Endoscopic surveillance for Barrett's oesophagus: the patients' perspective.
OBJECTIVE
Barrett's oesophagus (BO) is associated with the development of oesophageal adenocarcinoma and endoscopic surveillance is commonly practised. In view of the clinical, psychological and economic implications of BO, we have studied patients' attitudes towards surveillance, their levels of anxiety and quality of life.


METHODS
Patients with BO undergoing endoscopic surveillance were asked to complete a questionnaire,including seven questions on their experience of surveillance, the Hospital Anxiety and Depression Scale,the Trust in Physician Scale (TIPS) and the Short Form-36 quality of life questionnaire.


RESULTS
Of the 250 patients invited, 178 responded (71%).One hundred and fifty-one (60%) completed the questionnaire sufficiently for analysis [median age 66 (range 41-79) years, 101 male]. Twenty-nine percent of patients had received too little information concerning surveillance of BO and 22% no information at all. Information was deemed difficult to understand by 24%. Hospital Anxiety and Depression Scale anxiety score: 14%abnormal, 25% borderline. Quality of life was lower than the general population in seven of eight Short Form-36 parameters. Increasing TIPS score correlated with having received (r= 0.33, P <0.001) and understood (r = 0.2, P= 0.037) BO information, and negatively with the belief that endoscopic surveillance reduced oesophageal adenocarcinoma risk (r= - 0.19, P =0.025). Increasing TIPS score was associated with less anxiety (P= 0.015) and depression (P =0.001), and better quality of life.


CONCLUSIONS
Patients undergoing endoscopic surveillance for BO suffer anxiety and have impaired quality of life. As trust in their physicians is correlated with receiving sufficient BO information, we surmise that ensuring BO patients understand their condition is likely to improve quality of life, anxiety and depression.
Cooper
Sheldon C
SC
Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK.
El-agib
Amul
A
Dar
Sadaf
S
Mohammed
Imtiyaz
I
Nightingale
Peter
P
Murray
Iain A
IA
Cooper
Brian T
BT
Trudgill
Nigel J
NJ
D000230:Adenocarcinoma / Q000473:pathology / Q000523:psychology*; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001471:Barrett Esophagus / Q000473:pathology / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D055088:Early Detection of Cancer; D004739:England; D004938:Esophageal Neoplasms / Q000473:pathology / Q000523:psychology*; D004945:Esophagoscopy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome