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1.
Asian Pac J Cancer Prev ; 23(1): 33-37, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35092369

RESUMO

INTRODUCTION: The cancer burden in the Middle East is high and growing. Colorectal cancer (CRC) is the second most common cancer for both men and women in the UAE. Although early diagnosis of malignancy reduces morbidity and increases the survival rates, non-attendance of gastroenterology (GI) endoscopic procedures is a significant global problem, which can lead to delay in cancer diagnosis and treatment. Several factors have been found to contribute to non-attendance behavior, including socioeconomic, cultural, and organizational related barriers. The purpose of this study was to identify factors contributing to non-attendance behavior among outpatients scheduled for GI endoscopic procedures in a tertiary hospital in the United Arab Emirates. We conclude with recommendations that can help in reducing the rate of patient no-shows for GI endoscopic procedures in the region. METHODS: In a tertiary medical center in the Middle East, we surveyed patients who did not attend their scheduled GI endoscopic procedures over a period of one year. The questionnaire sought to identify possible reasons for patient's non-attendance. Descriptive measures including means, standard deviation, frequencies, and percentages were used to analyze the demographic characteristics of the study participants. The chi-square test was performed to analyze gender differences. RESULTS: Of 314 outpatients who met study inclusion criteria, 168 agreed to participate (53.5% response rate). The majority of participants were women (n=96, 60.4 %), aged 18 to 73, with a mean of 42 years. The largest age group was between 35 and 44 (n=46, 28.9 %). Approximately equal numbers of non-attendance appointments were scheduled for combined colonoscopy and upper endoscopy (36.3 %), colonoscopy alone (31.3 %), or upper endoscopy alone (31.3 %). The most common causes for cancellation or non-attendance included concerns about the appointment (35.5%), inconvenient timing of the appointment (27.9%) and changes in medical status (26.4%). Gender differences were noted for non-attendance behaviors, with women significantly more likely than men to report feelings of embarrassment (Chi-square 6.261, df=1, p=.012). CONCLUSION: Our study has identified several barriers to patient attendance of endoscopic procedures, as well as opportunities to reduce the rate of patient no-shows, including patient education, scheduling options, and protocols to minimize discomfort and misconceptions around GI endoscopic procedures, particularly accommodating for same gender endoscopists, with the ultimate goal of increasing early cancer screening and prevention.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/estatística & dados numéricos , Endoscopia Gastrointestinal/estatística & dados numéricos , Pacientes não Comparecentes/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adolescente , Adulto , Idoso , Colonoscopia/psicologia , Colonoscopia/estatística & dados numéricos , Detecção Precoce de Câncer/psicologia , Endoscopia Gastrointestinal/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes não Comparecentes/psicologia , Pacientes Ambulatoriais/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Centros de Atenção Terciária , Emirados Árabes Unidos , Adulto Jovem
2.
JAMA Netw Open ; 4(10): e2128000, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34605915

RESUMO

Importance: Screening for breast and colorectal cancer has resulted in reductions in mortality; however, questions remain regarding how these interventions are being diffused to all segments of the population. If an intervention is less amenable to diffusion, it could be associated with disparities in mortality rates, especially in rural vs urban areas. Objectives: To compare the prevalence of breast and colorectal cancer screening adherence and to identify factors associated with screening adherence among women residing in rural vs urban areas in the United States. Design, Setting, and Participants: This population-based cross-sectional study of women aged 50 to 75 years in 11 states was conducted from 2017 to 2020. Main Outcomes and Measures: Adherence to cancer screening based on the US Preventative Services Task Force guidelines. For breast cancer screening, women who had mammograms in the past 2 years were considered adherent. For colorectal cancer screening, women who had (1) a stool test in the past year, (2) a colonoscopy in the past 10 years, or (3) a sigmoidoscopy in the past 5 years were considered adherent. Rural status was coded using Rural Urban Continuum Codes, and other variables were assessed to identify factors associated with screening. Results: The overall sample of 2897 women included 1090 (38.4%) rural residents; 2393 (83.5%) non-Hispanic White women; 263 (9.2%) non-Hispanic Black women; 68 (2.4%) Hispanic women; 1629 women (56.2%) aged 50 to 64 years; and 712 women (24.8%) with a high school education or less. Women residing in urban areas were significantly more likely to be adherent to colorectal cancer screening compared with women residing in rural areas (1429 [82%] vs 848 [78%]; P = .01), whereas the groups were equally likely to be adherent to breast cancer screening (1347 [81%] vs 830 [81%]; P = .78). Multivariable mixed-effects logistic regression analyses confirmed that rural residence was associated with lower odds of being adherent to colorectal cancer screening (odds ratio [OR], 0.81; 95% CI, 0.66-0.99, P = .047). Non-Hispanic Black race was associated with adherence to breast cancer screening guidelines (OR, 2.85; 95% CI, 1.78-4.56; P < .001) but not colorectal cancer screening guidelines. Conclusions and Relevance: In this cross-sectional study, women residing in rural areas were less likely to be adherent to colorectal cancer screening guidelines but were similarly adherent to breast cancer screening. This suggests that colorectal cancer screening, a more recent intervention, may not be as available in rural areas as breast cancer screening, ie, colorectal screening has lower amenability.


Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/psicologia , Colonoscopia/métodos , Colonoscopia/psicologia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/psicologia , Estudos Transversais , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Mamografia/métodos , Mamografia/psicologia , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos
3.
Medicine (Baltimore) ; 100(23): e26296, 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34115035

RESUMO

TRIAL DESIGN: Elimination of small colorectal polyps with cold snare polypectomy (CSP) is reported to be as safe as hot snare polypectomy (HSP). The effectiveness of CSP has not been clearly defined, and the incidence of long-term recurrence has not been determined. We conducted a randomized control study and one-year follow-up study to assess their safety and efficacy. METHODS: Patients with small colorectal polyps were randomized to receive CSP or HSP. Polypectomy was performed to determine the pathological curability, and patients completed a questionnaire about the tolerability of the procedure. Follow-up colonoscopy was performed to determine the local recurrence of adenoma. The major outcome was the non-inferiority of CSP to HSP in the rate of delayed bleeding and minor outcomes, including the incidence of immediate bleeding and perforation, procedural time, and the resection rate. RESULTS: A total of 119 participants were recruited in this randomized study and underwent polypectomy. Among the 458 polyps, 332 eligible polyps were analyzed. The rate of adverse events was 0.6% (1/175) for CSP and 0% (0/157) for HSP, which showed the non-inferiority of CSP. While the complete resection rate of CSP was very high (100%), the R0 rate was not satisfactory (horizontal margin, 65.5%; vertical margin, 89.1%). Two local recurrences (2.5%) were observed in the follow-up of 80 adenomas treated with CSP. No recurrence was found in 79 lesions in the HSP group, which was not significant (P = .06). CONCLUSIONS: Colorectal polyps were safely resected using CSP, similar to HSP. Most would agree to say that CSP is considered safer than HSP. The main question is then related to efficacy. Our results of the present study demonstrate that recurrence after CSP should be carefully managed for curative treatment.


Assuntos
Adenoma , Pólipos do Colo , Colonoscopia , Preferência do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/diagnóstico , Adenoma/patologia , Adenoma/cirurgia , Assistência ao Convalescente/métodos , Idoso , Biópsia/métodos , Pólipos do Colo/patologia , Pólipos do Colo/cirurgia , Colonoscopia/efeitos adversos , Colonoscopia/métodos , Colonoscopia/psicologia , Dissecação/métodos , Feminino , Humanos , Masculino , Recidiva , Resultado do Tratamento
4.
Cancer Prev Res (Phila) ; 14(8): 803-810, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34127509

RESUMO

Few studies have directly targeted nonparticipants in colorectal cancer screening to identify effective engagement strategies. We undertook a randomized controlled trial that targeted nonparticipants in a previous trial of average-risk subjects which compared participation rates for mailed invitations offering a fecal test, a blood test or a choice of either. Nonparticipants (n = 899) were randomized to be offered a kit containing a fecal immunochemical test (FIT), directions on how to arrange a blood DNA test, or the option of doing either. Screening participation was assessed 12 weeks after the offer. To assess the cognitive and attitudinal variables related to participation and invitee choice, invitees were surveyed after 12 weeks, and associations were investigated using multinomial logistic regression. Participation rates were similar between groups (P = 0.88): 12.0% for FIT (35/292), 13.3% for the blood test (39/293), and 13.4% for choice (39/290). Within the choice group, participation was significantly higher with FIT (9.7%, 28/290) compared with the blood test (3.8%, 11/290, P = 0.005). The only variable significantly associated with participation was socioeconomic status when offered FIT, and age when offered choice but there was none when offered the blood test. Survey respondents indicated that convenience, time-saving, comfort, and familiarity were major influences on participation. There was no clear advantage between a fecal test, blood test, or choice of test although, when given a choice, the fecal test was preferred. Differences in variables associated with participation according to invitation strategy warrant consideration when deciding upon an invitation strategy for screening nonparticipants. PREVENTION RELEVANCE: This trial of screening for those at average risk for colorectal cancer targeted past fecal-test nonparticipants and compared participation rates for mailed invitations offering a fecal test, blood test, or choice of either. Although there was no clear advantage between strategies, factors associated with participation differed between each strategy.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Pacientes não Comparecentes , Participação do Paciente/métodos , Idoso , Austrália/epidemiologia , Comportamento de Escolha , Colonoscopia/psicologia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Pacientes não Comparecentes/psicologia , Pacientes não Comparecentes/estatística & dados numéricos , Sangue Oculto , Recusa de Participação/psicologia , Recusa de Participação/estatística & dados numéricos
5.
Acta Med Indones ; 53(1): 132-139, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33818416

