Audit of sedated versus unsedated gastroscopy: Do patients notice a difference?

Jonathan Peter Watson MA, MBBCh, MRCP, PhD, FRACP, Carmel Goss RN, Grant Phelps MBBS, FRACP
{"title":"Audit of sedated versus unsedated gastroscopy: Do patients notice a difference?","authors":"Jonathan Peter Watson MA, MBBCh, MRCP, PhD, FRACP,&nbsp;Carmel Goss RN,&nbsp;Grant Phelps MBBS, FRACP","doi":"10.1111/j.1440-1762.2001.00391.pp.x","DOIUrl":null,"url":null,"abstract":"<p> <b>Abstract</b> Unsedated diagnostic gastroscopy has become widely accepted as a diagnostic procedure which avoids the risk of an anaesthetic. It also provides advantages for patients and hospitals in converting the procedure to an ambulatory care investigation. Patient perception of the procedure can sometimes differ from that of medical and nursing staff. We have decided to report our usual clinical practice by auditing 100 consecutive patients undergoing this procedure in a large rural private hospital. Patient tolerance was analyzed in various categories including degree of comfort, degree of pain, ease of breathing and willingness to repeat the procedure under the same conditions. The perceived comfort rating was compared between the patient, the endoscopist and the endoscopy nurse. A total of 100 consecutive patients were evaluated; 55 chose to be sedated and 45 were unsedated. Of the 100 patients tested, 88% stated they would have the procedure the same way if a repeat procedure was required. There was no significant difference between male/female or sedated/unsedated patients. The most important consideration for patients who chose to have the procedure unsedated was the ability to speak to the endoscopist immediately post-procedure. Patient rating of pain was not significantly different between the sedated and unsedated groups. There was no significant difference in the independent assessment by the endoscopist and the nurse with respect to patient comfort in both the sedated and the unsedated groups. However, their assessment differed significantly from the patients own rating, as endoscopists and gastrointestinal (GI) nurses rated the patient degree of comfort as higher than the patients themselves (<i>P</i> &lt; 0.01 for doctor/patient and nurse/patient score, Student’s <i>t</i>-test). No complications were reported in either group of patients during the audit. Unsedated diagnostic gastroscopy is perceived to be an acceptable alternative to a sedated procedure by the majority of patients. Patients rate the procedure as more uncomfortable than their health care professionals, but the majority of patients would still have the repeat procedure the same way.</p>","PeriodicalId":79407,"journal":{"name":"Journal of quality in clinical practice","volume":"21 1-2","pages":"26-29"},"PeriodicalIF":0.0000,"publicationDate":"2008-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1440-1762.2001.00391.pp.x","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of quality in clinical practice","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/j.1440-1762.2001.00391.pp.x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

Abstract Unsedated diagnostic gastroscopy has become widely accepted as a diagnostic procedure which avoids the risk of an anaesthetic. It also provides advantages for patients and hospitals in converting the procedure to an ambulatory care investigation. Patient perception of the procedure can sometimes differ from that of medical and nursing staff. We have decided to report our usual clinical practice by auditing 100 consecutive patients undergoing this procedure in a large rural private hospital. Patient tolerance was analyzed in various categories including degree of comfort, degree of pain, ease of breathing and willingness to repeat the procedure under the same conditions. The perceived comfort rating was compared between the patient, the endoscopist and the endoscopy nurse. A total of 100 consecutive patients were evaluated; 55 chose to be sedated and 45 were unsedated. Of the 100 patients tested, 88% stated they would have the procedure the same way if a repeat procedure was required. There was no significant difference between male/female or sedated/unsedated patients. The most important consideration for patients who chose to have the procedure unsedated was the ability to speak to the endoscopist immediately post-procedure. Patient rating of pain was not significantly different between the sedated and unsedated groups. There was no significant difference in the independent assessment by the endoscopist and the nurse with respect to patient comfort in both the sedated and the unsedated groups. However, their assessment differed significantly from the patients own rating, as endoscopists and gastrointestinal (GI) nurses rated the patient degree of comfort as higher than the patients themselves (P < 0.01 for doctor/patient and nurse/patient score, Student’s t-test). No complications were reported in either group of patients during the audit. Unsedated diagnostic gastroscopy is perceived to be an acceptable alternative to a sedated procedure by the majority of patients. Patients rate the procedure as more uncomfortable than their health care professionals, but the majority of patients would still have the repeat procedure the same way.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
镇静与非镇静胃镜检查的审计:患者是否注意到差异?
非镇静诊断胃镜检查已成为广泛接受的诊断程序,以避免风险的麻醉。它还为患者和医院提供了将程序转换为门诊护理调查的优势。病人对手术的看法有时可能与医护人员不同。我们决定报告我们的常规临床实践,通过审计100名连续患者在一个大型农村私立医院接受这种程序。对患者的耐受性进行分类分析,包括舒适度、疼痛程度、呼吸的容易程度和在相同条件下重复手术的意愿。比较患者、内窥镜医师和内窥镜护士的感知舒适度。共对100例连续患者进行评估;55人选择镇静,45人不选择镇静。在接受测试的100名患者中,88%的人表示,如果需要重复手术,他们会以同样的方式进行手术。男性/女性、镇静/未镇静患者之间无显著差异。对于选择非镇静手术的患者来说,最重要的考虑因素是术后立即与内窥镜医师交谈的能力。在镇静组和未镇静组之间,患者的疼痛评分无显著差异。内窥镜医师和护士对镇静组和非镇静组患者舒适度的独立评估无显著差异。然而,他们的评估与患者自己的评分有显著差异,因为内镜医师和胃肠道(GI)护士对患者舒适程度的评分高于患者自己(P <医生/病人和护士/病人评分为0.01,学生t检验)。两组患者在审核期间均无并发症报告。大多数患者认为非镇静诊断性胃镜检查是一种可接受的替代镇静手术。患者认为手术比他们的医疗保健专业人员更不舒服,但大多数患者仍然会以同样的方式重复手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Health technology assessment. Notices Letters to the Editor Notices Author index
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1