PubMed · 519290
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A W Fowler. 1979-10-27. Diazepam for distressing procedures.. https://doi.org/10.1136/bmj.2.6197.1073-c
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BACKGROUND/AIMS: Several studies have reported improved patient comfort with music in the preoperative setting, however music has seldom been assessed during gastrointestinal endoscopy. We aimed to assess how background music may influence the perception of patients and examiners involved in endoscopic examinations. METHODS: 301 patients (128 females, 173 males; mean age 59 years) were included in the study (EGD and colonoscopy) in a prospective fashion. 90 EGD and 61 colonoscopies were performed with music (50.17%) and 102 EGD and 48 colonoscopies without music (49.83%). Patients, nurses and endoscopists completed a questionnaire. RESULTS: No significant differences in demographic data were found between the patients examined with or without music. Tolerance to the examination, pain sensation and perception of the endoscopy room ambiance were similar in both groups. The majority of patients (83.4%) expressed a preference for music during any future endoscopic examination and none perceived the music as disturbing. During the 151 examinations, music was considered unpleasant in 14 examinations by the physicians (9.3%) and in 11 examinations by the nurses (7.3%). CONCLUSIONS: Music has little influence on patients' experience of gastrointestinal endoscopy. Nevertheless, the majority of patients felt music to be helpful and expressed a preference for music during any future examination. This positive attitude to music of patients is in contrast with the assessment of some endoscopists and nurses.
Gynecologic malignancies occur in approximately 1 in 20 women in the United States. Until recently, clinical management of these cancers has focused almost exclusively on prolonging the survival of patients. A recent literature search using MEDLINE revealed relatively few research studies that reported data on quality of life (QOL) in a gynecologic cancer population. Reports in the literature have been conflicting, with some studies finding deterioration in QOL and some finding stability or improvement in QOL over time. Until recently, the impact of various treatments (surgery, radiation, chemotherapy) on QOL in this population was unknown. Recently, the QOL of women with gynecologic cancer has been compared to that of women with other types of cancer. Also, risk factors for poor adjustment in gynecologic cancer are beginning to be investigated. This presentation will attempt to 1) summarize the relevant literature on QOL in a gynecologic cancer population, 2) compare QOL in this population to other types of cancer, 3) examine risk factors for poor adjustment and 4) describe the limitations of the literature and future research directions. Overall, it appears that QOL is most negatively affected from time of diagnosis through completion of treatment. Following treatment, QOL appears to improve over the course of 6-12 months, but then appears to remain stable from that time through two years post-treatment. Compared to breast cancer patients, it appears that gynecologic cancer patients experience poorer QOL on several domains during active treatment, but that after completion of treatment, overall QOL is similar between groups. Risk factors for maladjustment include treatment with radiotherapy or multi-modality treatment, increased length of treatment, younger age, and coping using a disengaged style. Other risk factors include lower education, poor social support and lower levels of religious belief. The significance of these findings and future research directions will be discussed.