RESUMO

Colorectal cancer (CRC) is one of the top three leading causes of death in both men and women. However, screening can help detect and prevent CRC. Multiple guidelines recommend CRC screening using stool-based screening and direct visualization via colonoscopy. Anatomically, women have a longer total colonic length, especially in the transverse colon, which makes it redundant; thus it is more difficult to perform complete endoscopy in women. Women also have a higher risk of developing right-sided colon cancer of the flat and depressed type, which is harder to detect than the other types. Moreover, women are less likely to undergo colonoscopy due to embarrassment, especially when the procedure is performed by male gastroenterologists, and the lack of available female gastroenterologists further complicates the problem. The current COVID-19 pandemic also decreases patients' willingness to undergo screening due to the fear of contracting the COVID-19. Delay in diagnosis leads to more advanced tumors upon detection and ultimately decreases the survival rate, especially in women, as they have lower 1-year survival rate when CRC is detected in its later stages than in men. Innovative options for CRC screening have recently emerged, including colon capsule endoscopy, which can be performed in a clinic and may reduce the need for colonoscopy. However, sex-specific CRC screening guidelines and tools are not available. The objective of this review is to identify the barriers and challenges faced when performing screening colonoscopy in women, especially during the pandemic and to encourage the development of sex-specific CRC screening.


Assuntos
COVID-19 , Colonoscopia , Neoplasias Colorretais , Detecção Precoce de Câncer , Atitude Frente a Saúde , COVID-19/epidemiologia , COVID-19/prevenção & controle , Colonoscopia/métodos , Colonoscopia/psicologia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Feminino , Humanos , Determinação de Necessidades de Cuidados de Saúde , SARS-CoV-2 , Fatores Sexuais
6.
Cancer Prev Res (Phila) ; 14(5): 603-614, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33888515

RESUMO

Recommended colorectal cancer screening modalities vary with respect to safety, efficacy, and cost. Better understanding of the factors that influence patient preference is, therefore, critical for improving population adherence to colorectal cancer screening. To address this knowledge gap, we conducted a panel survey focused on three commonly utilized colorectal cancer screening options [fecal immunochemical test or guaiac-based fecal occult blood test (FIT/gFOBT), multi-target stool DNA (mt-sDNA) test, and colonoscopy] with a national sample of U.S. adults, ages 40-75 years and at average risk of colorectal cancer, in November 2019. Of 5,097 panelists invited to participate, 1,595 completed the survey (completion rate, 31.3%). Our results showed that when presented a choice between two colorectal cancer screening modalities, more respondents preferred mt-sDNA (65.4%) over colonoscopy, FIT/gFOBT (61%) over colonoscopy, and mt-sDNA (66.9%) over FIT/gFOBT. Certain demographic characteristics and awareness of and/or experience with various screening modalities influenced preferences. For example, uninsured people were more likely to prefer stool-based tests over colonoscopy [OR, 2.53; 95% confidence interval (CI), 1.22-5.65 and OR, 2.73; 95% CI, 1.13-7.47]. People who had heard of stool-based screening were more likely to prefer mt-sDNA over FIT/gFOBT (OR, 2.07; 95% CI, 1.26-3.40). People who previously had a stool-based test were more likely to prefer FIT/gFOBT over colonoscopy (OR, 2.75; 95% CI, 1.74-4.41), while people who previously had a colonoscopy were less likely to prefer mt-sDNA or FIT/gFOBT over colonoscopy (OR, 0.39; 95% CI, 0.24-0.63 and OR, 0.40; 95% CI, 0.26-0.62). Our survey demonstrated broad patient preference for stool-based tests over colonoscopy, contrasting the heavy reliance on colonoscopy for colorectal cancer screening in clinical practice and highlighting the importance of considering patient preference in colorectal cancer screening recommendations. PREVENTION RELEVANCE: Our national survey demonstrated broad patient preference for stool-based tests over colonoscopy, contrasting the heavy reliance on colonoscopy for colorectal cancer screening in clinical practice and highlighting the importance of considering patient preference in colorectal screening recommendations.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Preferência do Paciente/estatística & dados numéricos , Adulto , Idoso , Colonoscopia/psicologia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/genética , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/prevenção & controle , DNA/isolamento & purificação , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Fezes/química , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sangue Oculto , Estados Unidos/epidemiologia
7.
Medicine (Baltimore) ; 100(9): e23799, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655906

RESUMO

BACKGROUND: Colonoscopy is an uncomfortable procedure. Distraction is thought to reduce pain by decreasing the amount of attention a person spends on a painful stimulus. We aimed to assess the usefulness of smartphones on discomfort associated with the colonoscopy. METHODS: We designated 360 enrolled patients according to prospective randomized controlled study into two groups, including smartphone (SP) group (Relaxation by smartphones) and Control group (No relaxation). Measured outcomes included the discomfort, satisfaction, polyp detection rate and the willingness to repeat colonoscopy were analyzed between groups. RESULTS: The pain and distension scores of SP group patients were significantly lower than those of the Control group (2.18 ±â€Š2.80 vs 3.55 ±â€Š3.07, P < .001; 4.15 ±â€Š2.35 vs 4.79 ±â€Š2.36, P = .011, respectively). Importantly, patient-reported satisfaction scores of the SP group were significantly higher than those of the Control group (96.45 ±â€Š7.17 vs 91.12 ±â€Š10.49, respectively; P < .001). Moreover, although there were no statistical differences, patients using smartphones were more likely to have shorter reach cecum times (09m:11 s vs 07m:37 s, P = .116) and more polyp detection rate (13.3% vs 9.4%, P = .246). In addition, more patients using smartphones were willing to repeat colonoscopy but no statistical difference (85.0% vs 81.7%, P = .396). CONCLUSION: Patient using smartphone is a special manner to increase satisfaction during colonoscopy with a less discomfort and is more likely to be polyp detection rate.


