Patient satisfaction with screening flexible sigmoidoscopy

Background: Screening flexible sigmoidoscopy is an underused cancer prevent ion procedure. Physicians often cite patient discomfort as a reason for not requesting sigmoidoscopy, but patient experiences and attitudes toward sig moidoscopy have not been well studied. Objective: To measure patient satisfaction and the determinants of satisfac tion with screening sigmoidoscopy. Methods: An instrument to assess satisfaction with screening sigmoidoscopy was developed. Responses were evaluated with a factor analysis, tested for reproducibility and internal consistency, and validated against an external standard. Results: A total of 1221 patients (666 men and 555 women; mean age, 61.8 ye ars) were surveyed after sigmoidoscopy. Examinations were performed by a nu rse practitioner (n = 668), internist (n = 344), or gastrointestinal specia list (n=184). More than 93% of the participants strongly agreed or agreed t hey would be willing to undergo another examination, and 74.9% would strong ly recommend the procedure to their friends. Regarding pain and discomfort, 76.2% strongly agreed or agreed that the examination did not cause a lot o f pain, 78.1% stated that it did not cause a lot of discomfort, and 68.5% t hought that it was more comfortable than they expected. Fifteen percent to 25% of the patients indicated they had a lot of pain, great discomfort, or more discomfort than expected. Women were more likely to have significant p ain or discomfort than men (adjusted odds ratio, 2.9; 95% confidence interv al, 1.9-4.3; P<.001). Conclusions: Approximately 70% of individuals who undergo screening sigmoid oscopy are satisfied and find the procedure more comfortable than expected, whereas only 15% to 25% find the procedure unpleasant. Physicians should n ot project discomfort onto patients as a reason for not requesting screenin g sigmoidoscopy.