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Kılınç T, Karaman Özlü Z, İlgin VE, Yayla A, Dişçi E. The Effect of Informing Patients Who Will Undergo a Colonoscopy via Short Messaging Service on the Procedure Quality and Satisfaction: An Endoscopist-Blinded, Randomized Controlled Trial. J Perianesth Nurs 2024; 39:447-454. [PMID: 37999686 DOI: 10.1016/j.jopan.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 08/24/2023] [Accepted: 09/14/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE The present research was carried out to determine the impact of informing patients who would undergo a colonoscopy via short messaging service (SMS) on the procedure quality and satisfaction. DESIGN The study was designed as a randomized controlled experimental and single-blind. METHODS The study was completed with 170 patients (87 in the control group and 83 in the intervention group). Verbal and written information about bowel preparation was provided to all patients at the first appointment. Additionally, a total of nine informative SMS, including the time of colonoscopy, dietary restrictions to be followed, purgative drugs to be used, and the time of taking the drugs, were sent to the patients in the intervention group starting 2 days before the procedure. Data were collected using a patient questionnaire, Boston Bowel Preparation Scale (BBPS), and postcolonoscopy follow-up form. FINDINGS The mean score of each colon segment and the total BBPS mean score of the patients in the intervention group were higher compared to the control group, and the difference between them was statistically significant. The percentage of patients with adequate bowel preparation was significantly higher in the intervention group (84.3%) in comparison with the control group (71.3%). The intervention group had high compliance with a clear diet, enema application, and oral medication intake (P < .05). The cecum was reached in 85.5% of the intervention group. The majority of the patients (89.2%) in the intervention group reported that the information provided via SMS was adequate, and 91.6% were satisfied with the information provided by SMS. CONCLUSIONS The study shows that, in addition to written and verbal information provided before colonoscopy, SMS information positively impacts the quality of patients' bowel preparation, increases their compliance with the preparation instructions, the rate of reaching the cecum, and their satisfaction. Patient education with this practice can help ensure adequate bowel preparation quality and increase patient comfort in the colonoscopy procedure.
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Affiliation(s)
- Tülay Kılınç
- Faculty of Nursing, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey.
| | - Zeynep Karaman Özlü
- Faculty of Nursing, Department of Surgical Nursing, Anesthesiology Clinical Research Office, Ataturk University, Erzurum, Turkey
| | - Vesile Eskici İlgin
- Faculty of Nursing, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey
| | - Ayşegül Yayla
- Faculty of Nursing, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey
| | - Esra Dişçi
- Faculty of Medicine, Department of General Surgery, Atatürk University, Erzurum, Turkey
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Shiang A, Wang JS, Cho DH, Kushner B, Panahi AK, Awad MM. Patient Factors Affect Ergonomic Strain of Endoscopists During Colonoscopy. Dig Dis Sci 2023; 68:736-743. [PMID: 36352078 DOI: 10.1007/s10620-022-07721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Endoscopic procedures place a great deal of muscular strain on providers, especially over the span of their careers. In this study we quantitatively analyzed the effects of patient factors such as age, body mass index, and sex on the ergonomics of endoscopists performing colonoscopies. METHODS Surface electromyography (sEMG) was used to measure ergonomic strain of physicians while performing colonoscopies in several key muscle groups. The percent of the maximum voluntary contraction (%MVC) was used as a measure of muscular strain. Data was then analyzed based on the patient characteristics above. RESULTS Endoscopists performing colonoscopies on female patients (n = 47) experienced significantly higher ergonomic strain in their right trapezius and right posterior forearm muscle groups when compared to colonoscopies performed on males (n = 35) (%MVC R-trapezius: Male: 8.2; Female: 8.9; p = 0.048); (%MVC R-posterior forearm: Male: 10.4; Female: 11.6; p = 0.0006). Operators experienced greater strain in the same muscle groups when performing colonoscopies on patients with BMI ≤ 25 (n = 25) when compared to patients with BMI > 25 (n = 57) (%MVC R-trapezius: BMI < 25: 9.7; BMI ≥ 25: 8.2; p = 0.0002); (%MVC R-posterior forearm: BMI < 25: 11.9; BMI ≥ 25: 10.8; p = 0.0001). CONCLUSION Physicians experienced greater ergonomic strain when performing colonoscopies on female patients and on patients with a BMI < 25. We believe that these factors potentially impact the tortuosity of the colon and therefore influence the difficulty of navigating the endoscope. These results may aid physicians in gauging the anticipated difficulty of colonoscopies based on patient factors. Increased awareness of their posturing and ergonomics during challenging cases will alleviate musculoskeletal injuries in the long run.