Assuntos
Colonoscopia/psicologia , Dor Processual/terapia , Satisfação do Paciente , Terapia de Relaxamento/instrumentação , Smartphone , Adolescente , Adulto , Colonoscopia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Processual/psicologia , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
8.
PLoS One ; 16(2): e0247252, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33626070

RESUMO

BACKGROUND: We sought to investigate intentions to undergo primary screening with colonoscopy in an attempt to predict future colorectal cancer screening behaviors and the feasibility of implementing colonoscopy as the primary screening modality for colorectal cancer in the National Cancer Screening Program (NCSP) of Korea. METHODS: Data were obtained from a nationwide online survey conducted in 2018. The survey included a total of 800 eligible adults aged over 45 years. Study measures included the history of screening colonoscopy within the past 10 years and intentions to undergo primary screening with colonoscopy under the NCSP based on the five constructs of the Health Belief Model. Logistic regression analysis was conducted to examine factors associated with intentions to undergo primary screening with colonoscopy. RESULTS: Approximately 77% of the participants expressed strong willingness to undergo primary screening with colonoscopy under the NCSP. Higher perceived severity and perceived benefits were significantly associated with stronger intentions to undergo screening with colonoscopy (adjusted odds ratio [aOR], 1.53; 95% confidence interval [CI], 1.10-2.14 and aOR, 2.74; 95% CI, 1.76-4.28, respectively). Greater perceived barriers (aOR, 0.65; 95% CI, 0.45-0.93) were significantly associated with weaker intentions. Cues to action elicited the strongest screening intentions (aOR, 8.28; 95% CI, 5.23-13.12). CONCLUSION: The current study findings highlight the need for increasing awareness of the severity of CRC and the benefits of colonoscopy screening. Family-orientated recommendation strategies and reducing complications may boost an individual's intentions to undergo colonoscopy.


Assuntos
Colonoscopia/psicologia , Neoplasias Colorretais/diagnóstico , Intenção , Idoso , Idoso de 80 Anos ou mais , Colonoscopia/métodos , Detecção Precoce de Câncer , Estudos de Viabilidade , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , República da Coreia
9.
Dig Dis ; 39(4): 399-406, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32961537

RESUMO

INTRODUCTION: Text message-based interventions reduce colonoscopy no-show rates and improve bowel preparation scores. In this non-randomized study, we assessed whether an interactive text messaging system could improve colonoscopy outcomes. METHODS: Colonoscopy pre-procedural instructions were programmed into a dedicated software platform created for this study. In the intervention arm, text messages were sent to veterans during a 4-week study period. Validated pre-procedural satisfaction questionnaires were completed by patients during standard protocol and intervention periods. Demographics and colonoscopy outcomes data were compared between the standard protocol and intervention arms, including procedure completion rate on scheduled date, Boston bowel preparation score (BPPS), adenoma detection rate, and satisfaction. RESULTS: Of 241 patients, 128 were in the standard protocol arm and 113 in the intervention arm. Higher proportions of patients receiving text messages underwent colonoscopy on their scheduled date (69.9%) compared to the ones in the standard protocol (50.8%, p = 0.015). Patients with ≥3 interactions with the system had 80.6% likelihood of completing colonoscopy on the scheduled date compared to 56.9% with <3 interactions and 50.8% with standard protocol (p < 0.001). Frequency of interaction with the system was similar between older (>65 years) and younger patients (p = 1.0). Among older patients, colonoscopy was completed successfully in 84.2% when alert-based human interactions occurred compared to 65.6% in those without and 47.9% with standard protocol (p = 0.018). More than 90% indicated they would recommend the system to patients undergoing future colonoscopy. CONCLUSION: An interactive text messaging system improves successful colonoscopy rates in a VA setting, with greatest impact in older patients.


Assuntos
Colonoscopia/estatística & dados numéricos , Pacientes não Comparecentes/estatística & dados numéricos , Pacientes Ambulatoriais/psicologia , Participação do Paciente/estatística & dados numéricos , Envio de Mensagens de Texto , Idoso , Instituições de Assistência Ambulatorial , Colonoscopia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes não Comparecentes/psicologia , Participação do Paciente/psicologia
10.
Dig Dis Sci ; 66(2): 541-546, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32193861

