Development and validation of a nurse-assessed patient comfort score for colonoscopy

被引：57

作者：

Rostom, Alaa ^{[1
,2
,3
]}

Ross, Erin D. ^{[1
]}

Dube, Catherine ^{[1
,2
,3
]}

Rutter, Matthew D. ^{[4
]}

Lee, Thomas ^{[5
]}

Valori, Roland ^{[6
]}

Bridges, Ronald J. ^{[1
]}

Pontifex, Darlene ^{[3
]}

Webbink, Veronica ^{[3
]}

Rees, Colin ^{[7
]}

Brown, Carly ^{[7
]}

Whetter, Deborah H. ^{[4
]}

Kelsey, Susan G. ^{[4
]}

Hilsden, Robert J. ^{[1
,2
,3
]}

机构：

[1] Univ Calgary, Div Gastroenterol, Dept Med, Calgary, AB T2N 4N1, Canada

[2] Univ Calgary, Dept Community Hlth Sci, Calgary, AB T2N 4N1, Canada

[3] Alberta Hlth Serv, Forzani & MacPhail Colon Canc Screening Ctr, Calgary, AB T2N 4N1, Canada

[4] Univ Hosp N Tees, Dept Gastroenterol, Stockton On Tees, Teesside, England

[5] Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[6] NHS Fdn Trust, Gloucestershire Hosp, Gloucester, England

[7] S Tyneside NHS Fdn Trust, S Shields, England

来源：

GASTROINTESTINAL ENDOSCOPY | 2013年 / 77卷 / 02期

关键词：

LOWER GASTROINTESTINAL ENDOSCOPY; QUALITY;

D O I：

10.1016/j.gie.2012.10.003

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Comfort during colonoscopy is a critical component of safety and quality. Objective: To develop and validate the Nurse-Assessed Patient Comfort Score (NAPCOMS). Design: Prospective scale validation. Setting: Colorectal cancer screening centers in the United Kingdom and Canada. Patients: A total of 300 consecutive patients undergoing colonoscopy at participating colorectal cancer screening centers. Intervention: The NAPCOMS was developed by using a modified Delphi process. During colonosco`py, two endoscopy room nurses independently observed and rated patient comfort and tolerability by using NAPCOMS. In addition, endoscopists reported global comfort scores and patients' reported global comfort by using visual 4-point Likert and National Health Service-United Kingdom Global Rating Scales. Main Outcome Measurements: Reliability and validity of NAPCOMS was measured by using intraclass correlations (ICC) between nurse ratings of colonoscopies and between NAPCOMS, endoscopist ratings, and patient ratings of global comfort. Results: The ICC for the overall NAPCOMS was 0.84 (95% confidence interval [CI], 0.80-0.87). There was high agreement between the NAPCOMS and endoscopist ratings of comfort (ICC = 0.77; 95% CI, 0.72-0.81), moderate agreement between the NAPCOMS and patient ratings (ICC = 0.61; 95% CI, 0.53-0.67), and moderate agreement between the endoscopist and patient ratings (ICC = 0.52; 95% CI, 0.43-0.60). Limitations: NAPCOMS was validated in outpatients who received colonoscopy with minimal to moderate sedation as part of a screening and surveillance program, so performance among inpatients or those requiring deep sedation was not tested. Conclusion: NAPCOMS is a reliable and valid tool for assessing patient comfort in the setting of outpatient colonoscopy performed with minimal to moderate sedation. (Gastrointest Endosc 2013; 77: 255-61.)

引用

页码：255 / 261

页数：7

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