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Factors Associated with Anxiety About Colonoscopy: The Preparation, the Procedure, and the Anticipated Findings

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Abstract

Background

Previous research has assessed anxiety around colonoscopy procedures, but has not considered anxiety related to different aspects related to the colonoscopy process.

Aims

Before colonoscopy, we assessed anxiety about: bowel preparation, the procedure, and the anticipated results. We evaluated associations between patient characteristics and anxiety in each area.

Methods

An anonymous survey was distributed to patients immediately prior to their outpatient colonoscopy in six hospitals and two ambulatory care centers in Winnipeg, Canada. Anxiety was assessed using a visual analog scale. For each aspect, logistic regression models were used to explore associations between patient characteristics and high anxiety.

Results

A total of 1316 respondents completed the questions about anxiety (52% female, median age 56 years). Anxiety scores > 70 (high anxiety) were reported by 18% about bowel preparation, 29% about the procedure, and 28% about the procedure results. High anxiety about bowel preparation was associated with female sex, perceived unclear instructions, unfinished laxative, and no previous colonoscopies. High anxiety about the procedure was associated with female sex, no previous colonoscopies, and confusing instructions. High anxiety about the results was associated with symptoms as an indication for colonoscopy and instructions perceived as confusing.

Conclusions

Fewer people had high anxiety about preparation than about the procedure and findings of the procedure. There are unique predictors of anxiety about each colonoscopy aspect. Understanding the nuanced differences in aspects of anxiety may help to design strategies to reduce anxiety, leading to improved acceptance of the procedure, compliance with preparation instructions, and less discomfort with the procedure.

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Acknowledgments

This study was funded by an operating research grant from Research Manitoba. The funding agency had no role in the conduct of the study or the reporting of the findings. Ms. Celeste Waldman died during the duration of the study; she was involved in the development of the study, leading the conduct of the study and the first set of analysis. All other authors were involved in the analysis and interpretation of data and critical revision of the manuscript for important intellectual content. Drs. Walker, Sisler, Park, Bernstein, Restall, Wittmeier, and Singh were involved in the study concept and design. Dr. Shafer performed the analysis and wrote the first draft. Dr. Bernstein is supported in part by the Bingham Chair in Gastroenterology. Dr. Singh has been on advisory board of Pendopharm and Ferring and has received research funding from Merck Canada. Dr. Bernstein has served on advisory boards for Abbvie Canada, Ferring Canada, Janssen Canada, Shire Canada, Pfizer Canada, and Takeda Canada. He has consulted to Mylan Pharmaceuticals and Bristol Myers Squibb. He has received unrestricted educational grants from Abbvie Canada, Janssen Canada, Shire Canada, and Takeda Canada. He has been on speaker’s bureau for Abbvie Canada, Ferring Canada, and Shire Canada.

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Gastroenterology, University of Manitoba, 805-715 McDermot Avenue, Winnipeg, MB, R3E3P4, Canada

    L. A. Shafer, C. Waldman, C. Yang, V. Michaud, C. N. Bernstein, L. Hathout & H. Singh

  2. Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    L. A. Shafer & H. Singh

  3. IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada

    L. A. Shafer, J. R. Walker, C. N. Bernstein & H. Singh

  4. Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada

    J. R. Walker

  5. Faculty of Nursing, University of Manitoba, Winnipeg, MB, Canada

    C. Waldman

  6. Department of Surgery, University of Manitoba, Winnipeg, MB, Canada

    J. Park

  7. Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada

    J. Park, J. Sisler & H. Singh

  8. Department of Family Medicine, University of Manitoba, Winnipeg, MB, Canada

    J. Sisler

  9. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada

    K. Wittmeier

  10. Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    G. Restall

Authors
  1. L. A. Shafer
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  2. J. R. Walker
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  4. C. Yang
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  5. V. Michaud
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  6. C. N. Bernstein
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  7. L. Hathout
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  8. J. Park
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  9. J. Sisler
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  10. G. Restall
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  11. K. Wittmeier
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  12. H. Singh
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Corresponding author

Correspondence to H. Singh.

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Shafer, L.A., Walker, J.R., Waldman, C. et al. Factors Associated with Anxiety About Colonoscopy: The Preparation, the Procedure, and the Anticipated Findings. Dig Dis Sci 63, 610–618 (2018). https://doi.org/10.1007/s10620-018-4912-z

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  • DOI: https://doi.org/10.1007/s10620-018-4912-z

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