Indicadores de calidad y de seguridad de la colonoscopia de cribado desde la perspectiva del paciente

Resumen

Title: Quality and safety indicators of colorectal cancer screening colonoscopy from the patient'S perspective background endoscopy services working in colorectal cancer screening programs must perform periodic controls to improve the quality based on patients’ experience. One of the recommendations for improving colonoscopy quality is to measure patient satisfaction using questionnaires developed specifically for this process. However, to date, there is no questionnaire published in the literature that has been validated to know the patient'S opinion on colorectal cancer screening colonoscopy and that includes the two core dimensions for optimal care: Satisfaction and safety. Aims the aim of this study was to design and validate a specific questionnaire for patients undergoing screening colonoscopy following a positive fecal occult blood test, the colonoscopy satisfaction and safety questionnaire based on patient experience (cssqp). Patients and methods observational study based on qualitative research methods. The design included a review of the available evidence and used focus groups to identify the relevant dimensions to produce the instrument (content validity). Face validity was analyzed involving 15 patients. Reliability and construct and empirical validity were calculated. Validation involved patients from the colorectal screening programme at two referral hospitals in spain: Elche university hospital and vega baja hospital of orihuela. Results the study involved 370 patients (global response rate of 73%) between april 2016 and april 2017. Final version of the cssqp (version 1) consisted of 15 elements. The principal components analysis of the satisfaction items isolated three factors with saturation of elements above 0.52 and with high internal consistency and split-half readability: Information, care, and service and facilities features. The analysis of the safety items isolated two factors with element saturation above 0.58: Information gaps and safety incidents. Significant differences were observed in the indicators derived from the groups (information, care, service and facilities features) according to sex, age, center and studies. Conclusions this study presents, for the first time, a validated questionnaire for colonoscopy as a part of colorectal cancer screening developed from patients’ experience and the health professionals’ opinion. New indicators for quality and safety were identified in regards to information and healthcare consideration bases on patient-reported outcomes that were not included in other scales, nor described in other studies. To facilitate the use and diffusion of the cssqp version 1 is presented in spanish and english. Keywords: Colonoscopy; Patient satisfaction; Patient safety; Patient experience; Colorectal cancer screening program; Questionnaire; Crc