基于患者的胃肠内镜评估：文献的荟萃叙述性综述。

Patient-derived measures of GI endoscopy: a meta-narrative review of the literature.

机构信息

School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, United Kingdom; Northern Region Endoscopy Group, Newcastle, United Kingdom.

Northern Region Endoscopy Group, Newcastle, United Kingdom; South Tyneside District Hospital, South Shields, United Kingdom.

出版信息

Gastrointest Endosc. 2015 May;81(5):1130-40.e1-9. doi: 10.1016/j.gie.2014.11.047.

DOI:10.1016/j.gie.2014.11.047

PMID:25864891

Abstract

BACKGROUND AND AIMS

GI endoscopy (GIE) is widely performed, with 1 in 3 people requiring an endoscopic procedure at some point. Patient experience of medical procedures is important, but, to date, experience measures of GIE are derived from clinician opinion rather than from patients themselves. In this meta-narrative review, the literature on methods of assessing patient experience in GIE is reported.

METHODS

ScienceDirect, MEDLINE, Web of Knowledge, Web of Science, CINAHL, and PsycINFO were searched to November 2013 using meta-narrative standards. Search terms included those related to endoscopic procedures, combined with those related to patient experience.

RESULTS

A total of 3688 abstracts were identified and reviewed for relevance. A total of 3549 were excluded, leaving 139 for full-text review. We subsequently included 48 articles. Three sub-groups of studies were identified--those developing original measures of endoscopy-specific patient experience (27 articles), those modifying existing measures (10 articles), and those testing existing measures for reliability or validity (11 articles). Most measures focused on pain, discomfort, anxiety, and embarrassment. Three studies explored wider aspects of experience, including preparation, unit organization, and endoscopist preference. Likert scales, visual analog scale scores, and questionnaires were used most commonly. The Global Rating Scale was validated for use in 2 studies, confirming that those domains cover all aspects of endoscopy experience. Other measures were modified to assess endoscopic experience, such as the modified Group Health Association of America survey (mGHAA-9) (modified by 5 studies).

CONCLUSIONS

No patient-derived and validated endoscopy-specific experience measures were found. Patient-derived and validated experience measures should be developed and used to model optimal healthcare delivery.

摘要

背景与目的

胃肠内镜（GI）检查广泛开展，每 3 个人中就有 1 人在某个时间需要进行内镜检查。患者对医疗程序的体验很重要，但迄今为止，GI 检查患者体验的评估方法均源自临床医生的意见，而非患者自身。在本次元叙述性综述中，报告了 GI 内镜检查中评估患者体验的方法的文献。

方法

使用元叙述性标准，检索 ScienceDirect、MEDLINE、Web of Knowledge、Web of Science、CINAHL 和 PsycINFO 数据库，检索截至 2013 年 11 月。检索词包括与内镜操作相关的术语，与患者体验相关的术语。

结果

共确定了 3688 篇摘要，并对其相关性进行了审查。共排除了 3549 篇，剩下的 139 篇进行了全文审查。随后纳入了 48 篇文章。确定了 3 组研究：开发内镜特定患者体验原始测量方法的研究（27 篇）、修改现有测量方法的研究（10 篇）以及检验现有测量方法可靠性或有效性的研究（11 篇）。大多数测量方法都侧重于疼痛、不适、焦虑和尴尬。有 3 项研究探索了更广泛的体验方面，包括准备、单位组织和内镜医生偏好。最常用的是李克特量表、视觉模拟评分和问卷。2 项研究验证了全球评估量表（Global Rating Scale）可用于评估内镜检查体验，证实这些维度涵盖了内镜检查体验的所有方面。其他测量方法也被修改用于评估内镜检查体验，例如 5 项研究中修改后的美国团体健康协会调查（modified Group Health Association of America survey，mGHAA-9）。