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Affiliation(s)
- Alexander Shiang
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA.
| | - Jean S Wang
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA
| | | | - Bradley Kushner
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA
| | - Ali K Panahi
- Nova Southeastern University, Fort Lauderdale, USA
| | - Michael M Awad
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA
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Wang K, Xu WT, Kou WJ, Qi XS. Factors affecting cecal intubation time during colonoscopy. Shijie Huaren Xiaohua Zazhi 2023; 31:105-112. [DOI: 10.11569/wcjd.v31.i3.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
In recent years, the morbidity and mortality of colorectal cancer (CRC) have increased significantly in China, and it has become one of the major malignancies that threaten the health of residents. Colonoscopy is the gold standard for the diagnosis of CRC. High-quality colonoscopy can effectively reduce the mortality of CRC. Cecal intubation time (CIT) is one of the indicators to reflect the quality of colonoscopy. Studies have found that many factors can affect CIT. This paper reviews the literature to identify the factors that affect CIT, such as those related to doctors, patients, assistive technologies, and equipment, in order to improve the quality of colonoscopy performed by endoscopists.
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Affiliation(s)
- Ke Wang
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Postgraduate College, China Medical University, Shenyang 110122, Liaoning Province, China
| | - Wen-Tao Xu
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China,Postgraduate College, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China
| | - Wen-Jing Kou
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
| | - Xing-Shun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
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Gender Differences in Colonoscopy: Implications for Clinical Practice and Female Gastroenterologists. Dig Dis Sci 2022; 67:810-816. [PMID: 34114156 DOI: 10.1007/s10620-021-07079-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/27/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIMS Performing colonoscopy can be technically challenging in female patients. Female patients may prefer having a female endoscopist. This preference, coupled with the fact that there are fewer female endoscopists, may result in gender differences in colonoscopy practice. We hypothesized that the duration of female colonoscopy is longer and that female endoscopists perform a higher proportion of female colonoscopy than male colleagues. We explored the potential revenue implications of gender differences in screening colonoscopy. METHODS We analyzed procedure time and gender differences in 16,573 screening colonoscopies performed by 27 male and 7 female endoscopists over a three-year period in one large academic practice. We modeled the potential revenue impacts of differences in procedure duration, proportion of female colonoscopy and the frequency of detected adenomas. RESULTS We found that screening colonoscopy takes 8.8% more time to complete in female patients compared to male patients for all endoscopists (p < 0.001), and that female endoscopists perform an average of 71.2% female exams compared to male endoscopists, who perform an average of 50.8% female exams (p < 0.001). Female patients had a lower detection adenoma rate (ADR), reducing the frequency of polypectomy and reimbursement in an RVU model. The observed gender differences could account for an estimated 9.6% revenue loss per 8-h session for a female gastroenterologist performing screening colonoscopy compared to a male counterpart. CONCLUSION Longer colonoscopy duration in females, increased proportion of female colonoscopies for female endoscopists and lower ADR in females may contribute to the gender gap in physician pay in gastroenterology.
