Effects of visual aid on state anxiety, fear and stress level in patients undergoing endoscopy: a randomized controlled trial

Figures & data

Figure 1. CONSORT flow chart of the participants through the trial.

Table 1. Comparison of baseline characteristics among two groups.

	Visual aid Group^a		No visual aid group^a		p Value
	f	%	f	%
Gender					1.00
Female	54	46.6	53	45.7
Male	62	53.4	63	54.3
Education					0.481
Illiterate	11	9.5	16	13.8
Primary	11	9.5	11	9.5
Middle	7	6.0	13	11.2
Matric	17	14.7	21	18.1
Intermediate	5	4.3	3	2.6
Bachelors	60	51.7	49	42.2
Masters	5	4.3	3	2.6
Marital status					0.250
Unmarried	23	19.8	24	20.7
Married	88	75.9	79	68.1
Widow	4	3.4	11	9.5
Divorce	1	0.9	2	1.7
Employment					0.452
Unemployed	23	19.8	21	18.1
Employed	71	61.2	65	56
Self-employed	22	19.0	30	25.9
Family system					0.235
Nuclear	47	40.5	57	49.1
Joint	69	59.5	59	50.9
Nature of complaints					0.157
Acute	18	15.5	10	8.6
Chronic	98	84.5	106	91.4
Awareness of diagnosis					0.487
No	42	36.2	36	31
Yes	74	63.8	80	69
Type of procedure					1.000
Gastroscopy	88	75.9	88	75.9
Colonoscopy	28	24.1	28	24.1
History of psychological illness					1.000
No	112	96.6	112	96.6
Yes	4	3.4	4	3.4
Comorbidity					0.147
No	77	66.4	88	75.9
Yes	39	33.6	28	24.1
Medicine intake					0.110
No	14	12.1	24	20.7
Yes	102	87.9	92	79.3
PPI or H2 blockers					0.499
No	24	20.7	19	16.4
Yes	92	79.3	97	83.6
Satisfaction status on information provided					0.748
Satisfied	93	80.2	90	77.6
Partly satisfied	23	19.8	26	22.4
Thought about endoscope causes pain when goes inside					0.278
No	39	33.6	48	41.4
Yes	77	66.4	68	58.6
Thought about endoscope damages internal organs					0.029
No	65	56.0	82	70.7
Yes	51	44.0	34	29.3
Thought about endoscope causes death when goes inside					0.247
No	97	83.6	104	89.7
Yes	19	16.4	12	10.3
Fear related to seniority of doctor					0.002
No	67	57.8	90	77.6
Yes	49	42.2	26	22.4
	M	SD	M	SD
Age	44.01	13.29	40.37	13.20	0.130
Income	30,025.28	16,111.07	24,034.48	13,884.57	0.003
Pre-intervention anxiety	11.41	2.26	11.59	2.24	0.541
Pre-intervention stress	21.29	2.50	21.06	2.65	0.508
Pre-intervention fear	7.35	1.53	7.86	1.49	0.010

^aN = 232 (n = 116 for each group). For categorical variable, p-value was based on Pearson chi-square test and fisher’s exact test, and for continuous variable, p value is based on t-test.

Table 2. Unadjusted and covariate adjusted descriptive statistics of primary and secondary outcomes for interventions by analysis of covariance.

	Before intervention			After intervention (unadjusted)		After intervention (adjusted)
Interventions	N	Mean	SE mean	Mean	SE mean	Mean	SE mean
Anxiety (primary outcome)
Video	232	11.41	0.21	4.44	0.16	4.51	0.08
No-video	232	11.59	0.21	8.84	0.19	8.77	0.08
Stress (secondary outcome)
Video	232	21.29	0.23	11.80	0.23	11.69	0.10
No-video	232	21.06	0.25	16.94	0.26	17.05	0.10
Fear (secondary outcome)
Video	232	7.35	0.14	2.46	0.10	2.65	0.05
No-video	232	7.86	0.14	5.66	0.13	5.47	0.05

Table 3. Multiple regression for endoscopy-related variables as predictors of post-intervention anxiety, stress and fear.

Variables	Anxiety				Stress				Fear
	B	SE B	β	95% CI	B	SE B	β	95% CI	B	SE B	β	95% CI
Constant	3.75	1.05		1.67, 5.84	13.19	1.44		10.34, 16.04	2.61	0.64		1.34, 3.87
Age	0.02	0.01	.14	−.01, .04	0.02	0.02	.13	−.01, .05	0.01	0.01	.13	−.01, .02
Gender^a	−0.33	0.33	−.09	−.99, .33	−0.87	0.45	−.17*	−1.77, .03	−0.31	0.20	−.14	−.71, .09
Nature of complaints^b	−0.13	0.46	−.03	−1.05, .74	−1.58	0.63	−.23*	−2.84, −.33	−0.44	0.28	−.15	−1.00, .12
History of psychological illness^c	−1.66	0.92	−.17	−3.48, .15	−1.25	1.25	−.09	−3.74, 1.23	−0.78	0.56	−.13	−1.88, .32
Comorbidity^c	−0.14	0.36	−.04	−.86, .58	−0.58	0.49	−.11	−1.56, .41	−0.12	0.22	−.05	−.56, .32
Satisfaction on briefing^d	0.72	0.43	.16	−.13, 1.56	1.64	0.58	.26**	.48, 2.79	0.61	0.26	.23*	.09, 1.12
Endoscope causes pain^c	−0.06	0.43	−.02	−.90, .78	−0.39	0.58	−.07	−1.54, .76	−0.08	0.26	−.03	−.59, .43
Endoscope damages internal organs^c	−0.03	0.45	−.01	−.92, .87	0.22	0.62	.04	−1.00, 1.44	−0.04	0.27	−.02	−.58, .51
Endoscope causes death^c	−0.18	0.47	−.04	−1.13, .76	−1.01	0.65	−.15	−2.29, .28	0.06	0.29	.02	−.52, .63
Seniority of doctor^c	−0.67	0.36	−.19	−1.37, .03	−0.79	0.48	−.16	−1.75, .17	−0.44	0.22	−.20*	−.87, −.01
R^2	0.11				0.20				0.14
F	1.28				2.54**				1.72

Note. N = 116. *p< .05. **p < .01. ^aFemale = 0, male = 1. ^bacute = 1, chronic = 2. ^cNo = 0, Yes = 1. ^dSatisfied = 1, partly satisfied = 2.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author.