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Coping With First-Time Endoscopy for a Select Sample of Chinese Patients With Functional Dyspepsia and Duodenal Ulcer: An Observational Study

From the Division of Social Science, Hong Kong University of Science and Technology (C.C.), Hong Kong; University Department of Medicine, University of Hong Kong (W.H., S.L.), Hong Kong.

Address reprint requests to: Cecilia Cheng, PhD, Division of Social Science, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong. Email: c.cheng{at}ust.hk

OBJECTIVE: This study examined how patients with functional dyspepsia (FD) and duodenal ulcer (DU) coped with first-time endoscopy, a highly relevant real-life stressor. We adopted an observational method to enhance the ecological validity of the study on stress and coping.

METHODS: A matched case-control design was adopted to compare differences between 30 Chinese FD patients from a select sample and 30 Chinese DU patients (13 females and 17 males in each group) in observed coping behaviors, mood states, and subjective appraisals of endoscopy. A new observation checklist was developed for recording subjects’ coping behaviors, and our validation study showed that this newly developed measure had adequate reliability and criterion-related validity.

RESULTS: Compared with their DU counterparts, FD subjects 1) used more problem-focused coping, 2) used less emotion-focused coping, and 3) sought more instrumental support. They also had higher levels of anxious mood both before and after the endoscopy than did DU subjects. Moreover, compared with DU subjects, FD subjects reported having more pains and discomfort during the endoscopy and more dissatisfaction with the endoscopy.

CONCLUSIONS: Using an objective observational method in a select sample of FD patients, the present study provided tentative evidence that FD subjects tend to adopt an action-oriented coping pattern when encountering first-time endoscopy.

Key Words: functional dyspepsia, • duodenal ulcer, • psychological factors, • stress, • coping, • endoscopy.

Abbreviations: DU = duodenal ulcer;; EAS = Endoscopy Appraisals Scale;; FD = functional dyspepsia;; GI = gastrointestinal;; MAACL-R = Multiple Affect Adjective Checklist–Revised;; MANOVA = multivariate analysis of variance;; SES = socioeconomic status.

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