Condon Amanda, Graff Lesley, Elliot Lawrence, Ilnyckyj Alexandra
Section of Gastroenterology, St Boniface General Hospital, University of Manitoba, Winnipeg, Canada.
Can J Gastroenterol. 2008 Jan;22(1):41-7. doi: 10.1155/2008/107467.
Colon cancer screening, including colonoscopy, lags behind other forms of cancer screening for participation rates. The intrinsic nature of the endoscopic procedure may be an important barrier that limits patients from finding this test acceptable and affects willingness to undergo screening. With colon cancer screening programs emerging in Canada, test characteristics and their impact on acceptance warrant consideration.
To measure the acceptability of colonoscopy and define factors that contribute to procedural acceptability, in relation to another invasive gastrointestinal scope procedure, gastroscopy.
Consecutive patients undergoing a colonoscopy (n=55) or a gastroscopy (n=33) were recruited. Their procedural experience was evaluated and compared pre-endoscopy, immediately before testing and postendoscopy. Questionnaires were used to capture multiple domains of the endoscopy experience and patient characteristics.
Patient scope groups did not differ preprocedurally for general or procedure-specific anxiety. However, the colonoscopy group did anticipate more pain. Those who had a gastroscopy demonstrated higher preprocedural acceptance than those who had a colonoscopy. The colonoscopy group had a significant decrease in scope concerns and anxiety postprocedurally. As well, they reported less pain than they anticipated. Regardless, postprocedurally, the colonoscopy group's acceptance did not increase significantly, whereas the gastroscopy group was almost unanimous in their test acceptance. The best predictor of pretest acceptability of colonoscopy was anticipated pain.
The findings indicate that concerns that relate specifically to colonoscopy, including anticipated pain, influence acceptability of the procedure. However, the experience of a colonoscopy does not lead to improved test acceptance, despite decreases in procedural anxiety and pain. Patients' preprocedural views of the test are most important and should be addressed directly to potentially improve participation in colonoscopy.
包括结肠镜检查在内的结肠癌筛查在参与率方面落后于其他癌症筛查形式。内镜检查程序的内在性质可能是一个重要障碍，限制患者认为该检查可接受，并影响其接受筛查的意愿。随着加拿大出现结肠癌筛查项目，检查特征及其对接受度的影响值得考虑。
与另一种侵入性胃肠道检查程序胃镜检查相关，测量结肠镜检查的可接受性，并确定有助于程序可接受性的因素。
招募连续接受结肠镜检查（n = 55）或胃镜检查（n = 33）的患者。在检查前、即将检查前和检查后对他们的检查体验进行评估和比较。使用问卷来获取内镜检查体验和患者特征的多个方面。
在一般或特定检查的焦虑方面，患者检查组在检查前没有差异。然而，结肠镜检查组确实预期会有更多疼痛。接受胃镜检查的患者在检查前的接受度高于接受结肠镜检查的患者。结肠镜检查组在检查后的检查担忧和焦虑显著降低。此外，他们报告的疼痛比预期的要少。尽管如此，在检查后，结肠镜检查组的接受度没有显著提高，而胃镜检查组在接受检查方面几乎是一致的。结肠镜检查前接受度的最佳预测因素是预期疼痛。
研究结果表明，与结肠镜检查具体相关的担忧，包括预期疼痛，会影响该程序的可接受性。然而，尽管程序焦虑和疼痛有所减轻，但结肠镜检查的体验并未导致检查接受度的提高。患者检查前对检查的看法最为重要，应直接解决这些问题以潜在地提高结肠镜检查的参与率。
