Medication-free colonoscopy – factors related to pain and its assessment
Article first published online: 12 OCT 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 65, Issue 12, pages 2597–2607, December 2009
How to Cite
Ylinen, E.-R., Vehviläinen-Julkunen, K., Pietilä, A.-M., Hannila, M.-L. and Heikkinen, M. (2009), Medication-free colonoscopy – factors related to pain and its assessment. Journal of Advanced Nursing, 65: 2597–2607. doi: 10.1111/j.1365-2648.2009.05119.x
- Issue published online: 17 NOV 2009
- Article first published online: 12 OCT 2009
- Accepted for publication 19 June 2009
- pain assessment;
Title. Medication-free colonoscopy – factors related to pain and its assessment.
Aim. This paper is a report of a study conducted to determine the possibility of performing colonoscopy without medication, elucidate the factors related to a painful colonoscopy experience and compare colonoscopy patients’ reported pain assessment to nurses’ and endoscopists’ observations.
Background. Sedation and pain medication are routinely administered for colonoscopies in many countries. However, medication-free colonoscopies have attracted attention because the use of medication requires a time commitment from patients and increases complications. Earlier studies show that, for instance, gender, age and pelvic operations may increase the risk of painful colonoscopy and those healthcare professionals and patients appear to assess pain differently.
Method. A cross-sectional descriptive study was conducted in a Finnish university hospital using questionnaires developed for this study and analysed statistically. The sample of 138 colonoscopy patients, 11 nurses and 11 endoscopists was recruited in 2006.
Results. Over three-quarters of patients reported mild pain or no pain at all. Patients’ nervousness is a risk factor for experiencing pain during colonoscopy. Both nurses and endoscopists slightly underestimated the intensity of pain experienced by patients.
Conclusion. It is possible to perform colonoscopy without medication with most patients and focus sedation and pain medication on at-risk patients, especially those who are nervous. Before the procedure, nurses must devote time to discovering which patients are nervous and at risk of having a painful colonoscopy to present them for sedation. To improve pain management for patients having colonoscopy, endoscopists and nurses should participate systematically in pain education and use pain scales.