RESUMO

BACKGROUND: Pain associated with colonoscopies is a major barrier to patients participating in colorectal cancer screenings. While sedation and analgesia are used to reduce pain during the procedure, they are associated with increased complications and costs. Thus, it is necessary to identity novel techniques to relieve pain in a safe and cost-effective way. AIMS: To test whether watching real-time videos of colonoscopies while receiving detailed interpretations of the procedures reduces pain and anxiety and increases a patient's satisfaction. METHODS: Patients were randomized into three groups including a group who watched real-time videos of their colonoscopies (Group A), a group who watched real-time videos of their colonoscopies while receiving detailed interpretations of the procedures from the endoscopists (Group B), and a group who did not receive either method (Group C). RESULTS: Pain and anxiety scores were significantly (Group A vs. Group C, [Formula: see text]; Group B vs. Group C, [Formula: see text]) lower in Groups A and B compared to Group C. Additionally, significantly (Group A vs. Group C, [Formula: see text]; Group B vs. Group C, [Formula: see text]) increased satisfaction was observed in Groups A and B compared to Group C. There were no statistically significant differences observed in the pain and anxiety scores when comparing Groups A and B. However, the overall satisfaction score was significantly ([Formula: see text]) higher in Group B compared to Group A. CONCLUSIONS: Real-time videos of colonoscopies as well as videos along with detailed interpretations of the procedures decrease pain and anxiety while improving satisfaction in patients undergoing colonoscopies without sedation. Videos combined with interpretations lead to a greater increase in patient satisfaction.


Assuntos
Ansiedade/psicologia , Colonoscopia/psicologia , Dor/psicologia , Educação de Pacientes como Assunto/métodos , Satisfação do Paciente , Gravação em Vídeo/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/prevenção & controle , Manejo da Dor/métodos , Manejo da Dor/psicologia , Estudos Prospectivos , Adulto Jovem
11.
Turk J Gastroenterol ; 31(11): 799-804, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33361043

RESUMO

BACKGROUND/AIMS: There are a variety of factors that affect the quality of colonoscopy bowel preparations, although the relationship between the level of health literacy (HL) and the quality of bowel preparations has yet to be clarified. The present study evaluated the effect of HL on the quality of bowel preparation prior to a colonoscopy. MATERIALS AND METHODS: The data of 150 patients who underwent a colonoscopy for colorectal cancer screening and in whom the quality of bowel preparation was scored during the colonoscopy were recorded prospectively. The European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to evaluate HL prior to the colonoscopy, and the Boston bowel preparation scale was used to evaluate the quality of the bowel preparation during the colonoscopy. The demographic characteristics of the patients, the presence of comorbidities, socioeconomic characteristics (marital status, income level, and educational level), HLS-EU-Q47 questionnaire, and Boston bowel preparation scale scores were recorded and evaluated. RESULTS: A significant linear relationship was identified between the general HL index score, the cleanliness of the colonic segments (right, transverse, and left colon) and the total Boston bowel preparation scale score (p=0.013, p=0.010, p=0.008, p=0.001, respectively). In a HL subgroup analysis, a significant linear relationship was noted between disease prevention and health promotion index, the cleanliness of the colonic segments (right, transverse, and left colon), and the total Boston bowel preparation scale score. It was observed that an increase in the health care index resulted in an increase in the cleanliness of the relevant colonic segments and the total Boston bowel preparation scale score. No relationship was found between the right, transverse, and left colon and the total Boston bowel preparation scale scores and gender, age, Body Mass Index (BMI), comorbidity, marital status, level of income, or educational level. CONCLUSION: The level of HL affects the quality of colonoscopy bowel preparations.


Assuntos
Catárticos/uso terapêutico , Colonoscopia/psicologia , Letramento em Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Cuidados Pré-Operatórios/psicologia , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Socioeconômicos , Inquéritos e Questionários
12.
Medicine (Baltimore) ; 99(46): e23102, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181675

RESUMO

BACKGROUND: Colonoscopy is considered a safe and effective tool for detecting colorectal cancer. Nevertheless, the proportion of patients are hesitating to receive colonoscopy. Smartphone education may decrease the barrier of colonoscopy. The aim of this study is to examine the effectiveness of smartphone education in colonoscopy. METHODS: We conducted a prospective, double-blinded, randomized, controlled study to examine the effectiveness of smartphone education on embarrassment, bowel preparation, and satisfaction in colonoscopy. The patients' embarrassment was measured by the colonoscopy embarrassment scale. The quality of the bowel preparation was evaluated by gastroenterologists according to the Aronchik Scale. The satisfaction of colonoscopy care was assessed by a satisfaction scale developed by the authors. RESULTS: A total of 150 patients were analyzed in the smartphone education and control groups (n = 75 in each group). The smartphone education group reported fewer embarrassment (B = -2.78, P = .02) than those of the control group, the patients who were older (B = .15, P = .001) and who were male (B = 2.91, P = .003) showed higher embarrassment. Additionally, smartphone education group were likely to have better colon preparation (odds ratio = 2.46, 95% confidence interval: 1.20-5.02) than that of the control group. Smartphone education also improved the satisfaction with care (ß = 4.60, P < .001), and above normal body mass index decreased the satisfaction with care (ß = -0.19, P < .05). CONCLUSION: Smartphone education improves embarrassment, bowel preparation, and satisfaction with care in patients receiving colonoscopy.


