RESEARCH FINDINGS USING GUIDED IMAGERY FOR
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.
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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