Govert Veldhuijzen

138 Chapter 7 Patient pain An eleven point Numeric Rating Scale (NRS) was used to measure pain of the patient before and during the procedure: 0, no pain and 10, highest imaginable pain. 32 Patient anxiety The State Trait Anxiety Inventory (STAI) was used to measure the anxiety of the patient before and after the procedure. The 20-item STAI is widely used with scores ranging from 20 (absence of anxiety) to 80 (high anxiety). 33 Patient satisfaction The general health of the participants was measured using the RAND 36 questionnaire 31 . Net Promoter Score (NPS) 35 and an eleven point scale of willingness to return: 0, no willing at all and 10, definitely willing, were used to measure participant satisfaction with the procedure. Statistical Analysis Statistical analysis was performed using SPSS version 22 (International Business Machines Corporation, Armonk, New York, United States). Mann Whitney U-tests were used to test whether the median scores for, i.e., age, pain, dose of medication, duration of the procedure, anxiety, satisfaction, NPS, and willingness to return, of the VR (intervention) and non-VR (control) group were comparable to each other. Fisher’s Exact tests were used to test categorical data. A P-value of 0.05 or less was considered statistically significant. RESULTS In total 24 patients entered the trial. (Figure 2.) Patients were recruited at the endoscopy outpatient clinic. There were 55 eligible patients scheduled for colonoscopy within a 4 week timeframe and we invited 38 consecutive patients. A total of 24 accepted our invitation. and Informed consent was obtained from all patients. After allocation, two patients in the VR (intervention) group and three patients in the non-VR (control) group were excluded (three patients cancelled the scheduled appointment, one was admitted to the hospital and in one patient there was a technical problem with the endoscopy equipment). As a result, 19 patients were entered the final analysis, 10 in the VR group and 9 in the non-VR group. All patients in the intervention group accepted the VR glasses during the whole procedure. In all patients no adverse events of VR distraction in combination with medication were observed. One endoscopist performed all procedures (FV) except one in the VR group (BvH). FV had > 5 years of experience, BvH >3 years.