患者教育对水辅助进镜法结肠镜术前肠道准备质量的影响

Impact of patient education on bowel preparation quality before water-aided colonoscopy

背景水辅助进镜法肠镜检查,临床证实可减轻患者术中不适,提高腺瘤检出率.因该技术(水浸没/水交换)对于肠道尤其左半结肠清洁程度要求较高,采用复方聚乙二醇分次给药方案,并予微信公众号相关视频及科普文章推送加强患者教育,可确保肠道准备质量.目的本文研究患者教育对于水辅助进镜法结肠镜术前诊疗患者肠道准备质量的影响.方法400例拟行肠镜诊疗门诊患者按照随机数字表随机分为对照组与观察组.两组均予口头及书面告知复方聚乙二醇分次给药肠道准备方法.观察组同时给予微信公众号相关视频及科普文章推送.波士顿评分量表评价肠道准备质量, 7分及以上视为充分.结果观察组方案完全执行率及充分肠道准备患者比例高于对照组,差异有统计学意义.对于既往采取复方聚乙二醇单次给药患者,患者教育能够提高该亚组换用新方法准备的依从性.结论患者教育有助于提高水辅助进镜法肠镜术前诊疗患者肠道准备依从性及肠腔清洁程度,并指导既往肠镜诊疗史患者摒弃单次用药方法,接受分次服药方案.

BACKGROUND Water-aided colonoscopy may relieve patients’ discomfort and increase adenoma detection rate, but this technique requires excellent bowel preparation. In order to ensure bowel preparation quality, split-dose polyethylene for colonoscopy preparation is implemented at our hospital, and educational interventions are given, including a short video and an instruction article released through our official public WeChat account. AIM To evaluate the effectiveness of patient educational interventions on quality of bowel preparation among patients asked to follow split-dose bowel preparation before water-aided colonoscopy. METHODS A total of 400 outpatients who were scheduled to receive water-aided colonoscopy were randomly divided into a control group and an observation group. Both groups received routine oral and written notifications to inform the bowel preparation method. The observation group also received educational interventions including a short video and an article released through our official public WeChat account. Bowel preparation quality was scored using the Boston Bowel Preparation Scale (BBPS) and categorized as either adequate vs inadequate (BBPS ≥ 7 vs BBPS < 7). RESULTS More patients in the observation group achieved regimen completion and adequate bowel preparation than did patients in the control group. Patients who had previous colonoscopies and adopted single-dose bowel preparation method were more likely to follow newly implemented split-dose bowel preparation instructions after receiving educational interventions. CONCLUSION Patient educational interventions may improve bowel preparation quality and patient compliance. Educational interventions emphasizing the benefits of split-dose bowel preparation in patients with a prior colonoscopy may help ensure compliance and discard the habitual use of day-before preparations.