Assuntos
Colonoscopia/psicologia , Neoplasias Colorretais/diagnóstico , Instrução por Computador , Cooperação do Paciente/psicologia , Cuidados Pré-Operatórios , Smartphone , Colonoscopia/métodos , Instrução por Computador/instrumentação , Instrução por Computador/métodos , Método Duplo-Cego , Constrangimento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Educação de Pacientes como Assunto/métodos , Satisfação Pessoal , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/psicologia
13.
Value Health ; 23(10): 1373-1383, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33032782

RESUMO

OBJECTIVES: Approximately 800 000 people die globally from colorectal cancer (CRC) every year. Prevention programs promote early detection, but for people with precancerous lesions, tailoring surveillance to include lifestyle-change programs could enhance prevention potential and improve outcomes. METHODS: Those with intermediate or high-risk polyps removed during CRC screening colonoscopy within the Northern Ireland CRC Screening Programme were invited to complete 8 discrete choice questions about tailored surveillance, analyzed using random-parameters logit and a latent class modeling approach. RESULTS: A total of 231 participants (77% male) self-reported comorbid hypertension (53%), high cholesterol (48%), and mean body mass index of 28.7 (overweight). Although 39% of participants were unaware of their CRC risk status, 30.9% indicated they were already making changes to reduce their risk. Although all respondents were significantly risk- and cost-averse, the latent class analysis identified 3 segments (classes): 1. Class 1 (26.8%) significantly favored phone or email support for a lifestyle change, a 17-month testing interval, and noninvasive testing. 2. Class 2 (48.4%) preferred the status quo. 3. Class 3 (24.7%) significantly favored further risk reduction and invasive testing. CONCLUSIONS: This is the first documented preference study focusing on postpolypectomy surveillance offering lifestyle interventions. Although current care is strongly preferred, risk and cost aversion are important for participants. Latent class analysis shows that some respondents are willing to change diet and lifestyle behaviors, reflecting a teachable moment, with opportunities to personalize and optimize surveillance. Significant discordance between perceived and known risk of recurrence and limited recall of risk information provided within current practice suggest necessary improvements to surveillance programs.


Assuntos
Comportamento de Escolha , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Preferência do Paciente , Pólipos do Colo/cirurgia , Colonoscopia/psicologia , Detecção Precoce de Câncer/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Irlanda do Norte , Preferência do Paciente/psicologia , Preferência do Paciente/estatística & dados numéricos , Comportamento de Redução do Risco
14.
Asian Pac J Cancer Prev ; 21(8): 2231-2236, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32856849

RESUMO

INTRODUCTION: Colorectal cancers (CRC) continues to increase worldwide and is associated with significant morbidity and mortality. CRC can be prevented through early detection using several modalities. However, like any screening program participation remains suboptimal. This study assessed the factors associated with participation in a stool based CRC screening that was carried out as part of an Integrated Health Screening Survey for civil servants. MATERIALS AND METHODS: Civil servants who participated in a health survey (N=10,756, mean age 48.08 ± 5.26 years old) were studied. Demographic factors (gender, age groups, marital status, employment status, body mass index [BMI] categories, smoking status, personal and family history of cancers) were analyzed to assess for features associated with willingness to participate in this fecal immunohistochemistry test (FIT) screening for CRC. Comorbid conditions studied were cardiac disease, diabetes mellitus, dyslipidemia, hypertension and stroke. Multivariate analysis was performed to evaluate variables associated with participation in CRC screening programme. RESULTS: Of the invited 10,756 participants, 7,360 returned a stool specimen giving a participation rate of 68.4%. Those who participated were significantly older (60 years [77.8%], p0.05). Multivariate analyses showed that older age (45-49, 50-54, 55-59 and >60) and employment status (professional) remained significant factors associated with participation in a stool based CRC screening. CONCLUSIONS: Our study showed that older age and professional employment status were significantly associated with willingness to participate in a stool based CRC screening.


Assuntos
Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico , Testes Diagnósticos de Rotina/estatística & dados numéricos , Detecção Precoce de Câncer/estatística & dados numéricos , Fezes/química , Adulto , Brunei/epidemiologia , Colonoscopia/psicologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/psicologia , Testes Diagnósticos de Rotina/psicologia , Detecção Precoce de Câncer/psicologia , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
15.
BMJ Open ; 10(7): e035264, 2020 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-32713846

RESUMO

OBJECTIVES: In England, a significant proportion of people who take part in the national bowel cancer screening programme (BCSP) and have a positive faecal occult blood test (FOBt) result, do not attend follow-up colonoscopy (CC). The aim of this study was to investigate differences in intended participation in a follow-up investigation by diagnostic modality offered including CC, CT colonography (CTC) or capsule endoscopy (CE). SETTING: We performed a randomised online experiment with individuals who had previously completed an FOBt as part of the English BCSP. METHODS: Participants (n=953) were randomly allocated to receive one of three online vignettes asking participants to imagine they had received an abnormal FOBt result, and that they had been invited for a follow-up test. The follow-up test offered was either: CC (n=346), CTC (n=302) or CE (n=305). Participants were then asked how likely they were to have their allocated test or if they refused, either of the other tests. Respondents were also asked to cite possible emotional and practical barriers to follow up testing. Multivariable logistic regression models were used to investigate intentions. RESULTS: Intention to have the test was higher in the CTC group (96.7%) compared with the CC group (91.8%; OR 2.64; 95% CI 1.22 to 5.73). CTC was considered less 'off-putting' (OR 0.66, 95% CI 0.47 to 0.94) and less uncomfortable compared with CC (OR 0.51, 95% CI 0.34 to 0.77). For those who did not intend to have the test they were offered, CE (39.7%) or no investigation (34.5%) was preferable to CC (8.6%) or CTC (17.2%). CONCLUSIONS: Alternative tests have the potential to increase attendance at diagnostic follow-up appointments.


