Development and validation of a nurse-assessed patient comfort score for colonoscopy

作者：Rostom Alaa^*; Ross Erin D; Dube Catherine; Rutter Matthew D; Lee Thomas; Valori Roland; Bridges Ronald J; Pontifex Darlene; Webbink Veronica; Rees Colin; Brown Carly; Whetter Deborah H; Kelsey Susan G; Hilsden Robert J

来源：Gastrointestinal Endoscopy, 2013, 77(2): 255-261.

DOI：10.1016/j.gie.2012.10.003

Background: Comfort during colonoscopy is a critical component of safety and quality. %26lt;br%26gt;Objective: To develop and validate the Nurse-Assessed Patient Comfort Score (NAPCOMS). %26lt;br%26gt;Design: Prospective scale validation. %26lt;br%26gt;Setting: Colorectal cancer screening centers in the United Kingdom and Canada. %26lt;br%26gt;Patients: A total of 300 consecutive patients undergoing colonoscopy at participating colorectal cancer screening centers. %26lt;br%26gt;Intervention: The NAPCOMS was developed by using a modified Delphi process. During colonosco`py, two endoscopy room nurses independently observed and rated patient comfort and tolerability by using NAPCOMS. In addition, endoscopists reported global comfort scores and patients%26apos; reported global comfort by using visual 4-point Likert and National Health Service-United Kingdom Global Rating Scales. %26lt;br%26gt;Main Outcome Measurements: Reliability and validity of NAPCOMS was measured by using intraclass correlations (ICC) between nurse ratings of colonoscopies and between NAPCOMS, endoscopist ratings, and patient ratings of global comfort. %26lt;br%26gt;Results: The ICC for the overall NAPCOMS was 0.84 (95% confidence interval [CI], 0.80-0.87). There was high agreement between the NAPCOMS and endoscopist ratings of comfort (ICC = 0.77; 95% CI, 0.72-0.81), moderate agreement between the NAPCOMS and patient ratings (ICC = 0.61; 95% CI, 0.53-0.67), and moderate agreement between the endoscopist and patient ratings (ICC = 0.52; 95% CI, 0.43-0.60). %26lt;br%26gt;Limitations: NAPCOMS was validated in outpatients who received colonoscopy with minimal to moderate sedation as part of a screening and surveillance program, so performance among inpatients or those requiring deep sedation was not tested. %26lt;br%26gt;Conclusion: NAPCOMS is a reliable and valid tool for assessing patient comfort in the setting of outpatient colonoscopy performed with minimal to moderate sedation. (Gastrointest Endosc 2013; 77: 255-61.)

• 出版日期2013-2