胃肠镜检查前患者恐惧心理的现状及其影响因素

doi:10.3760/cma.j.cn441417-20250618-22023

摘要/Abstract

摘要： 目的　探讨胃肠镜检查前患者恐惧心理现状及影响因素，为制定心理干预策略提供依据。方法　采用便利抽样法选取528例2024年5月至12月于广东省第二人民医院进行胃肠镜检查的患者进行横断面研究。收集患者人口学资料。采用焦虑自评量表（SAS）和恐惧疾病进展简化量表（FoP-Q-SF）评估患者焦虑及恐惧心理情况。运用Pearson相关性分析和多重线性回归分析影响因素。结果　患者FoP-Q-SF总分（23.22±10.39）分，其中16.90%患者达高恐惧心理（≥34分）。单因素分析显示，女性、年龄18～30岁、未婚及慢性病患者恐惧心理较高（均P<0.05）。SAS总分与FoP-Q-SF总分呈正相关（r=0.745，P<0.01）。多重线性回归分析表明，慢性病史（β=0.050，P=0.017）和焦虑水平（β=0.721，P<0.001）是恐惧心理的独立预测因子。结论　胃肠镜检查前患者恐惧心理普遍存在，受焦虑、慢性病史及部分人口学特征（女性、年龄18～30岁）影响。需针对高危人群实施分层干预，强化认知纠偏、焦虑管理及疾病认知重构，提升患者依从性及医疗体验。

关键词: 胃肠镜检查, 恐惧心理, 焦虑, 影响因素

Abstract:

Objective　To investigate the current status of fear and its influencing factors in patients before gastrointestinal endoscopy, and to provide a basis for developing targeted psychological interventions. Methods　A total of 528 patients scheduled for gastrointestinal endoscopy at Guangdong Second Provincial General Hospital between May and December 2024 were selected by the convenient sampling method for the cross-sectional survey. Their demographic data were collected. The Self-Rating Anxiety Scale (SAS) and Fear of Progression Questionnaire-Short Form (FoP-Q-SF) were used to assess their anxiety levels and fear of disease progression. The Pearson correlation analysis and multiple linear regression analysis were utilized to identify the influencing factors. Results　The total FoP-Q-SF score was 23.22±10.39. Notably, 16.90% of the patients exhibited a high level of fear (FoP-Q-SF score≥34). The univariate analysis revealed significantly higher fear levels in the females, patients who were 18-30 years old, unmarried individuals, and patients with chronic diseases (all P<0.05). The total SAS score was positively correlated with the total FoP-Q-SF score (r=0.745, P<0.01). The multiple linear regression analysis identified the history of chronic diseases (β= 0.050, P=0.017) and anxiety level (β=0.721, P < 0.001) as the independent predictors of fear. Conclusions　Fear is prevalent among patients before gastrointestinal endoscopy and is influenced by anxiety levels, history of chronic diseases, and specific demographic characteristics (female gender and being 18-30 years old). Implementing stratified interventions targeting high-risk groups is warranted. These interventions should focus on cognitive restructuring, anxiety management, and reframing disease perceptions to enhance procedural adherence and improve the overall healthcare experience.

Key words: Gastrointestinal endoscopy, Fear, Anxiety, Influencing factors

谭文惠孙艺宁梁彪吕芳王益敏. 胃肠镜检查前患者恐惧心理的现状及其影响因素[J]. 国际医药卫生导报, 2025, 31(22): 3815-3820.

Tan Wenhui, Sun Yining, Liang Biao, Lyu Fang, Wang Yimin. Current status and influencing factors of fear in patients before gastrointestinal endoscopy[J]. International Medicine and Health Guidance News, 2025, 31(22): 3815-3820.