Assuntos
Endoscopia por Cápsula/psicologia , Colonografia Tomográfica Computadorizada/psicologia , Colonoscopia/psicologia , Cooperação do Paciente/psicologia , Idoso , Comportamento de Escolha , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/diagnóstico por imagem , Inglaterra , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Sangue Oculto , Distribuição Aleatória
16.
Am J Health Behav ; 44(4): 460-472, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32553027

RESUMO

Objectives: In this study, we conducted telephone interviews with patients in community clinics who had abnormal fecal immunochemical test (FIT) results to identify follow-up colonoscopy challenges. The FIT is an effective colorectal cancer screening method, but its value is contingent on follow-up diagnostic colonoscopy. Methods: We explored barriers at 3 timepoints: (1) abnormal FIT-result communication, (2) scheduling/completion of colonoscopy, and (3) receipt of results. We sought to understand variation in experience by both Spanish and English language patients. Results: We interviewed 32 patients (16 English; 16 Spanish), 66% of whom were women. There were 13 early completers (≤ 2 months after FIT result), 14 later completers (> 2 months after FIT result), and 5 non-completers of the colonoscopy. The greatest challenge was fear of the procedure, expressed more often by Spanish language (SL) participants and later completers. SL participants also cited cost and lack of clear communication about the need for a colonoscopy. English language (EL) participants experienced lack of reliable transportation. Conclusions: Barriers to timely colonoscopy completion following an abnormal FIT can occur at different transitions in care and vary by patient characteristics. Our findings may inform the design of programs to improve colonoscopy completion in safety net clinics.


Assuntos
Colonoscopia , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Provedores de Redes de Segurança , Idoso , Colonoscopia/psicologia , Colonoscopia/estatística & dados numéricos , Detecção Precoce de Câncer/psicologia , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Provedores de Redes de Segurança/estatística & dados numéricos
17.
Cir Cir ; 88(4): 441-447, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32567586

RESUMO

BACKGROUND: Screening colonoscopy requires quality parameters to determine its efficacy to detect cancerous or precancerous lesions. Limitations of the procedure are the patient's rejection, difficulty for its preparation or lack of preparation. OBJECTIVE: To assess whether patient satisfaction correlates with the quality of the procedure. METHOD: 100 consecutive patients for a screening colonoscopy were included, they were randomized to use a preparation with polyethylene glycol (PEG) or sodium picosulfate (P). In addition, a second parameter evaluated was related to a follow-up phone call performed to half of the patients prior to the study, during the preparation time. RESULTS: P was better tolerated and qualified, however, there was no difference with the quality of preparation, adenomatous polyps detection rate, cecum insertion rate and patient satisfaction. A difference was found in whom had a follow-up phone call. DISCUSSION: A good colon preparation is a key factor to have a quality colonoscopy, and it has been shown important that a good relationship for explain the doubts and follow the preparation. CONCLUSION: It was found that the type of preparation and patient follow-up during the study correlate with the quality of the study and patient satisfaction.


ANTECEDENTES: La colonoscopia de escrutinio requiere parámetros de calificación para determinar su eficiencia en la detección de lesiones cancerosas o precancerosas. Sus limitantes son su rechazo, la dificultad durante su preparación o la falta de preparación. OBJETIVO: Evaluar la satisfacción del paciente y los criterios de calidad del estudio. MÉTODO: Se incluyeron 100 pacientes enviados para colonoscopia de escrutinio asignados aleatoriamente a uno de dos grupos de preparación colónica: polietilenglicol (PEG) o picosulfato de sodio (P), para evaluar la satisfacción y la limpieza colónica. Otra evaluación fue por medio de llamada de refuerzo al momento de la preparación. RESULTADOS: Con P se tuvieron mejores tolerabilidad y calificaciones de satisfacción, en comparación con PEG. No hubo diferencia para la calidad de la limpieza, la tasa de detección de pólipos adenomatosos ni la intubación cecal. La llamada telefónica de reforzamiento incrementó la satisfacción, la limpieza colónica y la tasa de detección de adenomas. DISCUSIÓN: Una relación estrecha con el paciente durante su proceso de limpieza y explicación del procedimiento se ha visto como uno de los factores más importantes para lograr una colonoscopia de alta calidad. CONCLUSIÓN: El tipo de preparación colónica y la intervención durante la preparación se relacionaron con una mejor calidad del estudio y una mayor satisfacción del paciente.


