title: Development and validation of a nurse-assessed patient comfort score for colonoscopy.
abstract: BACKGROUND
  Comfort during colonoscopy is a critical component of safety and quality.
  
  
  OBJECTIVE
  To develop and validate the Nurse-Assessed Patient Comfort Score (NAPCOMS).
  
  
  METHODS
  Prospective scale validation.
  
  
  METHODS
  Colorectal cancer screening centers in the United Kingdom and Canada.
  
  
  METHODS
  A total of 300 consecutive patients undergoing colonoscopy at participating colorectal cancer screening centers.
  
  
  METHODS
  The NAPCOMS was developed by using a modified Delphi process. During colonoscopy, 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  NAPCOMS is a reliable and valid tool for assessing patient comfort in the setting of outpatient colonoscopy performed with minimal to moderate sedation.
authors: Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada. arostom@ucalgary.ca
authors: Alaa
authors: A
authors: Rostom
authors: Erin D
authors: ED
authors: Ross
authors: Catherine
authors: C
authors: Dubé
authors: Matthew D
authors: MD
authors: Rutter
authors: Thomas
authors: T
authors: Lee
authors: Roland
authors: R
authors: Valori
authors: Ronald J
authors: RJ
authors: Bridges
authors: Darlene
authors: D
authors: Pontifex
authors: Veronica
authors: V
authors: Webbink
authors: Colin
authors: C
authors: Rees
authors: Carly
authors: C
authors: Brown
authors: Deborah H
authors: DH
authors: Whetter
authors: Susan G
authors: SG
authors: Kelsey
authors: Robert J
authors: RJ
authors: Hilsden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D003113:Colonoscopy / Q000009:adverse effects / Q000451:nursing*; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000451:nursing*; D010147:Pain Measurement / Q000451:nursing*; D017060:Patient Satisfaction; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult