Shafer L A, Walker J R, Waldman C, Michaud V, Yang C, Bernstein C N, Hathout L, Park J, Sisler J, Wittmeier K, Restall G, Singh H
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Endosc Int Open. 2018 Jun;6(6):E706-E713. doi: 10.1055/s-0044-102298. Epub 2018 May 25.
Many endoscopists do not use split-dose bowel preparation (SDBP) for morning colonoscopies. Despite SDBP being recommended practice, they believe patients will not agree to take early morning bowel preparation (BP). We assessed patients' opinions about waking early for BP.
A self-administered survey was distributed between 08/2015 and 06/2016 to patients in Winnipeg, Canada when they attended an outpatient colonoscopy. Logistic regression was performed to determine predictors of reluctance to use early morning BP.
Of the 1336 respondents (52 % female, median age 57 years), 33 % had used SDBP for their current colonoscopy. Of the 1336, 49 % were willing, 24 % neutral, and 27 % reluctant to do early morning BP. Predictors of reluctant versus willing were number of prior colonoscopies (OR 1.20; 95 %CI: 1.07 - 1.35), female gender (OR 1.65; 95 %CI: 1.19 - 2.29), unclear BP information (OR 1.86; 95 %CI: 1.21 - 2.85), high BP anxiety (OR 2.02; 95 %CI: 1.35 - 3.02), purpose of current colonoscopy being bowel symptoms (OR 1.40; 95 %CI: 1.00 - 1.97), use of 4 L of polyethylene glycol laxative (OR 1.45; 95 %CI: 1.02 - 2.06), not having SDBP (OR 1.96; 95 %CI: 1.31 - 2.93), and not having finished the laxative for the current colonoscopy (OR 1.66; 95 %CI: 1.01 - 2.73). Most of the same predictors were identified when reluctance was compared to willing or neutral, and in ordinal logistic regression.
Almost three-quarters of patients do not express reluctance to get up early for BP. Among those who are reluctant, improving BP information, allaying BP-related anxiety, and use of low volume BP may increase acceptance of SDBP.
许多内镜医师在进行上午的结肠镜检查时不采用分剂量肠道准备（SDBP）。尽管SDBP是推荐的做法，但他们认为患者不会同意在清晨进行肠道准备（BP）。我们评估了患者对于早起进行BP的看法。
在2015年8月至2016年6月期间，向加拿大温尼伯市参加门诊结肠镜检查的患者发放了一份自填式调查问卷。进行逻辑回归分析以确定不愿采用清晨BP的预测因素。
在1336名受访者中（52%为女性，中位年龄57岁），33%在本次结肠镜检查中使用了SDBP。在这1336人中，49%愿意，24%持中立态度，27%不愿进行清晨BP。不愿与愿意的预测因素包括既往结肠镜检查次数（比值比[OR]1.20；95%置信区间[CI]：1.07 - 1.35）、女性性别（OR 1.65；95%CI：1.19 - 2.29）、BP信息不明确（OR 1.86；95%CI：1.21 - 2.85）、高血压焦虑程度高（OR 2.02；95%CI：1.35 - 3.02）、本次结肠镜检查的目的是肠道症状（OR 1.40；95%CI：1.00 - 1.97）、使用4升聚乙二醇泻药（OR 1.45；95%CI：1.02 - 2.06）、未采用SDBP（OR 1.96；95%CI：1.31 - 2.93）以及本次结肠镜检查未完成泻药服用（OR 1.66；95%CI：1.01 - 2.73）。在将不愿与愿意或中立进行比较时，以及在有序逻辑回归分析中，确定了大多数相同的预测因素。
近四分之三的患者对于早起进行BP并不表示不愿。在那些不愿的患者中，改善BP信息、减轻与BP相关的焦虑以及使用小剂量BP可能会增加对SDBP的接受度。
