SJG：结肠镜检查中患者中重度焦虑与预期疼痛有关

　　日间结肠镜是一种常见的消化道操作，这方面的相关资料较少。英国的Jude McRntire医师评价了患者对于该项操作的偏好和期望。该文发表在2013年第48卷第3期《斯堪的纳维亚胃肠病学杂志》（Scand J Gastroenterol）上。

　　研究团队邀请进行结肠镜检查的患者完成一份经过验证的专用复合内镜问卷。问卷包括Likert量表问题及一份15条的偏好量表，内容为在内镜检查中对于获得满意体验最不重要至最重要的因素。

　　该团队报告224名患者中216名返回了问卷。56%的患者中记录了中至重度的焦虑，多与预期的疼痛或操作结果有关。医师们发现偏好评分排序的中位值显示对于满意体验最重要的为内镜医师的操作技能、操作过程中的不适及内镜医师的态度。被认为重要性程度相对较低的因素包括同性环境、噪音水平及解释较晚。研究团队发现仅有14%的患者回答他们将为获得同性环境而推迟预约。

　　McEntire医师的团队总结道：“接受结肠镜检查的患者更看重检查中与内镜医师的互动及检查本身有关的因素”。“环境因素被认为相对更不重要一些”。“这些结果可能有助于围绕患者所认为的重要因素重新设计医疗服务”。

与结肠镜相关的拓展阅读：

• Lancet：推荐结直肠癌疑似患者首选CT结肠镜成像诊断方法
• ANN INTERN MED :英国结肠镜检查指南更具优势
• Ann Intern Med：是否有必要对结肠镜结果阴性的患者在10年后再次行结肠镜检查？
• USMSTF发布新的《结肠镜检查及息肉切除术后随访指南》
• 结肠镜筛查对部分老人仍有益
更多信息请点击：有关结肠镜更多资讯

An evaluation of patient attitudes to colonoscopy and the importance of endoscopist interaction and the endoscopy environment to satisfaction and value

Objective

Understanding patients' attitudes to their medical experience is essential for identifying value in the patient pathway, optimizing care and use of resources. This service evaluation was undertaken to determine patients' preferences and expectations for day case colonoscopy, a common gastrointestinal procedure for which there is limited such data. 

Methods

Patients attending for elective colonoscopy were invited to complete a composite, validated dedicated endoscopy questionnaire, with Likert-scale questions and a 15-point preference (ranking) scale of domains of endoscopy care that were considered most important (1) to least important (15) as contributing to a satisfactory experience. 

Results

Two hundred and sixteen out of 224 patients returned questionnaires. Moderate to severe anxiety was recorded in 56% of patients, commonly with respect to anticipation of pain or the results of the procedure. The median values for ranked preference scores consistent with greatest importance for satisfaction were technical skill of the endoscopist (1), discomfort during the procedure (4), and manner of the endoscopist (5). Factors considered of relatively low importance included the single-sex environment (15) (although this was more important to female patients), noise levels (13), and explanation of delay (11). Only 14% of patients responded that they would be prepared to delay an appointment for a single-sex environment. 

Conclusio

Patients undergoing colonoscopy highly prioritize aspects of care relating to the interaction with the endoscopist and the procedure itself. Environment factors are considered to be less important. These findings may assist in service redesign around patient-identified value within the patient pathway.