Increased Patient Education Lowers Anxiety Before a Medical Procedure

From the WebMD Archives

Dec. 10, 1999 (Minneapolis) -- A new study shows that anxiety over a medical procedure can be significantly reduced by improved patient education prior to the procedure. Patients who watched a video prior to having a colonoscopy also were much more aware of the details of the procedure and had a quicker recovery.

Anxiety before a medical or surgical procedure has been shown to have adverse consequences. The authors cite several previous studies showing that anxiety may cause a stress response leading to elevations of stress hormones in the body, such as adrenaline. This may increase requirement for anesthesia as well as prolong recovery times from surgery, according to the authors.

The current study "shows that the medical profession ... is ... investigating ways of allowing our patients to understand what the procedures involve," the study's lead researcher, Andrew Luck, MD, tells WebMD. "Most [patients] understand the concept of video, and many will be interested in the ability to actually watch the procedure they are being offered before consenting to the procedure." Luck is a fellow in colorectal surgery at Concord Hospital in Sydney, Australia.

Health care professionals routinely give patients information prior to any medical or surgical procedure, the authors write. The hope is that sharing of information will help patients participate in their medical treatment, improve their postoperative recovery, and reduce any anxiety triggered by the procedure. However, the best means for communicating that information is unclear, the authors write. A traditional patient-physician consultation is the typical format. In this setting, the quality of patient education, and the ability of the physician to reduce a patient's anxiety, depend on the individual doctor's communication skills.

Although brochures are often provided to fill in any gaps in the patient-physician consult, these have yielded mixed results. "Many patients do not read such forms, and many of those ... do not fully understand the information provided," the authors write. They see a solution in electronic media, including audiotapes, videotapes, and interactive CDs, which they think may "have the potential to overcome these deficiencies."

A total of 150 patients completed an anxiety questionnaire at the time of enrollment, as well as immediately before and after the colonoscopy. Both groups had similar amounts of anxiety prior to the procedure, although women were found to have more anxiety overall. Compared with people that read an educational pamphlet prior to the colonoscopy, the video group was significantly less anxious prior to the procedure. The results are published in the Dec. 11 issue of the British medical journal, The Lancet.

"The factors significantly affecting anxiety immediately before colonoscopy were the anxiety score at enrollment and whether or not the patient had watched the video," the authors write. The patients who watched the video also had a higher level of knowledge regarding the purpose of the colonoscopy, some details about the procedure, and potential complications.