Caregivers and quality of bowel preparation of older people before receiving inpatient colonoscopy
Keywords:
motivation, bowel preparation, colonoscopyAbstract
Poor bowel preparation poses a risk of complications in older people requiring an inpatient colonoscopy. The development of a motivation program to provide caregivers with participation in bowel preparation before colonoscopy is considerable. The objective of this study is to (1) study the effects of the motivation program on the bowel preparation behaviors of the caregivers; (2) to compare the quality of bowel preparation among older patients between the caregivers who participated in the motivation program and the caregivers who did not. This quasi-experimental study had a Two-Group Posttest design. The samples were 36 caregivers who took care of older people undergoing an inpatient colonoscopy at Srinagarind Hospital, divided equally into a control group and an experimental group. The data were collected from January to May 2020. The experimental group participated in the motivation program for two weeks, while the control group was given routine suggestions. The data were collected using the following: (1) a demographic questionnaire; (2) the bowel preparation behavior of caregiver questionnaires with a content validity of 0.91, with a Kuder-Richardson reliability of 0.81 and an interrater reliability of 0.99; and 3) the Ottawa Bowel Preparation Scale. The data were analyzed using descriptive statistics, median, Inter Quartile Range, Chi-square, Fisher’s exact test, Mann-Whitney U test, and Independent sample T-test. The findings indicated that the experimental group had median scores on the bowel preparation behaviors of caregivers that were higher than the control group at .05 level of statistical significance (Mann-Whitney U= 6.000, p<0.001). Also, the quality bowel preparation and bowel cleansing of older patients in the experimental group was different from those in the control group (p=0.012, p<0.001, respectively). In conclusion, the caregivers who participated in the motivation program had better bowel preparation behavior than those who did not. The older patients under their care had a different quality of bowel preparation and bowel cleansing between the two groups. Therefore, this motivation program should be applied in bowel preparation for the older people to undergo an inpatient colonoscopy. There should be further development applications from the program integrated with nurse counseling for caregivers and older patients undergoing an inpatient colonoscopy and an outpatient colonoscopy.
References
2. National Cancer Institute Department of Medical Services Ministry of Pubilc Health. Colorectal cancer screening. Bangkok: Kosit Press; 2015.
3. Almadi MA, Alharbi O, Azzam N, et al. Bowel preparation quality between hospitalized patients and outpatient colonoscopies. Saudi J Gastroenterol 2019;25:159-67.
4. Srinagarind hospital KhonKaen university. Medical records & statistic department in Srinagarind hospital KhonKaen [Internet]. 2019 [cited 2019 Oct 12]. Available from: https://drive.google.com/file/d/1aBaA3t_YTN37eVSArU43jwFBl8GPTOAI/view.
5. Kanokwanwimol A. Colorectal cancer screening. In: Saiphoklang N, Pongcharoen P, Bhanthumkol P, Lolekha P, editors.Geriatric medicine. Bangkok: Bangkok Wetchasan; 2018. p. 256-76.
6. Cohen LB. Advances in bowel preparation for colonoscopy. Gastrointest Endosc CliN Am 2015;25:183-97.
7. Lebwohl B, Kastrinos F, Glick M, et al. The impact of suboptimal bowel preparation
on adenoma miss rates and the factors associated with early repeat colonoscopy. Gastrointest Endosc 2011;73:1207-14.
8. Yadlapati R, Johnston ER, Gregory DL, et al. Predictors of inadequate inpatient colonoscopy preparation and its association with hospital length of stay and costs. Dig Dis Sci 2015;60:3482-90.
9. Day LW, Kwon A, Inadomi JM, et al. Adverse events in older patients undergoing colonoscopy: a systematic review and meta-analysis. Gastrointest Endosc 2011;74:885-96.
10. Mahmood S, Farooqui SM, Madhoun MF. Predictors of inadequate bowel preparation for colonoscopy. Eur J Gastroenterol Hepatol 2018;30:819-26.
11. Amornyotin S. Colonoscopy: anesthesia consideration. TLMJ 2013;15:17-20.
12. Rotondano G, Rispo A, Bottiglieri ME, et al. Quality of bowel cleansing in hospitalized patients undergoing colonoscopy: a multicentre prospective regional study. Dig Liver Dis 2015;47:669-74.
