Patient preferences and factors related to the pre-procedure process at a large, urban county hospital

Abstract

Background: Evaluation of the pre-procedural process prior to endoscopic procedures has never been conducted. Methods: Prospective cross-sectional, multilanguage survey was administered to outpatients undergoing endoscopy at a large, diverse county hospital that examined patients' pre-procedural preferences. Multivariate logistic regression was used to assess the relationship between patient preferences and several patient-related variables. Results: 128/156 outpatients completed the survey. The majority of respondents were female (53.1%), did not speak English (61.7%), were of Asian (39.1%) or Hispanic (29.7%) racial background, and had a mean age of 56.1 ± 15.7 years. Most patients underwent colonoscopy (48.4%) with 90.6% of patients knowing the indication for their procedure. While waiting for their endoscopic procedure, 42.2% of patients preferred waiting in a gurney while 28.1% preferred to wait in a chair. In terms of being comfortable wearing a hospital gown and sitting in a chair or gurney in the pre-procedure area, mean patient anxiety scores were 5.2 ± 3.3 and 6.1 ± 3.2, respectively (scale of 1 -10). Race was associated with several pre-procedural patient preferences; Hispanics were less comfortable than Asians wearing a hospital gown while sitting in a chair with other patients prior to their procedure (OR = 0.3, CI 0.1 -1.0) while Whites and African-Americans were less likely than Asians to prefer sitting in a chair as compared to a gurney before their procedure (OR = 0.09, CI 0.008 -0.9 and OR = 0.07, CI 0.007 -0.8, respectively). Patients who had undergone a prior endoscopic procedure were less comfortable wearing a hospital gown and sitting in a chair (OR = 0.3, CI 0.1 -0.7) or gurney (OR = 0.4, CI 0.2 -1.0) in the pre-procedure area. Conclusion: A patient's race and having had a prior endoscopic procedure were the most powerful predictors on pre-procedure patient preferences while sex, type of endoscopic procedure and patient knowledge of the indication for their procedure were not. Our study highlights the importance of patient preferences and factors involved in the pre procedure process at a large, diverse county hospital.

Effect of Early Preparation on Anxiety Level Among Patients Undergoing Upper Gastrointestinal Endoscopy

“…Higher levels of anxiety lead to physiologic fluctuations as increased blood pressure and pulse. Also anxiety prior to endoscopy can increase the requirement for sedation, analgesics and increased length of time during procedure in addition to increase cost [3] and [4].…”

Efek Akupunktur Telinga dengan Press Needle terhadap Kecemasan Pasien yang Menjalani Prosedur Esofagogastroduodenoskopi

“…Kecemasan menjadi isu penting di pusat pelayanan endoskopi, karena kecemasan berhubungan dengan keselamatan pasien, keberhasilan, dan durasi prosedur (Day, Nazareth, & Sewell, 2013) Kecemasan dapat menimbulkan akibat negatif. Akibat yang dimaksud seperti penurunan ambang nyeri, perubahan tekanan darah dan denyut jantung, pasien tidak mampu menerima informasi, pasien kurang kooperatif selama prosedur, peningkatan ketidaknyamanan pasien, penambahan analgesia atau sedasi, serta penundaan atau penolakan terhadap prosedur (Day et al, 2013) Penelitian Gian (Gian, 2020) yang dilakukan di RSUP Dr. M. Djamil Padang padapasien yang akan dilakukan pemeriksaan endoskopi saluran cerna menunjukkan bahwa 48,8% pasien mengalami kecemasan sedang. Menurut Ersöz et al, (2010) kecemasan dan ketakutan dapat terjadi pada semua prosedur endoskopi saluran cerna dan semakin meningkat pada saat pasien berada di ruang tunggu pemeriksaan.…”