TITLE:
Patient preferences and factors related to the pre-procedure process at a large, urban county hospital
AUTHORS:
Lukejohn W. Day, Michelle Nazareth, Justin L. Sewell
KEYWORDS:
Pre-Procedure Process; Quality; Endoscopy; Patient Preferences
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.3 No.1,
February
17,
2013
ABSTRACT:
Background:
Evaluation of the pre-procedural process prior to endoscopic procedures has
never been conducted. Methods: Prospective
cross-sectional, multi-language survey was administered to outpatients
undergoing endoscopy at a large, diverse county hospital that examined
patients’ pre-procedural preferences. Multivariate logistic regression was
used to assess the relationship between patient preferences and several patient-related variables. Results: 128/156 outpatients completed the survey. The majority of respondents were
female (53.1%), did not speak English (61.7%), were of Asian (39.1%) or
Hispanic (29.7%) racial background, and had a mean age of 56.1 ± 15.7 years.
Most patients underwent colonoscopy (48.4%) with 90.6% of patients knowing
the indication for their procedure. While waiting for their endoscopic
procedure, 42.2% of patients preferred waiting in a gurney while 28.1%
preferred to wait in a chair. In terms of being comfortable wearing a hos- pital
gown and sitting in a chair or gurney in the pre-procedure area, mean patient
anxiety scores were 5.2 ± 3.3 and 6.1 ± 3.2, respectively (scale of 1 - 10).
Race was associated with several pre-procedural patient preferences;
Hispanics were less comfortable than Asians wearing a hospital gown while
sitting in a chair with other patients prior to their procedure (OR = 0.3, CI
0.1 - 1.0) while Whites and African-Americans were less likely than Asians to
prefer sitting in a chair as compared to a gurney before their procedure (OR = 0.09,
CI 0.008 - 0.9 and OR = 0.07, CI 0.007 - 0.8, respectively). Patients who had
undergone a prior endoscopic procedure were less comfortable wearing a hospital
gown and sitting in a chair (OR = 0.3, CI 0.1 - 0.7) or gurney (OR = 0.4, CI
0.2 - 1.0) in the pre-procedure area. Conclusion: A patient’s race and having had a prior endoscopic procedure were the most
powerful predictors on pre-procedure patient preferences while sex, type of
endoscopic procedure and patient knowledge of the indication for their
procedure were not. Our study highlights the importance of patient
preferences and factors involved in the pre procedure process at a large,
diverse county hospital.