The Patient Experience of an Inadequate-Quality Bowel Preparation During the Colonoscopy Process: A Qualitative Study.
Christine Cleary Kimpel, Kemberlee Bonnet, David Schlundt
PMID 35758928WHAT IT FOUND
Patients who had inadequate bowel preparation described higher anxiety than those who did not, plus embarrassment and anger when told to repeat it.
They also rated verbal prep instructions less clear, and repeat preparation added cost, time off work and health burden.
Key findings
01Participants who had experienced inadequate bowel preparation reported a median anxiety rating of 50 on a 0 to 100 scale, compared with 23 for those who had not, and rated verbal instructions less clear.
02Participants described anger, embarrassment, and persistent anxiety after being told the bowel preparation was inadequate.
03Most participants planned to repeat or had already repeated the colonoscopy, but the repeat process added costs, time off work, lost sleep and meals, and some reported illness or constipation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not use member checking, audit trails, or field notes, which are methods that support trustworthiness in qualitative work. Most participants were women, so the themes may not transfer to all genders. The study did not collect race, ethnicity, income, educational attainment, or occupation. Most participants appeared to have higher health literacy, and many gave occupational information suggesting education beyond a high school degree. Bowel preparation quality was self-reported and may differ from provider documentation or procedure findings. Participants were interviewed cross-sectionally without follow-up. Many described procedures from one year or more earlier, and 20% reported a lapse of six years or more. Purposive sampling made the sample less representative of the general population. Many interview participants were recruited from ResearchMatch. Such volunteers may be more motivated than the general population. The reported participant counts were not fully consistent: 39 survey respondents and 20 interview participants, 44 women and 15 men, and 33 with inadequate preparation and 28 with adequate preparation.
The easy way to misread this
Do not conclude that inadequate verbal instructions caused inadequate bowel preparation or that clearer instructions will prevent it. The study compared patient reports after the event and did not test an intervention.