Screening flexible sigmoidoscopy: patient attitudes and compliance.
OBJECTIVE
To measure patients' expectations and attitudes about screening flexible sigmoidoscopy and their discomfort during the procedure, and to identify factors affecting compliance among patients scheduled for sigmoidoscopy.


METHODS
Patient survey at the time sigmoidoscopy was ordered and again one week after the procedure was performed.


METHODS
An academic general internal medicine practice.


METHODS
105 consecutive patients scheduled for screening flexible sigmoidoscopy.


RESULTS
Seventy-five percent of patients (79/105) scheduled for sigmoidoscopy complied with the procedure. Compliance was higher among men and among patients who had family histories of colon cancer. Although many patients experienced moderate to extreme embarrassment (27%), discomfort (42%), and pain (31%), patients experienced less embarrassment (p = 0.03) and pain (p = 0.02) than they had expected. Patients aged 65 years and older were twice as likely as younger ones (52% versus 25%) to experience moderate to extreme pain (p = 0.04). Only 1.4% of patients reported that they would probably not have the test again.


CONCLUSIONS
Although flexible sigmoidoscopy is an uncomfortable procedure for some patients, especially those aged 65 and older, in general it is not as bad as patients expect and most would have the test again. Therefore, rather than assuming sigmoidoscopy is too uncomfortable for all patients to tolerate as a screening test, clinicians should inform their patients about the potential benefits and risks of sigmoidoscopy and about what the patient can expect during the procedure, thus enabling the patient to make an informed decision about whether to undergo screening sigmoidoscopy.
McCarthy
B D
BD
Evans Department of Clinical Research, University Hospital, Boston University Medical Center, Massachusetts.
Moskowitz
M A
MA
D000368:Aged; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000523:psychology; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D010349:Patient Compliance; D017060:Patient Satisfaction; D012812:Sigmoidoscopy / Q000523:psychology*; D011795:Surveys and Questionnaires