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The Experience of Anxiety in Colonoscopy Outpatients: A Mixed-Method Study

Rollbusch, Nicole BPsych (Hons); Mikocka-Walus, Antonina A. PhD, MA (Psych); Andrews, Jane M. PhD, MBBS, FRACP

doi: 10.1097/SGA.0000000000000037

Colonoscopy is commonly used to investigate gastrointestinal symptoms such as pain or changes in bowel habits and may either induce patient anxiety or assist in patient reassurance. Currently, 2 studies investigating negative colonoscopy, reassurance, and anxiety came to conflicting conclusions on this issue. Furthermore, it is possible that differences in coping styles may influence patient anxiety. A mixed-methods study was conducted with 26 precolonoscopy and 24 postcolonoscopy patients to address the conflicting, limited literature regarding colonoscopy, coping, and anxiety. Participants completed postal surveys and interviews were conducted with 16 participants. There was no significant difference between pre- and postcolonoscopy groups on any anxiety measures; however, this was possibly because of individual differences. Significant positive correlations were found between maladaptive coping and state anxiety indicating that healthcare professionals should consider screening for maladaptive coping in patients needing invasive procedures. Neither problem- nor emotion-focused coping showed any significant relationship with state anxiety. Interviews revealed that clinicians and endoscopy nurses should be aware that some patients are not absorbing correct information about colonoscopy, specifically that they may be conscious or experience pain during the procedure. Because of this, clinicians should ensure that patients understand standard practice at their hospital. In addition, interview data suggested that more attention should be given to pain management as it currently may not be adequate during conscious sedation.

Nicole Rollbusch, BPsych (Hons), is Honors Student, School of Psychology, University of Adelaide, Adelaide, Australia.

Antonina A. Mikocka-Walus, PhD, MA (Psych), is Visiting Associate Professor, School of Psychology, University of Adelaide, and Adjunct Senior Research Fellow, School of Nursing and Midwifery and Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.

Jane M. Andrews, PhD, MBBS, FRACP, is Professor, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, and Discipline of Medicine, University of Adelaide, Adelaide, Australia.

Correspondence to: Antonina A. Mikocka-Walus, PhD, MA (Psych), School of Nursing and Midwifery, University of South Australia, Adelaide, Australia (

The authors declare no conflict of interest.

Received February 27, 2011

Accepted September 15, 2012

© 2014 by the Society of Gastroenterology Nurses and Associates, Inc.