参考文献

[1] 中华医学会消化内镜学分会. 胃肠镜检查麻醉管理专家共识[J]. 中华消化内镜杂志, 2023, 40(5): 387-395. DOI: 10.3760/cma.j.cn321463-20230210-00089.
[2] 武群燕,叶洁桐,徐雪和,等. 恐惧疾病进展在胃癌风险人群疾病感知与胃镜筛查行为间的中介作用分析[J]. 护理与康复,2024,23(6):26-29. DOI:10.3969/j.issn.1671-9875.2024.06.005.
[3] 杨海霞,李雪蕊,郑晓永,等. 聚焦解决模式的心理护理对结肠镜检查患者恐惧心理及依从性的影响[J]. 中国肛肠病杂志,2024,44(1):69-71. DOI:10.3969/j.issn.1000-1174.2024.01.023.
[4] Yang Y, Xia Q, Wu L, et al. Examination tolerance, pre-examination anxiety, knowledge needs and cooperation in gastroscopic examinees: a prospective, correlational analysis in a health screening population[J]. Nurs Open, 2024, 11(8):e70006. DOI: 10.1002/nop2.70006.
[5] Sukartini T, Nursalam, Wahyuni ED, et al. Patients' readiness before undergoing gastrointestinal endoscopy: a descriptive study[J]. J Pak Med Assoc, 2023,73 Suppl 2: S92-S95. DOI: 10.47391/JPMA.Ind-S2-22.
[6] Liu Q, Zhang L, Wang Y, et al. The impact of pre-procedural education on anxiety and fear in patients undergoing gastrointestinal endoscopy: a randomized controlled trial[J]. J Clin Nurs, 2022, 31(7-8): 1024-1033. DOI: 10.1111/jocn.15968
[7] Ruan M, Li L, Wang T, et al. The effect of a micro-video-based nursing education on anxiety and depression in patients undergoing gastrointestinal endoscopy: a randomized controlled trial[J]. J Affect Disord, 2023, 339: 891-898.
[8] 陈婷,李雯,展薇,等. 门诊肠镜筛查受检者心理负担现状及影响因素调查[J]. 现代消化及介入诊疗,2024,29(4):457-461. DOI:10.3969/j.issn.1672-2159.2024.04.015.
[9] Zhang Y, Li Y, Smith H E, et al. Determining the minimal clinically important difference of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) in patients with cancer: A longitudinal study[J]. Journal of Psychosomatic Research, 2023, 165: 111103.
[10] 徐惠萍. 消化内镜检查患者心理应激现状及影响因素分析[J]. 中国医学创新,2022,19(13):104-108. DOI:10.3969/j.issn.1674-4985.2022.13.025.
[11] Apputhurai P, Palsson OS, Bangdiwala SI, et al. Confirmatory validation of the patient health questionnaire - 4 (PHQ-4) for gastrointestinal disorders: a large-scale cross-sectional survey[J]. J Psychosom Res, 2024, 180:111654. DOI: 10.1016/j.jpsychores.2024.111654.
[12] 王昕旭,陈晗晖,王宇昊,等. Zung焦虑自评量表在社区居民中的信效度检验[J]. 临床精神医学杂志,2024,34(5):397-401. DOI:10.3969/j.issn.1005-3220.2024.05.016.
[13] Mehnert A, Herschbach P, Berg P, et al. Fear of progression in breast cancer patients--validation of the short form of the Fear of Progression Questionnaire (FoP-Q-SF) [J]. Z Psychosom Med Psychother, 2006, 52(3):274-88. DOI: 10.13109/zptm.2006.52.3.274.
[14] Yıldırım S, Karaca S, Çınar F. The effect of preprocedure education delivered by a virtual group on anxiety and knowledge levels of patients undergoing gastrointestinal endoscopy: a randomized controlled study[J]. Gastroenterology Nursing, 2023, 46(6): 435-445.
[15] Alaqeel MK, Alowais JM, Alshunaifi AK, et al. Predicting endoscopy-related anxiety and depression in patients: the role of health beliefs, perceived social support, and physician-patient communication[J]. Psychology Research and Behavior Management, 2023, 16: 4917-4931. DOI: 10.2147/PRBM.S442256.
[16] 李罗燕. 无痛胃肠镜检查过程中发生不良事件的影响因素分析[J]. 中国保健营养,2022,32(10):94-96.
[17] Kang X, Zhang L, Wang J, et al. The mediating role of perceived social support between mindfulness and pre-procedural anxiety in patients undergoing gastrointestinal endoscopy: a cross-sectional study[J]. Frontiers in Psychology, 2022, 13: 1065002. DOI: 10.3389/fpsyg.2022.1065002.
[18] Rao DN, Cano J, Sheikh RA, et al. Preoperative anxiety and its impact on postoperative recovery: a randomized controlled trial[J]. Journal of Clinical Psychology, 2021, 77(6): 1234-1245.
[19] Nahon S, Doret M, Rocher G, et al. Women report higher levels of anxiety and pain than men before and during colonoscopy, despite similar sedation and medication[J]. Clinical and Translational Gastroenterology, 2022, 13(7): e00510.
[20] Kim J, Park S, Lee M, et al. Gender differences in anxiety and fear before gastrointestinal endoscopy: The mediating role of pain catastrophizing[J]. Psychology, Health & Medicine, 2021, 26(5): 618-628.
[21] Zhang L, Wang H, Liu B, et al. Digital health literacy and medical fear in young adults: the mediating role of online health information seeking[J]. Journal of Medical Internet Research, 2023, 25(1): e41589.
[22] Kim S, Park J, Lee Y, et al. Cognitive vulnerability model of procedural fear: validation in gastrointestinal endoscopy patients[J]. Anxiety, Stress, & Coping, 2022, 35(4): 456-470. DOI: 10.1080/10615806.2021.2020785.
[23] Gonzalez-Hernandez J, Silva C, Rojas L, et al. Digital health information seeking and fear of medical procedures among young adults: a cross-sectional study[J]. Health Communication, 2020, 35(11): 1390-1396.
[24] Kim HJ, Park E, Kang YJ. The mediating effect of anxiety on the relationship between job stress and fear of cancer recurrence in breast cancer survivors[J]. Journal of Psychosomatic Research, 2022, 161: 110991.
[25] Lo MT, Hsu CC, Chang HS, et al. The role of anxiety and depression in the relationship between socioeconomic status and poor health outcomes: a serial mediation analysis[J]. Journal of Affective Disorders, 2021, 282: 1215-1221.
[26] 李慧,高婷婷,董勇. 图文宣教结合共情沟通干预对结肠镜检查患者依从性影响[J]. 国际医药卫生导报,2022,28(9):1227-1230. DOI:10.3760/cma.j.issn.1007-1245.2022.09.010.
[27] Almeida R, Costa P, Santos C, et al. Effect of a brief cognitive-behavioral intervention on pre-endoscopy anxiety: a randomized clinical trial[J]. Digestive Diseases and Sciences, 2023, 68(4): 1234-1242.
[28] Chen X, Wang D, Zhang H, et al. The role of chronic illness perception in procedural fear among patients undergoing gastrointestinal endoscopy[J]. Journal of Psychosomatic Research, 2019, 116: 45-50.