Chewing Gum and Cold Gargle on Post-Bronchoscopy Symptoms

Study Implementation and Procedures

All patients in the intervention and control groups will be informed about the study's purpose. Patients undergoing bronchoscopy receive routine verbal education from bronchoscopy nurses. In addition to routine education, the intervention groups will receive specific instructions from the researchers. Patients will be blinded to their randomization status and study hypotheses. However, researchers will not be blinded as they will perform the interventions. The chewing gum and cold water gargle procedures will be explained and demonstrated to the intervention groups during face-to-face interviews.

Chewing Gum Procedure All patients will follow the hospital's standard pre-procedure fasting protocol (8 hours of fasting). A researcher will be responsible for supervising the chewing gum procedure. Patients in this group will be asked to chew a commercially available sugar-free gum containing xylitol for 15 minutes immediately before the procedure. After 15 minutes of chewing, patients will discard the gum. The researcher will ensure the gum is removed before the patient is admitted for bronchoscopy. Patients will be strictly instructed not to swallow the gum.

Cold Water Gargle Procedure Patients in this group will perform a cold water gargle under the supervision of a researcher 15 minutes before the procedure. Patients will be instructed not to swallow the water. The researcher will prepare the water at a temperature between 8-12°C (refrigerator coldness). Patients will gargle twice for 30 seconds each, approximately 15 minutes before the procedure.

Control Group The control group will receive standard hospital procedures without any additional intervention.

Data Collection and Evaluation Sore throat, difficulty swallowing (dysphagia), and patient satisfaction levels will be evaluated before the procedure, and at the 2nd and 24th hours post-procedure. The 24-hour evaluation will be conducted via telephone by the research team.

• Chewing Gum (Behavioral): Patients will chew sugar-free xylitol gum for 15 minutes immediately before the bronchoscopy procedure
• Cold Water Gargle (Behavioral): Patients will gargle with cold water (8-12°C) twice for 30 seconds each, 15 minutes before the bronchoscopy procedure.

Primary outcomes

• Severity of Post-Bronchoscopy Sore Throat [Baseline (pre-procedure), 2nd hour, and 24th hour post-procedure.]: Sore throat severity will be measured using a Visual Analog Scale (VAS), where 0 represents 'no pain' and 10 represents 'the most severe pain imaginable.' Higher scores indicate greater pain severity.

Secondary outcomes

• Severity of Post-Bronchoscopy Dysphagia [Baseline (pre-procedure), 2nd hour, and 24th hour post-procedure.]: Dysphagia severity will be measured using a Visual Analog Scale (VAS), where 0 represents "no difficulty swallowing" and 10 represents "extreme difficulty swallowing." Higher scores indicate greater difficulty swallowing
• Patient Satisfaction Level [Before bronchoscopy and 24 hours after the procedure.]: Patient satisfaction was assessed using the Patient Satisfaction Questionnaire Short Form (PSQ-18), which includes seven subscales: general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with the doctor, and accessibility and convenience.

Sex: All, ages: 18 Years to any

Inclusion Criteria

Being 18 years of age or older Being scheduled for a non-emergency bronchoscopy Having normal speech and swallowing functions Being conscious and able to communicate Agreeing to participate and providing written informed consent Exclusion Criteria

Gastroesophageal reflux Signs of active infection in the oral or throat region Use of non-steroidal anti-inflammatory drugs (NSAIDs) Any drug allergy Steroid therapy during the week before the procedure Anatomical or functional impairment that prevents chewing gum or gargling Undergoing emergency interventional bronchoscopy

• neriman yükseltürk şimşek, Principal investigator, ankara u