title: High level of patient satisfaction and comfort during diagnostic urological procedures performed by urologists and residents.
abstract: OBJECTIVE
  The aim of this study was to investigate how patients experience diagnostic urological procedures performed by urologists, junior residents and senior residents, and to assess the influence of procedure-related factors on patient experiences.
  
  
  METHODS
  Data were collected during 222 procedures: 84 transrectal ultrasound-guided prostate biopsies (TRUSP; urologists n = 39, residents n = 45) and 138 urethrocystoscopies (UCS; urologists n = 44, residents n = 94) in six hospitals. Patient experiences were assessed using a questionnaire focusing on pain, comfort and satisfaction (visual analogue scale, 0-10) and communication aspects on a four-point Likert scale. Clinical observations were made to identify influencing factors.
  
  
  RESULTS
  Median values for patient experiences across procedures were 10 (range 5-10) for patient satisfaction, 2 (0-9) for pain and 8 (0-10) for comfort. Generalized estimating equations revealed no significant differences between urologists, senior residents and junior residents in terms of experienced patient comfort, satisfaction or pain. Procedural time was longer for residents, but this did not correlate significantly with patient-experienced comfort (p = 0.3). In UCS, patient comfort and satisfaction were higher in the supine position for male and female patients, respectively (p < 0.01). In TRUSP, local anaesthesia resulted in a significant decrease in pain (p = 0.002) and an increase in comfort (p = 0.03). Finally, older patients experienced less pain and gave higher comfort and satisfaction responses than younger patients.
  
  
  CONCLUSIONS
  Patients expressed high levels of satisfaction and comfort during diagnostic urological procedures. Experiences were not affected by the level of training, suggesting highly developed interpersonal and communication skills for residents in an early stage of residency training. Patients demonstrated significant preferences for local anaesthesia in TRUSP and performance of UCS in the supine position over the lithotomy position.
authors.affiliation: a Department of Urology , Catharina Hospital , Eindhoven , The Netherlands ;
authors.forename: A H
authors.initials: AH
authors.lastname: de Vries
authors.affiliation: b Department of Urology , Westfriesgasthuis , Hoorn , The Netherlands ;
authors.forename: E
authors.initials: E
authors.lastname: Lesterhuis
authors.affiliation: c Netherlands Institute for Health Services Research (NIVEL) , Utrecht , The Netherlands ;
authors.forename: L M
authors.initials: LM
authors.lastname: Verweij
authors.affiliation: c Netherlands Institute for Health Services Research (NIVEL) , Utrecht , The Netherlands ;|d Department of Urology , Alrijne Hospital , Leiden , The Netherlands ;
authors.forename: B M A
authors.initials: BM
authors.lastname: Schout
authors.affiliation: e Department of Urology , VU Medical Center , Amsterdam , The Netherlands ;
authors.forename: H J R
authors.initials: HJ
authors.lastname: van der Horst
authors.affiliation: f Department of Educational Development and Research , School of Health Professions Education, Maastricht University , Maastricht , The Netherlands ;
authors.forename: J
authors.initials: J
authors.lastname: Leppink
authors.affiliation: a Department of Urology , Catharina Hospital , Eindhoven , The Netherlands ;|g Faculty of Health, Medicine and Life Sciences, Maastricht University , Maastricht , The Netherlands ;
authors.forename: E L
authors.initials: EL
authors.lastname: Koldewijn
authors.affiliation: c Netherlands Institute for Health Services Research (NIVEL) , Utrecht , The Netherlands ;|h Department of Public and Occupational Health , EMGO Institute for Health and Care Research , Amsterdam , The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Wagner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003950:Diagnostic Techniques, Urological / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D017060:Patient Satisfaction; D057566:Self Report; D014572:Urology; D055815:Young Adult
keywords: Non-technical skills; patient experience; patient satisfaction; resident; transrectal ultrasound-guided prostate biopsy; urethrocystoscopy