FEAR STRESS, AND COPING BEHAVIOR IN AMBUL ANT GASTROINTESTINAL ENDOSCOPY - IS PREMEDICATION JUSTIFIED

This study is a contribution to the the question, whether the fear of ambulant gastrointestinal endoscopy generally justifies an anxiolytic premedication. Intensity of the stress reaction (subjective stress rea ctions, cardiovascular and endocrinological stress parameters), situat ion-specific determinants and coping behavior were analyzed one week a nd immediately before and immediately after the diagnostic procedure i n N = 135 patients. The results showed significant effects of the proc edure on subjective, cardiovascular and endocrinological stress parame ters. Furthermore, other stress-eliciting conditions like former exper iences, with the procedure, behavior of the doctor and the assisting s taff, organisational conditions could be identified. All in all, for m ost of the patients the endoscopy examination was less aversive as rep orted in the literature. According to our results, the amount of fear and stress reactions cannot justify the risks of an anxiolytic premedi cation. Only for a small group of patients (about 25%) the question of premedication should be proved individually. These patients can be id entified by a questionnaire or by a rough screening of the anxiety lev el by behavior observation during a preparating anamnesis.