Schoen R E, Weissfeld J L, Bowen N J, Switzer G, Baum A
Department of Medicine and the University of Pittsburgh Cancer Institute, University of Pittsburgh, PA, USA.
Arch Intern Med. 2000 Jun 26;160(12):1790-6. doi: 10.1001/archinte.160.12.1790.
Screening flexible sigmoidoscopy is an underused cancer prevention procedure. Physicians often cite patient discomfort as a reason for not requesting sigmoidoscopy, but patient experiences and attitudes toward sigmoidoscopy have not been well studied.
To measure patient satisfaction and the determinants of satisfaction with screening sigmoidoscopy.
An instrument to assess satisfaction with screening sigmoidoscopy was developed. Responses were evaluated with a factor analysis, tested for reproducibility and internal consistency, and validated against an external standard.
A total of 1221 patients (666 men and 555 women; mean age, 61.8 years) were surveyed after sigmoidoscopy. Examinations were performed by a nurse practitioner (n = 668), internist (n = 344), or gastrointestinal specialist (n= 184). More than 93% of the participants strongly agreed or agreed they would be willing to undergo another examination, and 74.9% would strongly recommend the procedure to their friends. Regarding pain and discomfort, 76.2% strongly agreed or agreed that the examination did not cause a lot of pain, 78.1% stated that it did not cause a lot of discomfort, and 68.5% thought that it was more comfortable than they expected. Fifteen percent to 25% of the patients indicated they had a lot of pain, great discomfort, or more discomfort than expected. Women were more likely to have significant pain or discomfort than men (adjusted odds ratio, 2.9; 95% confidence interval, 1.9-4.3; P<.001).
Approximately 70% of individuals who undergo screening sigmoidoscopy are satisfied and find the procedure more comfortable than expected, whereas only 15% to 25% find the procedure unpleasant. Physicians should not project discomfort onto patients as a reason for not requesting screening sigmoidoscopy.
筛查性乙状结肠镜检查是一种未得到充分利用的癌症预防程序。医生经常将患者的不适作为不要求进行乙状结肠镜检查的理由，但患者对乙状结肠镜检查的体验和态度尚未得到充分研究。
评估患者对筛查性乙状结肠镜检查的满意度及其满意度的决定因素。
开发了一种评估筛查性乙状结肠镜检查满意度的工具。通过因子分析对回答进行评估，测试其可重复性和内部一致性，并与外部标准进行验证。
共有1221例患者（666例男性和555例女性；平均年龄61.8岁）在乙状结肠镜检查后接受了调查。检查由执业护士（n = 668）、内科医生（n = 344）或胃肠专科医生（n = 184）进行。超过93%的参与者强烈同意或同意他们愿意接受另一次检查，74.9%的人会强烈向朋友推荐该程序。关于疼痛和不适，76.2%的人强烈同意或同意检查不会引起很多疼痛，78.1%的人表示不会引起很多不适，68.5%的人认为比他们预期的更舒适。15%至25%的患者表示他们有很多疼痛、极大的不适或比预期更多的不适。女性比男性更有可能有明显的疼痛或不适（调整后的优势比为2.9；95%置信区间为1.9 - 4.3；P <.001）。
接受筛查性乙状结肠镜检查的个体中约70%感到满意，并发现该程序比预期更舒适，而只有15%至25%的人认为该程序不愉快。医生不应将不适归咎于患者，以此作为不要求进行筛查性乙状结肠镜检查的理由。
