Larsen I K, Grotmol T, Bretthauer M, Gondal G, Huppertz-Hauss G, Hofstad B, Efskind P, Jørgensen A, Hoff G
Kreftregisteret, Institute of Population-based Cancer Research, Montebello, Oslo, Norway.
Scand J Gastroenterol. 2002 Jul;37(7):850-5.
A randomized sample of 14,000 men and women, aged 55-64 years, resident in the City of Oslo and Telemark County, were drawn from the population registry to be offered a flexible sigmoidoscopy (FS) screening examination. A questionnaire was designed to modify routines and evaluate patient satisfaction.
Consecutive participants (4956) were given a questionnaire immediately after the FS to be filled in and returned by mail on the following day. Participants were asked questions about service, practical issues, and the level of pain during the FS and post-examination discomfort. They were also encouraged to give their comments in free text.
Questionnaire replies were received from 4574 (92%) out of 4956 participants. The vast majority reported to have experienced no (70%) or slight (21%) pain during the examination. Women reported pain and post-examination discomfort more often than men. Pain was also associated with age of the patient and length of bowel examined, but not with total examination time. The proportion of painless examinations varied between endoscopists from 62% to 81%. For all endoscopists collectively, this improved during the study period, irrespective of past experience, but trainees seemed to adopt the score of their masters.
The study demonstrated that the use of feedback information in an endoscopy screening unit may be useful in improving standards, including the performance of endoscopists. It is possible that the introduction of similar feedback systems in routine endoscopy laboratories may in the long run improve the reputation of gastrointestinal endoscopy.
从奥斯陆市和泰勒马克郡的人口登记册中随机抽取了14000名年龄在55 - 64岁之间的男性和女性，为他们提供乙状结肠镜弹性筛查（FS）检查。设计了一份问卷以调整流程并评估患者满意度。
连续的参与者（4956名）在FS检查后立即收到一份问卷，需填写并在次日邮寄返还。参与者被问及有关服务、实际问题、FS检查期间的疼痛程度以及检查后不适的问题。还鼓励他们以自由文本形式发表意见。
4956名参与者中有4574名（92%）回复了问卷。绝大多数人报告在检查期间没有（70%）或仅有轻微（21%）疼痛。女性比男性更常报告疼痛和检查后不适。疼痛也与患者年龄和检查的肠段长度有关，但与总检查时间无关。不同内镜医师进行的无痛检查比例在62%至81%之间。对于所有内镜医师总体而言，在研究期间这一比例有所提高，无论过去的经验如何，但实习生似乎采用其带教老师的评分。
该研究表明，在内镜筛查单位使用反馈信息可能有助于提高标准，包括内镜医师的表现。从长远来看，在常规内镜检查实验室引入类似的反馈系统可能会提升胃肠内镜检查的声誉。
