Development of an Instrument to Assess and Predict Satisfaction and Poor Tolerance Among Patients Undergoing Endoscopic Procedures

Abstract

We aimed to test the reliability of a developed questionnaire that measures and predict aversive endoscopic experience. Two questionnaires (pre- and postprocedure) were given to patients presenting for routine endoscopy. The first questionnaire elicited demographics, prior endoscopic experience, history of drug or alcohol use, patient expectations, and levels of anxiety and nervousness before procedure. After endoscopy, tolerance and willingness to repeat the examination were determined. The primary outcome of "adverse endoscopic experience" (AEE) was defined as a score of > or =5 on the postprocedure overall level of satisfaction or unwillingness to repeat endoscopy. Thirteen of 148 subjects reported an AEE. Items measuring the primary outcome were internally validated by reliability analysis which significantly correlated with measures of aversive experience like pain, nervousness, and suffering during the procedure. Preprocedure factors that were associated with AEE in the univariate analysis and multivariate analysis were nervousness (P = 0.02) and chronic use of psychotropic drugs or alcohol (P = 0.03). In conclusion, we have developed a questionnaire that reliably measures aversive endoscopic experience. Nervousness before procedure and chronic use of psychotropic drugs are reliable predictors of such experience.

The effect of periodic monitoring and feedback on screening colonoscopy withdrawal times, polyp detection rates, and patient satisfaction scores

“…Previous studies have shown that there are indeed many factors that affect patient satisfaction, including patient perception of physician technical skills and sedation adequacy 13 ; facility cleanliness, privacy, and nurse attention 14 ; procedure waiting time 15 ; baseline patient anxiety 16 ; and the use of psychotropic or narcotic drugs. 17,18 The patient's age, sex, education level, and socioeconomic class are also known to influence satisfaction scores. 7,19,20 Because an adequate withdrawal phase is thought to be an essential feature of quality colonoscopy, 4 there has been interest in methods that can improve withdrawal time.…”

What Are the Most Important Factors Regarding Acceptance to the Colonoscopy?

“…Despite the fact that (4,10,11,20,30) ; no consensus in the literature has been firmly established to date (1,22,24,26) . Longer colon, particularly the transverse, which predisposes to a more convoluted sigmoid colon, associated with acute angles due to the narrower pelvic cavity, combine to result in a more difficult procedure in women (30,32) .…”

Sedation Related to Gastrointestinal Endoscopy

“…There is evidence that oxygen supplementation reduces the risk of hypoxemia during colonoscopy (Holm et al, 1999) but there are studies showing that when given supplemental oxygen, oxygen saturation levels do not reflect the ventilation function and may mask the CO 2 retention (Lazzaroni&Bianchi, 2001). However, a recent Australian study conducted by anesthesiologists showed that the use of supplemental oxygen was universal (Pena et al, 2005). Preparing medical personnel in the management of airway obstruction and apnea is essential.…”