Preferences for receipt of information vary among individuals, with many patients showing an interest in receiving via video content. Although several educational videos on colonoscopy are available, most of them have not been evaluated systematically. To develop and compare a colonoscopy video educational resource to a previous video on similar subject matter. We developed a new video resource, based on feedback from patients and health care providers and recommended content in literature. A similar content video from the web was identified as the most highly rated by an advisory group. Individuals attending gastroenterology clinics, blinded to the source of videos, were recruited to watch both the New Video and the Similar Video. The order of watching the videos was randomly assigned to allow the assessment of order effects. After watching, participants were asked to rate each video based on: amount of information, clarity, trustworthiness, ease of watching/understandability, familiarity, reassurance, information learned, understanding from the patient’s point of view, appeal, and if they would recommend the video. Participants were then asked which video they preferred and why they preferred it based on clarity, trustworthiness, ease of watching/understandability, and reassurance. Participants were also asked to explain what they liked/disliked about the videos and if they had any suggestions for improving the material. 232 participants viewed both videos. When the New Video was viewed first 64% preferred the New Video and 31% preferred the Similar Video. When the Similar Video was viewed first 78% preferred the New Video and 20% preferred the Similar Video. Of the participants that had not had a previous colonoscopy, 66% preferred the New Video, while 74% of the participants with previous colonoscopy experience preferred the New Video. Multivariable logistic regression analysis also suggested that participants prefer the New Video if they saw it second. Participants rated the New Video as clearer and more trustworthy than the Similar Video. Many participants specified in the open-ended questions they liked New Video better because it was clearer, it was more informative, and was more visually appealing. We have developed and validated a new colonoscopy video educational material, which is freely available on the web. Our study suggests that in information evaluation studies, it is important to consider order effects. We have developed a process to appraise and compare different video information materials against each other. None
Abstract Background Adequate bowel cleansing before colonoscopy is, in theory, a simple concept but the high rate of inadequate or incomplete bowel cleanliness and its consequences have been the subject of many studies, guidelines, and meta- analyses. The complexity resides in all the pre-endoscopic factors surrounding preparation intake that may? influence quality of the bowel preparation. Aims To identify preendoscopic variables associated with inadequate bowel preparation Methods In this randomized trial conducted in adult outpatients in 10 Canadian hospitals, all early morning (AM) colonoscopies were scheduled between 7h30AM and 10h30AM and patients were randomized to PEG low volume or high- volume split-dose or high- volume day before. Later colonoscopies (PM) were scheduled between 10h30AM and 16h30PM and patients were randomized to PEG low-volume or high- volume split-dose or low- volume same day. A secondary random allocation assigned patients to a clear fluid or low residue diet. Inadequate bowel preparation was identified on the Boston Bowel Preparation Scale with a total score <6 with any of the 3 colonic segments subscores <2). All preendoscopic variables such as patients related factors, diet and type of bowel preparation were evaluated between groups with chi-square, Fisher’s exact or t-test where appropriate. All variables found to be significantly associated with a clean preparation on univariable analysis at the P=0.15 level were used to construct a multivariable model. Because of stratified randomization by time with possible resulting differing confounders, AM and PM patients were analysed separately. Results Over 29 months, 1726 patients were stratified in the AM group and 1750 patients in the PM group. 16.9% had inadequate bowel preparation in the AM group and 9.8% in the PM group. Pre-endoscopic variables associated with an inadequate bowel cleanliness in AM colonoscopy were a non screening indication (OR 1.36, 95%CI 1.04–1.78), a Charlson score>0 (OR 1.36, 95% 1.03–1.80) and a low residue diet (OR 1.53, 95%CI 1.17–2.01). Amongst PM colonoscopies, variables associated with an inadequate bowel cleanliness were increased age (OR 1.03, 95% 1.01–1.04), a non screening indication (OR 1.90 95%CI 1.35–2.70); a Charlson score>0 (OR 1.63, 95%CI 1.15–2.32), and a low residue diet (OR 1.41, 95%CI 1.01; 1.98). Conclusions In this large randomized trial, amongst patients undergoing an AM colonoscopy, pre- endoscopic factors associated with an inadequate bowel preparation were a non screening indication, comorbidities and a low residue diet. Amongst PM colonoscopy patients, in addition to these variables, an increased age was also associated with an inadequate bowel preparation. Funding Agencies received arm-length funding from Pendopharm Inc.
The Corona Virus Immune Disease-2019 (COVID-19) pandemic has broadly impacted the mental health of individuals worldwide, especially with restrictions including social distancing and quarantining. Persons with IBD are at increased risk of mental health disorders. The aim was to understand how the COVID-19 pandemic affected adults with a chronic health issue, inflammatory bowel disease (IBD), using a population-based sample.A survey study in Manitoba was conducted during the second COVID-19 wave in autumn 2020. We assessed proportions of health anxiety and perceived stress using validated measures, as well as stressors during the COVID-19 pandemic. We used univariable and multivariable logistic regression analysis to assess predictors of perceived stress and health anxiety.A total of 1,384 (47.1%) persons responded, with a mean age of 58.0, and 46.9% had Crohn's disease. Almost three quarters (73.7%) had increased stress, with 37.7% having increased stress about their IBD, and 33.6% worried about their IBD worsening. 46.0% felt increased stress about accessing their doctor or nurse, and 56.5% felt they had good access to their gastroenterologist. Elevated stress and health anxiety were seen in 63.5% and 17.2% of respondents, respectively. Younger age and being on immune-modifying therapy (IMT) was predictive of increased health anxiety and stress. Longer IBD duration was associated with decreased stress, including those on IMT.Persons with IBD reported high rates of stress and health anxiety early in the COVID-19 pandemic, especially among those on IMT. It will be important to determine how this evolved over time and to what extent this impacted on disease course.
La série d’articles Prévention en pratique[1][1] est publiée dans Le Médecin de famille canadien depuis 2017. Cette série repose en partie sur nos expériences en tant que médecins enseignants ou membres du Groupe d’étude canadien sur les soins de santé préventifs (GECSSP). Dans cet
