Original Papers

Patient experience surrounding bronchoscopy

Richard Bodington MBBS, Salim Meghjee MBBS, Muthu Thirumaran MBBS, Shoaib Faruqi MD
Patient experience surrounding bronchoscopy

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 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.

Patient experience surrounding bronchoscopy

Correlation between patient perception of the ability to perform morning activities and findings on clinical examination in COPD patients in Romania

Florin Mihălțan, Dragoș Ungureanu
Correlation between patient perception of the ability to perform morning activities and findings on clinical examination in COPD patients in Romania

Nivelul de activitate fizică este recunoscut ca un predictor de mortalitate și de spitalizare la pacienții cu BPOC. RELIEF (CorRELation Between PatIent PErception and Findings on Clinical Examination, NCT01627743) a fost un studiu nonintervențional, multicentric, prospectiv, de 12 săptămâni, care a inclus pacienți cu vârsta de cel puțin 40 de ani, cu BPOC stadiul C sau D tratati puțin cel puţin 1 lună anterior includerii cu terapie combinată ICS / LABA. Percepția pacienților asupra capacității de a efectua activități de dimineață a fost evaluată cu ajutorul chestionarului CDLM (Capacity of Daily Living during the Morning). În analiza finală au fost incluși 505 pacienți. Majoritatea pacienților au fost de sex masculin (85,1%), iar vârsta medie a subiecților studiului a fost de 65 de ani. Durata medie a BPOC a fost de 5,31 ani si mai mult de jumătate dintre pacienţi au avut BPOC stadiul C (61%). Durata medie a terapiei combinate inhalatorii înainte de studiu a fost de 36 de luni. Hipertensiunea arterială a fost cea mai frecventă comorbiditate raportată (38,2%), urmată de boala coronariană (20,6%). Media scorului CDLM a crescut pe parcursul urmăririi prospective de la 3.68 la 3.94, precum și procentul de pacienți cu o stare generală de sănătate de 4/5 de la 41,2% la 57,4%. O corelație pozitivă slabă până la moderată, a fost găsită între scorul total CDLM și starea generală de sanătate (valori Kendall tau-b de la 0.2269 la 0.3181). Aceste rezultate indică o îmbunătățire generală a percepției subiective a pacienților și a furnizorilor de servicii medicale și completează cercetarea BPOC în România, fiind primul studiu care a raportat o corelatie între rezultatele raportate de pacient și evaluările clinice efectuate de către specialiști din sănătate.

Cuvinte cheie: BPOC, terapie ICS / LABA, CDLM, calitatea vieții

Correlation between patient perception of the ability to perform morning activities and findings on clinical examination in COPD patients in Romania

Outpatient pleuroscopy: report of an experience in a referral hospital

Arda Kiani, Abolghasem Daneshvar Kakhaki, Ali Khalili, Mahsa Pourabdolah Tootkaboni, Mitra Sadat Rezaie, Atefeh Abedini
Outpatient pleuroscopy: report of an experience in a referral hospital

Pleuroscopy is a safe diagnostic procedure for evaluation of pleural diseases, with minimum complications. This procedure has been recently conducted on outpatient basis. Results support its safety, especially in busy referral hospitals. We aimed to report our experience on performing outpatient pleuroscopy at Masih Daneshvari hospital; Tehran, Iran. All eligible patients referred to Masih Daneshvari Hospital for pleuroscopy between May 2015 and May 2016 were enrolled. Air evacuation was conducted in operating room though a thin Nelaton catheter attached to low pressure suction. Compression dressing using Vaseline gauze was done after air leak terminated. Patients were discharged if first chest x-ray was negative for pneumothorax and were advised to stay in touch and return 12 hours later for second chest radiograph. Baseline characteristics, radiographic and pathologic reports were reviewed. Outpatient pleuroscopy was conducted on 10 patients. Average procedure time was 22±9 minutes. All patients were discharged after 4 hours. Eight of the patients remained free of complications after 12 hours, and 2 patients presented with pneumothorax (both who had massive pleural effusion) and were successfully managed by our team. Considering pathologic diagnosis, pleural tuberculosis was as common diagnosis as malignancy in our patients (4 patients), adenocarcinoma was the most malignancy reported (3 out of 4 patients). Chronic nonspecific inflammation was reported by our pathologist in 2 cases. Outpatient pleuroscopy can be conducted safely and effectively, reducing the number of unnecessary hospitalizations in a referral center. Closed follow up, patient education and proper patient selection are necessary for minimizing complications.

Keywords: pleuroscopy, pleural tuberculosis, adenocarcinoma

Outpatient pleuroscopy: report of an experience in a referral hospital