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Goksoy B, Kiyak M, Karadag M, Yilmaz G, Azamat IF. Factors Affecting Cecal Intubation Time in Colonoscopy: Impact of Obesity. Cureus 2021; 13:e15356. [PMID: 34094787 PMCID: PMC8169101 DOI: 10.7759/cureus.15356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aims to determine the factors that prolong cecal intubation time (CIT) and determine the effect of obesity on CIT measured using multiple indexes. Methods Patients who underwent elective colonoscopy between July 10, 2020, and January 20, 2021, were evaluated in this prospective observational study. Age, gender, constipation, bowel preparation, presence of diverticulosis, previous surgery history, auxiliary maneuver and additional analgesic requirement, cecum intubation length (CL) and obesity indices [body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR)] were analyzed. Factors affecting CIT were assessed by both univariate and multivariate logistic regression (LR) analyses. Results A total of 512 patients were analyzed. Mean CIT was 5.6 ± 1.6 min, and median CIT was 5.17 min. The CIT median was ≤5.17 min in 264 (51.5%) of the patients, and the CIT median was >5.17 min in 248 (48.5%). In the univariate LR results, young age, constipation, poor bowel preparation, increased CL, additional analgesic requirement, low WHtR, and low BMI (<25 kg/m2) were the factors that prolonged CIT (p <0.05). In the multivariate LR analysis results, WHtR >0.5 and BMI >30 kg/m2 were found to be independent factors that decrease CIT [OR: 0.01 (0.01 0.03) p <0.001; OR: 0.28 (0.13 0.57) p <0.001]. Conclusion Younger age, low WHtR, low BMI, increased CL, constipation, inadequate bowel preparation, and the use of extra analgesics were found to be associated with longer CIT. When all factors were evaluated together, obesity measured by only WHtR (>0.5) and BMI (>30 kg/m2) were the best predictors of decreased CIT.
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Affiliation(s)
- Beslen Goksoy
- General Surgery, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, İstanbul, TUR
| | - Mevlut Kiyak
- Gastroenterology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, TUR
| | - Mehmet Karadag
- Biostatistics, School of Medicine, University of Hatay Mustafa Kemal, Hatay, TUR
| | - Gokhan Yilmaz
- General Surgery, Istanbul Medipol University, Istanbul, TUR
| | - Ibrahim F Azamat
- General Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, TUR
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Okagawa Y, Sumiyoshi T, Tomita Y, Oiwa S, Ogata F, Jin T, Yoshida M, Fujii R, Minagawa T, Morita K, Ihara H, Hirayama M, Kondo H. Endocuff-Assisted versus Cap-Assisted Colonoscopy Performed by Trainees: A Retrospective Study. Clin Endosc 2020; 53:339-345. [PMID: 31918537 PMCID: PMC7280843 DOI: 10.5946/ce.2019.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022] Open
Abstract
Background/Aims The adenoma detection rate (ADR) of screening colonoscopies performed by trainees is often lower than that of colonoscopies performed by experts. The effcacy of cap-assisted colonoscopy (CAC) in adenoma detection is well documented, especially that of CACs performed by trainees. Endocuff, a new endoscopic cap, is reportedly useful for adenoma detection; however, no trials have compared the effcacy of Endocuff-assisted colonoscopy (EAC) and CAC conducted by trainees. Therefore, the present study retrospectively compared the effcacy between EAC and CAC in trainees.
Methods This was a single-center, retrospective study involving 305 patients who underwent either EAC or CAC performed by three trainees between January and December 2018. We evaluated the ADR, mean number of adenomas detected per patient (MAP), cecal intubation rate, cecal intubation time, and occurrence of complications between the EAC and CAC groups.
Results The ADR was significantly higher in the EAC group than in the CAC group (54.3% vs. 37.3%, p=0.019), as was the MAP (1.36 vs. 0.74, p=0.003). No significant differences were found between the groups with respect to the cecal intubation rate or cecal intubation time. No major complications occurred in either group.
Conclusions Our results suggest that EAC exhibits increased ADR and MAP compared to CAC when performed by trainees.
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Affiliation(s)
- Yutaka Okagawa
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Tetsuya Sumiyoshi
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Yusuke Tomita
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Shutaro Oiwa
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Fumihiro Ogata
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Takashi Jin
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Masahiro Yoshida
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Ryoji Fujii
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Takeyoshi Minagawa
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Kohtaro Morita
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Hideyuki Ihara
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Michiaki Hirayama
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Hitoshi Kondo
- Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan
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