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Patient experience surrounding bronchoscopy

Richard Bodington MBBS, Salim Meghjee MBBS, Muthu Thirumaran MBBS, Shoaib Faruqi MD

Abstract: 

Fiberoptic bronchoscopy (FOB) is a commonly performed procedure in thoracic medicine associated with significant discomfort, which greatly impacts patient satisfaction with the procedure. The UK DoH and BTS stress the benefits of collecting and reviewing patient experiences of a service and how this information should shape service provision.
In this current study we assess a number of tolerance and satisfaction related factors in 108 consecutive patients undergoing FOB. We demonstrate a highly significant
relationship between patient reported comfort and complete amnesia of FOB. We fail to demonstrate a relationship between patient reported comfort during FOB and the bronchoscopist’s assessment of tolerance.
We also suggest a relationship between poorer patient reported comfort and a lower WHO performance status. The identification of factors associated with satisfaction with FOB will allow creation of strategies to improve patient experience and lead to better outcomes.

 

Keywords: 
Bronchoscopy, patient satisfaction, patient comfort, questionnaire  

Fiberoptic bronchoscopy (FOB) is a commonly performed procedure in thoracic medicine. The procedure was first introduced in 1968 and its use has been refined so that it is associated with few serious adverse events (1) . However, FOB is associated with significant dysphagia, nose and throat pain, and fear, which greatly impact patient satisfaction with the procedure. The UK Department of Health stresses in their guidance the numerous benefits of collecting and reviewing patient experiences of a service and how this information should be the basis for shaping service provision (2) . The importance of studying and acting upon the factors that affect patient satisfaction with FOB are also prominent in the British Thoracic Society (BTS) bronchoscopy guidelines (3) . Indeed, patient satisfaction itself is a valid healthcare provision outcome measure. Despite this, relatively little research has gone into the investigation
of factors that affect patient satisfaction with bronchoscopy. These factors can be broadly broken down into patient characteristics, patient previous experience with healthcare, patient expectations, and care during and after the procedure itself (3) . Indicators of patient satisfaction may be assessed in a variety of ways and include patient willingness to return for repeat procedure, rating using a visual analogue scale (VAS), adherence to post procedure instructions or the recorded number of complaints or claims made against a unit (3) . Previous
studies have identified a number of factors associated with improved patient satisfaction with FOB and these are summarized in table 1.

References: 
  1. Lechtzin N, Rubin HR, White Jr P, Jenckes M, Diette GB. Patient satisfaction with bronchoscopy. Am J Respir Crit Care Med 2002;166(10):1326-31.
  2. Department of Health. Understanding what matters: A guide to using patient feedback to transform care. 22-5-2009. Crown.
  3. Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, et al. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax 2013 Aug 1;68(Suppl 1):i1-i44. 
  4. Hirose T, Okuda K, Ishida H, Sugiyama T, Kusumoto S, Nakashima M, et al. Patient satisfaction with sedation for flexible bronchoscopy. Respirology 2008;13(5):722-7.

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