title: An evaluation of patient attitudes to colonoscopy and the importance of endoscopist interaction and the endoscopy environment to satisfaction and value.
abstract: OBJECTIVE
  Understanding patients' attitudes to their medical experience is essential for identifying value in the patient pathway, optimizing care and use of resources. This service evaluation was undertaken to determine patients' preferences and expectations for day case colonoscopy, a common gastrointestinal procedure for which there is limited such data.
  
  
  METHODS
  Patients attending for elective colonoscopy were invited to complete a composite, validated dedicated endoscopy questionnaire, with Likert-scale questions and a 15-point preference (ranking) scale of domains of endoscopy care that were considered most important (1) to least important (15) as contributing to a satisfactory experience.
  
  
  RESULTS
  Two hundred and sixteen out of 224 patients returned questionnaires. Moderate to severe anxiety was recorded in 56% of patients, commonly with respect to anticipation of pain or the results of the procedure. The median values for ranked preference scores consistent with greatest importance for satisfaction were technical skill of the endoscopist (1), discomfort during the procedure (4), and manner of the endoscopist (5). Factors considered of relatively low importance included the single-sex environment (15) (although this was more important to female patients), noise levels (13), and explanation of delay (11). Only 14% of patients responded that they would be prepared to delay an appointment for a single-sex environment.
  
  
  CONCLUSIONS
  Patients undergoing colonoscopy highly prioritize aspects of care relating to the interaction with the endoscopist and the procedure itself. Environment factors are considered to be less important. These findings may assist in service redesign around patient-identified value within the patient pathway.
authors: Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK.
authors: Jude
authors: J
authors: McEntire
authors: Jagdeep
authors: J
authors: Sahota
authors: Theresa
authors: T
authors: Hydes
authors: Timothy Mark
authors: TM
authors: Trebble
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D002983:Clinical Competence; D003113:Colonoscopy / Q000009:adverse effects / Q000523:psychology*; D005260:Female; D006272:Health Facility Environment; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult