Expectations Of Discomfort Research Articles

Identification of factors during bronchoscopy that affect patient reluctance to undergo repeat examination: Questionnaire analysis after initial bronchoscopy.

BackgroundRe-biopsy by bronchoscopy is an important part of treatment for patients with relapsed lung cancer; however, some patients refuse to undergo a re-examination due to discomfort during their first bronchoscopy. The aim of the present study was to determine factors causing discomfort during bronchoscopy and to identify the factors that affect patients’ reluctance to undergo repeat examinations via a questionnaire administered immediately after the initial bronchoscopy.Methods and findingsWe evaluated 283 patients who underwent bronchoscopy at Chiba University Hospital between September 2015 and March 2017. Following bronchoscopy, the patients answered a questionnaire regarding the procedure. We identified patient characteristics and factors related to bronchoscopy that were associated with patients’ reluctance to undergo re-examination.Two hundred nine patients were ultimately enrolled in the study. The factors affecting patient tolerance for re-examination were female sex (odds ratio [OR], 2.81; 95% confidence interval [CI], 1.43–5.53), discomfort during the examination (OR, 1.70; 95% CI, 1.13–2.56), and unexpectedness of discomfort during the examination (OR, 1.83; 95% CI, 1.19–2.81). Patients experienced discomfort most frequently owing to throat anesthesia (n = 50 [24%]).ConclusionsComfort during bronchoscopy is an important factor influencing patient tolerance for re-examination. Expectations of discomfort during bronchoscopy, as indicated by instructions provided before examination, and throat anesthesia are also important factors. Detailed explanations about bronchoscopy and improvement of the methods of throat anesthesia could decrease patient discomfort and may help decrease patients’ reluctance to undergo re-examinations.

Determinants of pre-procedural state anxiety and negative affect in first-time colposcopy patients: implications for intervention

Women experience significant emotional distress in relation to further diagnostic evaluation of pre-cancerous cell changes of the cervix. However, less is known about the specific variables that contribute to elevated state anxiety and negative affect prior to colposcopy. The study aims to identify psychosocial factors that predict distress in this patient group, which can help in the development of more sophisticated interventions to reduce psychological distress. Socio-demographic variables, scores for state anxiety, negative affect, trait anxiety, fear of pain, coping style, pain-related expectancy and knowledge were assessed in 164 first-time colposcopy patients immediately before the colposcopy examination. Twenty-six per cent of variance in pre-colposcopy state anxiety was significantly explained by marital status, parity, trait anxiety, fear of minor pain and expectations of discomfort. Twenty-nine per cent of variance in pre-colposcopy negative affect was significantly explained by trait anxiety and expectations of pain. Women who are single, have children, are high trait anxious, and anticipate pain and discomfort appear to be at risk for pre-colposcopy distress. Interventions aimed at reducing pre-colposcopy psychological distress should include situation-specific variables that are amenable to change, and trait anxious women are likely to benefit from interventions to reduce distress.

The effect of verbal information on the experience of discomfort in mammography

Purpose : Discomfort experienced during mammography is a factor associated with non-participation of women in breast screening programmes. Women’s expectations of discomfort have been found to be related to the actual experiences of discomfort reported. The purpose of this study was to evaluate the effect of verbal information given prior to the examination on women’s expectations of discomfort and on actual discomfort experienced.Method : The study involved 136 attendees at the Central and Eastern Sydney BreastScreen Service, Sydney, Australia for routine breast screening by mammography. Prior to the mammogram, expectations of discomfort were recorded. Half of the women (68) were verbally provided with the prior outlined information about the procedure, the importance of the compression and the associated slight discomfort (experimental group). The other half (68) completed the procedure routinely without such information (control group). After the procedure, all the participants were asked to report the levels of actual discomfort they experienced. By comparing the responses of women in the experimental and control groups, the effects of the verbal information were evaluated.Results : A significant difference was found between the two groups in the relationship between levels of discomfort experienced and levels of expectations (P value=0.007).Conclusions : The results of this study indicated that verbal information had a significant effect on reducing the levels of discomfort experienced by reducing the expectations of discomfort of the women. This effect was more pronounced in the first time attendees. Further research is suggested.

Brief Treatment of Children's Dental Pain and Anxiety

Pain interferes with children's dental care, but anxiety and pain are often confounded. We tested a classical-conditioning model of dental pain with 45 8- to 11-yr.-old children but found little support for it. Instead, different treatments for pain were effective in reducing the children's expectations of discomfort. Expected discomfort may be the most important part of dental pain, so expectations might well be the focus of such treatments.

Children's expectations and recollections of discomfort associated with dental treatment.

It has been reported that adults, especially those most anxious about dentistry, expect more discomfort than they actually experience during treatment, and that, months after conservative treatment, they describe that experience as more uncomfortable than they had done immediately after treatment. This study sought to determine whether children's expectations and recollections of their discomfort are distorted in this way. Thirty-four children were asked to estimate, using a standard rating-scale, the degree of discomfort, if any, which they expected to experience in the dental treatment that was to follow. Immediately after treatment, which involved injection of local anaesthetic and preparation of a cavity, the children were asked to rate the degree of discomfort which they had just experienced. Six weeks and three months later, the children were sent an identical rating-scale and asked to record, under the supervision of their parents, the degree of discomfort which they recalled having experienced during that treatment. Like adults, the children experienced less discomfort during treatment than they had expected. Unlike adults, even the most anxious children recalled, 6 weeks and 3 months later, no more discomfort than they had reported immediately after treatment. Nevertheless, the unrealistic expectations of discomfort by children should be a prominent target for behavioural management by dentists.