Original articleClinical endoscopyDevelopment and validation of a nurse-assessed patient comfort score for colonoscopy
Section snippets
Background
Health care delivery should be patient focused, and, in keeping with this, patient comfort is important when performing colonoscopies and represents a key component of safety and quality. Comfort during the procedure is a measure of the patient experience and is associated with greater patient satisfaction, acceptability, and improved compliance with repeat colonoscopy.4, 5 Patient comfort is also a measure of the quality of the procedure and the endoscopist's technique.6
Procedural comfort is
Development and final NAPCOMS
An initial review of the literature and the Knowledge Management System from the United Kingdom Global Rating Scales Web site was conducted to identify existing scales. A modified Delphi approach was used to develop the items to be included in the new NAPCOMS. The Modified Gloucester Comfort Score, which is commonly used in the United Kingdom and has adequate face validity, was used as the initial base score (Table 1).10, 14
Seven endoscopists and 4 nurses from the United Kingdom and Canada
Results
Three hundred patients were enrolled, 150 in Calgary and 75 in each of North Tees and South Tees Hospitals NHS Foundation Trust. Just over half of the patients were men (51%), and the mean age of the study group was 56.8 years. All of the included patients underwent colonoscopy for colorectal cancer screening or surveillance under minimal to moderate levels of sedation by using predominantly midazolam and fentanyl. The majority of the patients (89%) had a minimal level of sedation (sedation
Discussion
This study is the first multicenter, multinational validation of an endoscopy comfort score for use in outpatient colonoscopy performed with minimal to moderate sedation. The results indicate that NAPCOMS is a valid, reliable, and easy to use instrument for rating patient comfort in this setting. NAPCOMS was developed by using a modified Delphi processes, reliability was established through demonstration of very good agreement between two independent nurse raters, and validity was established
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Cited by (0)
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 280.
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