Neilson Laura J, Patterson Joanne, von Wagner Christian, Hewitson Paul, McGregor Lesley M, Sharp Linda, Rees Colin J
Department of Gastroenterology, South Tyneside District Hospital, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK.
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK.
Frontline Gastroenterol. 2020 Jan 13;11(3):209-217. doi: 10.1136/flgastro-2019-101321. eCollection 2020.
Measuring patient experience is important for evaluating the quality of patient care, identifying aspects requiring improvement and optimising patient outcomes. Patient Reported Experience Measures (PREMs) should, ideally, be patient derived, however no such PREMs for gastrointestinal (GI) endoscopy exist. This study explored the experiences of patients undergoing GI endoscopy and CT colonography (CTC) in order to: identify aspects of care important to them; determine whether the same themes are relevant across investigative modalities; develop the framework for a GI endoscopy PREM.
Patients aged ≥18 years who had undergone oesophagogastroduodenoscopy (OGD), colonoscopy or CTC for symptoms or surveillance (but not within the national bowel cancer screening programme) in one hospital were invited to participate in semi-structured interviews. Recruitment continued until data saturation. Inductive thematic analysis was undertaken.
35 patients were interviewed (15 OGD, 10 colonoscopy, 10 CTC). Most patients described their experience chronologically, and five 'procedural stages' were evident: before attending for the test; preparing for the test; at the hospital, before the test; during the test; after the test. Six themes were identified: anxiety; expectations; choice & control; communication & information; comfort; embarrassment & dignity. These were present for all three procedures but not all procedure stages. Some themes were inter-related (eg, expectations & anxiety; communication & anxiety).
We identified six key themes encapsulating patient experience of GI procedures and these themes were evident for all procedures and across multiple procedure stages. These findings will be used to inform the development of the Newcastle ENDOPREM™.
衡量患者体验对于评估患者护理质量、识别需要改进的方面以及优化患者治疗效果至关重要。理想情况下,患者报告体验测量指标(PREMs)应由患者得出,但目前尚无针对胃肠(GI)内镜检查的此类指标。本研究探讨了接受GI内镜检查和CT结肠成像(CTC)的患者的体验,目的是:确定对他们重要的护理方面;确定相同主题在不同检查方式中是否相关;制定GI内镜检查PREM的框架。
邀请一家医院中因症状或监测(但不在国家肠癌筛查计划内)接受过食管胃十二指肠镜检查(OGD)、结肠镜检查或CTC的18岁及以上患者参加半结构化访谈。招募持续进行直至数据饱和。进行归纳主题分析。
对35名患者进行了访谈(15名接受OGD,10名接受结肠镜检查,10名接受CTC)。大多数患者按时间顺序描述了他们的体验,五个“程序阶段”很明显:在前往检查之前;为检查做准备;在医院,检查前;检查期间;检查后。确定了六个主题:焦虑;期望;选择与控制;沟通与信息;舒适度;尴尬与尊严。所有三种检查都存在这些主题,但并非所有程序阶段都有。一些主题相互关联(例如,期望与焦虑;沟通与焦虑)。
我们确定了六个关键主题,概括了患者对GI检查的体验,这些主题在所有检查和多个程序阶段都很明显。这些发现将用于为纽卡斯尔ENDOPREM™的开发提供信息。