the impression for upper GI endoscopy post-distraction improved significantly compared to pre-distraction between distraction groups and the satisfaction for distraction was highest in group 4 (p < 0.01). Regarding autonomic nerve function, the low- frequency power/ high- frequency power ratio post-distraction was significantly lower than that pre-distraction in all distraction groups (p < 0.001).

Conclusions: Although auditive distraction alone and visual distraction alone were effective, a combination distraction was more effective than any other distraction by subjective and objective assessments. These distractions, which were simple and safe, may play an assistive role in the stability of physical and psychological conditions prior to upper GI endoscopy.

Trial registration: This trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000022801 . Registered on 10 July 2016.

Keywords: Autonomic nervous system; Distraction; Esophagoscopy; Image; Music; Vital signs.

Fig. 1

Flow chart of the enrollment and the procedures of this study. GI gastrointestinal

Fig. 2

Comparison of vital signs between pre- and post-distractions in the 4 groups. a Comparison of P between pre- and post-distraction. b Comparison of SpO₂ between pre- and post-distraction. c Comparison of SBP between pre- and post-distraction. d Comparison of DBP between pre- and post-distraction. The white bar indicates the value at pre-distraction. The gray bar indicates value at post-distraction. DBP, diastolic blood pressure; P, pulse; SBP, systolic blood pressure; SpO₂, peripheral blood oxygen saturation; *p <  0.05; **p <  0.005; ***p <  0.001

Fig. 3

Comparison of autonomic nerve function between pre- and post-distraction among the 4 groups. a Comparison of Log HF power between pre- and post-distraction among the 4 groups. b Comparison of LF power/ HF power ratio between pre- and post-distraction among the 4 groups. The white bar indicates the value at pre-distraction. The gray bar indicates value at post-distraction. HF, high frequency; LF low frequency; *p <  0.001