Introduction Endoscopic procedures have the potential to be uncomfortable and distressing. Previous studies have suggested nurses are better than endoscopists at gauging patient’s pain during endoscopy, possibly reflecting the endoscopists focus on the procedure as opposed to the nurse whose focus remains on the patient. Currently, there is a paucity of work evaluating distress another important marker of endoscopic tolerability. This study evaluates endoscopists’ and nurses’ ability to gauge patient’s distress during gastrointestinal endoscopic procedures.
Methods Consecutive patients attending for clinically indicated gastrointestinal endoscopy were prospectively recruited from a tertiary referral centre between September 2011 and June 2012. Following informed consent being obtained patients were asked to record distress post endoscopy using a validated numeric rating scale (NRS), with scores recorded between 0 (no distress) and 10 (worst distress imaginable). Endoscopists undertaking the procedure and their assisting nurses were then asked to give their estimates of patient’s distress using the same NRS, with recordings undertaken separately so as not to influence potential outcomes. Data was analysed using SPSS version 20, with a correlation coefficient used to determine levels of agreement in distress scores.
Results 929 patients were recruited to the study (425 (46%) male, median age of 58 years, range 17–92 years). Of these, 306 (33%) underwent an OGD, 304 (33%) had a colonoscopy, 100(11%) had a flexible sigmoidoscopy, 86 (9%) had an endoscopic ultrasound, 100 (11%) had an ERCP and 33 (4%) had a double balloon enteroscopy. 319 (34%) of the patients recruited had NRS scores > 5 for distress, with multivariate analysis identifying pre-procedure anxiety (p < 0.0001) as the only variable predictive of patient distress. Both endoscopist and nurse assessments of patient’s distress moderately correlated with the patient’s actual reported distress (Table 1), with significant correlation identified between each other.
Conclusion This study demonstrates that estimates of patient’s distress during endoscopy are comparable between nurses and endoscopists. Whilst this finding is reassuring, procedural pain remains an important outcome measure better identified by nursing staff. We advocate that increased importance should be given to nursing assessments during endoscopic examinations.
Disclosure of Interest None Declared.
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