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.
Cite this paper
Day, L. , Nazareth, M. and Sewell, J. (2013) Patient preferences and factors related to the pre-procedure process at a large, urban county hospital. Open Journal of Gastroenterology, 3, 5-11. doi: 10.4236/ojgas.2013.31002.
 Fidler, H., Hartnett A., Cheng, M.K., Derbyshire, I. and Sheil, M. (2000) Sex and familiarity of colonoscopists: Patient preferences. Endoscopy, 32, 481-482.
 Varadarajulu, S., Petruff, C. and Ramsey, W.H. (2002) Patient preferences for gender of endoscopists. Gastrointestinal Endoscopy, 56, 170-173.
 Schneider, A., Kanagarajan, N., Anjelly, D., Reynolds, J.C. and Ahmad, A. (2009) Importance of gender, socioeconomic status, and history of abuse on patient preference for endoscopist. American Journal of Gastroenterology, 104, 340-348. doi:10.1038/ajg.2008.96
 Subramanian, S., Liangpunsakul, S. and Rex, D.K. (2005) Preprocedure patient values regarding sedation for colonoscopy. Journal of Clinical Gastroenterol, 39, 516-519.
 Chartier, L., Arthurs, E. and Sewitch, M.J. (2009) Patient satisfaction with colonoscopy: A literature review and pilot study. Canadian Journal of Gastroenterology, 23, 203-209.
 Kowalski, T., Edmundowicz, S. and Vacante, N. (2004) Endoscopy unit form and function. Gastrointestinal Endoscopy Clinics of North America, 14, 657-666.
 Marasco, J.A. and Marasco, R.F. (2002) Designing the ambulatory endoscopy center. Gastrointestinal Endosco py Clinics of North America, 12, 185-204.
 Petersen, B.T. (2006) Promoting efficiency in gastrointestinal endoscopy. Gastrointestinal Endoscopy Clinics of North America, 16, 671-685.
 SGNA Position Statement (2002) Minimal registered nurse staffing for patient care in the gastrointestinal endoscopy unit. Gastroenterology Nursing, 25, 269-270.
 Al-Kawas, F.H. and Brugge, W.R. (2008) Report of the first endoscopy unit directors meeting: March 29-30, 2008, Georgetown University Conference Center, Washington DC. Gastrointestinal Endoscopy, 68, 1153-1157.
 Harewood, G.C., Chrysostomou, K., Himy, N. and Leong, W.L. (2008) A “time-and-motion” study of endoscopic practice: Strategies to enhance efficiency. Gastrointestinal Endoscopy, 68, 1043-1050.
 Johanson, J.F., Overholt, B.F. and Frakes, J.T. (1999) Characteristics of best gastroenterology practices. American Journal of Gastroenterology, 94, 2519-2530.
 Brandt, L.J. (2001) Patients’ attitudes and apprehensions about endoscopy: How to calm troubled waters. American Journal of Gastroenterology, 96, 280-284.
 Johnson, J.E., Morrissey, J.F. and Leventhal, H. (1973) Psychological preparation for an endoscopic examination. Gastrointestinal Endoscopy, 19, 180-182.
 Hayes, A., Buffum, M., Lanier, E., Rodahl, E. and Sasso, C. (2003) A music intervention to reduce anxiety prior to gastrointestinal procedures. Gastroenterology Nursing, 26, 145-149. doi:10.1097/00001610-200307000-00002
 Salmore, R.G. and Nelson, J.P. (2000) The effect of preprocedure teaching, relaxation instruction, and music on anxiety as measured by blood pressures in an outpatient gastrointestinal endoscopy laboratory. Gastroenterology Nursing, 23, 102-110.
 Bechtold, M.L., Puli, S.R., Othman, M.O., Bartalos, C.R., Marshall, J.B. and Roy, P.K. (2009) Effect of music on patients undergoing colonoscopy: A meta-analysis of randomized controlled trials. Digestive Diseases and Sciences, 54, 19-24. doi:10.1007/s10620-008-0312-0
 El-Hassan, H., McKeown, K. and Muller, A.F. (2009) Clinical trial: Music reduces anxiety levels in patients attending for endoscopy. Alimentary Pharmacology & Therapeutics, 30, 718-724.
 Inadomi, J.M., Vijan, S., Janz, N.K., et al. (2012) Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Archives of Internal Medicine, 172, 575-582. doi:10.1001/archinternmed.2012.332
 Schoenfelder, T., Klewer, J. and Kugler J. (2010) Factors associated with patient satisfaction in surgery: The role of patients’ perceptions of received care, visit characteristics, and demographic variables. Journal of Surgical Research, 164, e53-e59. doi:10.1016/j.jss.2010.08.001