13. Garber A, Sarvepalli S, Burke CA, et al. Modifiable factors associated with quality of bowel preparation among hospitalized patients undergoing colonoscopy. J Hosp Med 2019;14:278-83.
14. Bhanthumkomol P, Siramolpiwat S, Vilaichone RK. Incidence and predictors of inadequate bowel preparation before elective colonoscopy in Thai patients. Asian Pacific J Cancer Prev 2014;15: 10763-8.
15. Nguyen DL, Wieland M. Risk factors predictive of poor quality preparation during average risk colonoscopy screening: the importance of health literacy. J Gastrointest Liver Dis 2010;19:369-72.
16. Yee R, Manoharan S, Hall C, et al. Optimizing bowel preparation for colonoscopy: what are the predictors of an inadequate preparation?. Am J Surg 2015;209:787-92.
17. Peery A, Keku T, Martin C, et al. Distribution and characteristics of colonic diverticula in a United States screening population. Clin Gastroenterol Hepatol 2016;14:980-5.
18. McNabb-Baltar J, Dorreen A, Al Dhahab H, et al. Age is the only predictor of poor bowel preparation in the hospitalized patient. Can J Gastroenterol Hepatol 2016;1-5.
19. Aroonsang P. Nursing care for major problem of the elderly: application. Khon Kean: Klungnana publisher; 2011. p.17-25.
20. King-Marshall EC, Mueller N, Dailey A, et al. “It is just another test they want to do”: patient and caregiver understanding of the colonoscopy procedure. Patient Educ Couns 2016;99:651-8.
21. Klaypikun K, Choowattanapakorn T. The effect of the individual and family self management program on bowel preparation behavior for colonoscopy in older persons. HCU Journal 2017;21:123-37.(in Thai)
22. Katseesung P, Asdornwised U, Pinyopasakul W, et al. Effects of continuing care program on quality of bowel preparation and anxiety in who receiving ambulatory colonoscopy. J Nurs Sci 2015;33:61-73. (in Thai)
23. Fatima S, Jain D, Hibbard C. Impact of video aid on quality of bowel preparation among patients undergoing outpatient screening colonoscopy. Clin Med Insights Gastroenterol 2018;11:1-5.
24. Chomali N, Navicharern R. The effect of health teaching on self-practice among persons with colorectal cancer rick. JNSCU 2019;31:85-97. (in Thai)
25. Back SY, Kim HG, Ahn EM, et al. Impact of patient audiovisual re-education via a smartphone on the quality of bowel preparation before colonoscopy: a singleblinded randomized study. Randomized Controlled Trial 2018;87:789-99.e4.
26. Gálvez M, Zarate A, Espino H, et al. A short telephone-call reminder improves bowel preparation, quality indicators and patient satisfaction with first colonoscopy. Endosc Int Open 2017;5:E1172-8.
27. Jung JW, Park J, Jeon GJ, et al. The effectiveness of personalized bowel preparation using a smartphone camera application: a randomized pilot study. Gastroenterol Res Pract 2017;2017:1-7.
28. Jeon SC, Kim JH, Kim SJ, et al. Effect of sending educational video clips via smartphone mobile messenger on bowel preparation before colonoscope. Clin Endosc 2019;52:53-8.
29. Maddux J, Rogers R. Protection motivation and self-efficacy: a revised theory of fear appeals and attitude change. J Exp Soc Psychol 1983;19:469-79.
30. Juntachum W. Nursing research: sampling and sample size. Khon Kean: Khonkean Print; 2002.
31. Rostom A, Jolicoeur E. Validation of a new scale for the assessment of bowel preparation quality. Gastrointest Endosc 2004;59:482-6.
32. Kang X, Zhao L, Leung F, et al. Delivery of instructions via mobile social media app increases quality of bowel preparation. Clin Gastroenterol Hepatol 2016;14:429- 435.e3.
33. Liu X, Luo H, Zhang L, et al. Telephonebased re-education on the day before colonoscopy improves the quality of bowel preparation and the polyp detection rate: a prospective, colonoscopist-blinded, randomised, controlled study. Gut 2014;63:125-30.
34. Jawa H, Mosli M, Alsamadani W, et al. Predictors of inadequate bowel preparation for inpatient colonoscopy. Turkish J Gastroenterol 2017;28:460-4.
