Mahajan R J, Johnson J C, Marshall J B
Division of Gastroenterology, University of Missouri Health Sciences Center, Columbia 65212, USA.
J Clin Gastroenterol. 1997 Jun;24(4):220-3. doi: 10.1097/00004836-199706000-00007.
We examined a number of patient variables, including three different scales of preprocedure patient anxiety, to determine which best predicted patient cooperation and satisfaction with gastrointestinal endoscopy. We prospectively evaluated 251 patients undergoing outpatient diagnostic esophagogastroduodenoscopy and colonoscopy under conscious sedation. All were given a questionnaire on arrival to our endoscopy center that included three measures of preprocedure anxiety: (a) a single question asking how anxious the patient was (termed "Anxiety I" scale); (b) a visual linear analog scale of anxiety; and (c) the Hospital Anxiety and Depression scale. Patient cooperation during the procedure was rated by the attending endoscopist. Patients were telephoned the next day to complete a questionnaire assessing their endoscopic experience. Logistic regression analysis was used to construct models for predicting which patients were most likely to have difficulty during their procedures from both the endoscopists' and the patients' standpoint. Statistical analysis identified three parameters that by themselves significantly correlated with patient cooperation during endoscopy: age (p = 0.008), Anxiety I scale (p = 0.03), and visual linear analog anxiety score (p = 0.02). When used together, age, type of procedure, and Anxiety I scale were the best predictors of patient cooperation from the standpoint of the endoscopist. Age, type of procedure, Anxiety I scale, and education level were the best predictors of satisfaction with endoscopy from the perspective of the patient. Good cooperation during endoscopy was associated with greater patient satisfaction.
我们检查了一些患者变量，包括三种不同的术前患者焦虑量表，以确定哪一种最能预测患者对胃肠内镜检查的配合程度和满意度。我们前瞻性地评估了251例在清醒镇静下接受门诊诊断性食管胃十二指肠镜检查和结肠镜检查的患者。所有患者在抵达我们的内镜中心时都收到了一份问卷，其中包括三种术前焦虑测量方法：(a) 一个询问患者有多焦虑的单一问题（称为“焦虑I”量表）；(b) 焦虑视觉线性模拟量表；(c) 医院焦虑抑郁量表。手术过程中患者的配合程度由主治内镜医师进行评分。第二天给患者打电话，让他们完成一份评估内镜检查体验的问卷。逻辑回归分析用于构建模型，从内镜医师和患者的角度预测哪些患者在手术过程中最有可能遇到困难。统计分析确定了三个自身与内镜检查期间患者配合程度显著相关的参数：年龄（p = 0.008）、焦虑I量表（p = 0.03）和视觉线性模拟焦虑评分（p = 0.02）。从内镜医师的角度来看，年龄、手术类型和焦虑I量表一起使用时，是患者配合程度的最佳预测指标。从患者的角度来看，年龄、手术类型、焦虑I量表和教育水平是内镜检查满意度的最佳预测指标。内镜检查期间的良好配合与更高的患者满意度相关。