Assuntos
Pólipos Adenomatosos/diagnóstico por imagem , Catárticos , Citratos , Colonoscopia/psicologia , Compostos Organometálicos , Satisfação do Paciente , Picolinas , Polietilenoglicóis , Idoso , Colonoscopia/normas , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
18.
Gastroenterol Nurs ; 43(3): 258-263, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32433429

RESUMO

Meperidine and fentanyl are opioids currently used in addition to midazolam for sedation and analgesia during colonoscopy in Italy. The aim of the study was to assess the impact of patients' psychological state before elective colonoscopy on the efficacy of the sedation regimens. Eighty outpatients who underwent an elective colonoscopy were included in our study. The Hospital Anxiety and Depression Scale questionnaire was self-administered to evaluate basal anxiety and depression state. The rate of baseline discomfort was evaluated by a standard 100-mm visual analog scale. Sedation was obtained alternatively with a midazolam-meperidine or midazolam-fentanyl combination. There were no statistically significant differences between the fentanyl and meperidine groups on body mass index, age, and gender composition. Patients in the meperidine group reported less pain during colonoscopy than patients in the fentanyl group. There were statistically significant positive correlations in the meperidine group with the distress, anxiety, and depression. Our study has pointed out greater effectiveness of the midazolam plus meperidine regimen, equal recovery times, and no significant differences in the duration of the endoscopic examinations. The evaluation of patients' psychological status seems to predict the efficacy of sedation when the nociceptive component of pain is well controlled.


Assuntos
Colonoscopia/psicologia , Sedação Consciente , Fentanila/uso terapêutico , Meperidina/uso terapêutico , Midazolam/uso terapêutico , Angústia Psicológica , Adulto , Idoso , Analgésicos Opioides/uso terapêutico , Quimioterapia Combinada , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Pessoa de Meia-Idade
19.
Asian Pac J Cancer Prev ; 21(5): 1253-1258, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32458630

RESUMO

BACKGROUND: Patients with positive immunochemical faecal occult blood test results were found to have poor compliance for a subsequent colonoscopy procedure. This study was conducted to explore patients' perceived deterrence for colonoscopy following a positive stool test. METHODS: Using qualitative study method, a phone interview was conducted with 16 patients to elicit their views on the reasons for failure to attend the colonoscopy procedure following a positive stool test. The interviews were audio recorded, transcribed verbatim and translated before proceeded with the data analysis. Content analysis was made on the translated interview, followed by systematic classification of data by major themes. RESULTS: Reasons for nonattendance were categorized under five main themes; unnecessary test, fear of the procedure, logistic obstacles (subthemes; time constraint, transportation problem), social influences, and having other health priority. Lacking in information about the procedure during the referral process was identified to cause misperception and unnecessary worry towards colonoscopy. Fear of the procedure was commonly cited by female respondents while logistic issues pertaining to time constraint were raised by working respondents. CONCLUSIONS: More effective communication between patients and health care providers are warranted to avoid misconception regarding colonoscopy procedure. Support from primary care doctors, customer-friendly appointment system, use of educational aids and better involvement from family members were among the strategies to increase colonoscopy compliance.


Assuntos
Colonoscopia/psicologia , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Cooperação do Paciente/psicologia , Idoso , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/psicologia , Testes Diagnósticos de Rotina , Feminino , Seguimentos , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Pesquisa Qualitativa
20.
Psychooncology ; 29(6): 1084-1091, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32237002

RESUMO

OBJECTIVE: This study aimed to assess psychological functioning, quality of life, and regret about screening after a positive fecal immunochemical test (FIT) and subsequent colonoscopy, and to evaluate changes over time. METHODS: This is a prospective cohort study. Individuals aged 55 to 75 with a positive FIT that were referred for colonoscopy between July 2017 and November 2018, were invited to complete questionnaires related to psychological distress and health-related quality of life at three predefined time points: before colonoscopy, after histopathology result notification, and after 6 months. Four questionnaires were used: the Psychological Consequences Questionnaire (PCQ), the six-item Cancer Worry Scale (CWS), the Decision Regret Scale (DRS), and the 36-item Short-Form (SF-36). RESULTS: A total of 1066 participants out of 2151 eligible individuals were included. Patients with cancer showed a significant increase in psychological dysfunction (P = .01) and cancer worry (P = .008) after colonoscopy result notification, and a decline to pre-colonoscopy measurements after 6 months. In the no-cancer groups, psychological dysfunction and cancer worry significantly decreased over time (P < .05) but there was no ongoing decline. After 6 months, 17% of participants with no cancer experienced high level of cancer worry (CWS ≥ 10). Yet, only 5% reported high level of regret about screening participation (DRS > 25). A good global quality of life was reported in participants with no cancer. CONCLUSION: Some psychological distress remains up to 6 months after colonoscopy in participants who tested false-positive in the Dutch bowel cancer screening program.


Assuntos
Neoplasias Colorretais/psicologia , Detecção Precoce de Câncer/psicologia , Qualidade de Vida/psicologia , Estresse Psicológico/psicologia , Adulto , Idoso , Colonoscopia/psicologia , Feminino , Humanos , Masculino , Programas de Rastreamento/psicologia , Pessoa de Meia-Idade , Sangue Oculto , Estudos Prospectivos , Inquéritos e Questionários
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