Effect of Diaphragmatic Breathing on Procedural Anxiety During Transrectal Prostate Biopsy

Abstract

To improve the tolerability of transrectal ultrasound guided prostate biopsy through use of diaphragmatic breathing. Forty-seven patients, aged 52-79 years, who were scheduled for a transrectal ultrasound guided prostate biopsy with or without MRI guidance, were recruited at a single Veterans Affairs medical center for the diagnosis or evaluation of prostate cancer. Patients either met with a health psychologist for a 1-time, diaphragmatic breathing intervention immediately prior to their biopsy, or received usual care. All biopsies were performed using local anesthetic without sedation or anxiolytic therapy. The primary outcome was the difference in self-reported procedural situational anxiety as measured with the State Trait Anxiety Inventory, assessed both pre- and post-transrectal ultrasound guided prostate biopsy. We also examined secondary outcomes including physiological parameters (heart rate and blood pressure). There were no significant differences in preprocedural anxiety or physiological parameters between patients who received the intervention and those who received usual care. Patients who received the intervention had a significantly larger decrease in situational anxiety from pre- to postprocedure (M=14.15, SD=6.64) compared with those who received usual care (M=3.45, SD=9.97); t (38)=-4.0, P <.000; d=1.26. Patients who received the intervention had a significantly larger decrease in heart rate (bpm) from pre- to postprocedure (M=10.63, SD=12.21) compared with those who received usual care (M=0.07, SD=9.25); t (31)=2.75 P=0.010; d=0.97. A guided diaphragmatic breathing intervention reduced procedural anxiety during prostate biopsy and improved patient experience.