Children's knowledge, anticipatory anxiety, procedural distress, and recall of esophagogastroduodenoscopy

Background: This study evaluates the relations among children's knowledge of esopbagogastroduodenoscopy (EGD) and anticipatory anxiety, procedural distress, and the nature of postprocedural recall and evaluations. Methods: One hundred patients, aged 8 to 17 years, completed self-report measures of knowledge and anxiety before EGD. Parents completed a self-report measure assessing how they prepared their children. Nurses and trained observers completed observational ratings of distress. Children's recall and evaluation of the procedure were assessed by self-report I hour after the procedure and by telephone that evening. Results: Most children knew about the major components of EGD. Children with greater knowledge experienced less distress and reported that they would be less anxious and upset when undergoing future EGDs. Children with greater anticipatory anxiety exhibited more procedural distress. Children's distress varied by the phase of the procedure. Children who were more distressed during intravenous line insertion experienced greater distress during esophageal intubation and the endoscopic examination. Approximately 20% of patients reported at least some memory of the procedure even at the end of the day. Children with greater recall reported greater aversion and a more negative attitude toward future EGDs. Conclusions: This study provides information about children's distress during EGD and the effects of conscious sedation on patients' memories and attitudes toward future procedures. The study indicates that preparation before EGD may reduce patient distress.