Department of Surgery, University College London, London, UK.
Br J Radiol. 2012 Jun;85(1014):765-9. doi: 10.1259/bjr/36231529. Epub 2011 Oct 18.
The aim of this study was to apply qualitative techniques to assimilate data on patient experience and attitudes during MR colonography (MRC) and colonoscopy (CC).
18 patients (11 male, 8 female, median age 40.5 years), 10 of whom had known colonic inflammatory bowel disease (IBD) and 8 who were under investigation for suspected colonic neoplasia (non-IBD), underwent MRC and conventional CC. Semi-structured interviews were performed to assimilate test experiences and preferences, and themes were extracted using thematic analysis.
Thematic analysis identified three main themes: (i) physical experience, (ii) information provision and (iii) overall preference. Patients expressed mixed views about the physical experience of MRC but specifically identified water filling, breath holding and lying still as problematic. Anxiety was expressed regarding potential incontinence. Scanner noise interfered with the understanding of instructions, particularly amongst non-IBD patients. Non-IBD patients expressed greater anxiety over the delay in receiving the MRC report than IBD patients. In general MRI was considered as the more informative and safer investigation. Patients reported more physical discomfort during CC (notably IBD patients) related to air insufflation and colonoscopic manipulation but were more satisfied with the feedback they received. 10 patients (56%) stated an overall preference for MRC and 5 (28%) preferred CC. Reasons for preferences stated by the patients included discomfort, speed of the test, safety, perceived diagnostic ability and the ability to take biopsies.
Experiences of MRC and CC are complex and influenced by clinical indication. Individuals place different weightings on the relative importance of test attributes including discomfort, noise, immobility, feedback, safety and fear of incontinence and this defines overall preference.
本研究旨在应用定性技术整合关于磁共振结肠成像（MRC）和结肠镜检查（CC）期间患者体验和态度的数据。
18 名患者（11 名男性，8 名女性，中位年龄 40.5 岁），其中 10 名患有已知的结肠炎症性肠病（IBD），8 名患有疑似结肠肿瘤（非 IBD），接受了 MRC 和常规 CC。进行半结构化访谈以整合测试体验和偏好，并使用主题分析提取主题。
主题分析确定了三个主要主题：（i）身体体验，（ii）信息提供和（iii）整体偏好。患者对 MRC 的身体体验表达了混合看法，但特别指出水填充、屏住呼吸和保持静止是有问题的。对于潜在的失禁，患者感到焦虑。扫描仪噪音干扰了对指令的理解，特别是在非 IBD 患者中。非 IBD 患者比 IBD 患者更担心延迟收到 MRC 报告。一般来说，MRI 被认为是更具信息性和更安全的检查。患者在 CC 期间报告了更多的身体不适（特别是 IBD 患者），与空气充气和结肠镜检查操作有关，但对他们收到的反馈更满意。10 名患者（56%）表示总体上更喜欢 MRC，5 名患者（28%）更喜欢 CC。患者表示偏好的原因包括不适、测试速度、安全性、感知诊断能力以及进行活检的能力。
MRC 和 CC 的体验是复杂的，受临床指征的影响。个人对测试属性的相对重要性有不同的权重，包括不适、噪音、不能活动、反馈、安全性和对失禁的恐惧，这定义了整体偏好。
