He B, Xin Y, Li R, Lin FC, Zhang GM, Zhu HJ. Bowel preparation experiences and needs before follow-up colonoscopy in older adult postoperative colorectal cancer patients: A qualitative study. World J Gastrointest Surg 2024; 16(9): 2968-2978 [PMID: 39351553 DOI: 10.4240/wjgs.v16.i9.2968]
Corresponding Author of This Article
Rui Li, MSc, Chief Nurse, Department of Nursing, The Tongren Hospital Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai 200335, China. 18616365160@163.com
Research Domain of This Article
Nursing
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2968-2978 Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2968
Bowel preparation experiences and needs before follow-up colonoscopy in older adult postoperative colorectal cancer patients: A qualitative study
Bin He, Yi Xin, Rui Li, Fu-Cai Lin, Guang-Ming Zhang, Hai-Jing Zhu
Bin He, Yi Xin, Fu-Cai Lin, Wuxi Medical College, The Jiangnan University, Wuxi 214122, Jiangsu Province, China
Rui Li, Department of Nursing, The Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
Guang-Ming Zhang, Department of Anesthesiology, The Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
Hai-Jing Zhu, Department of Endoscopy, The Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
Co-first authors: Bin He and Yi Xin.
Co-corresponding authors: Rui Li and Guang-Ming Zhang.
Author contributions: He B, Xin Y, Lin FC, Zhang GM and Li R contributed to the research design and thesis writing; He B, Xin Y and Zhu HJ collected and analyzed the data; He B, Xin Y and Lin FC contributed to the data collection; Li R and Zhang GM overall supervise the study; and all authors contributed to the article and approved the submitted version.
Institutional review board statement: The study was reviewed and approved by The Shanghai Tongren Hospital Ethics Committee.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Li, MSc, Chief Nurse, Department of Nursing, The Tongren Hospital Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai 200335, China. 18616365160@163.com
Received: July 13, 2024 Revised: July 23, 2024 Accepted: July 29, 2024 Published online: September 27, 2024 Processing time: 67 Days and 2 Hours
Abstract
BACKGROUND
The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation, which in turn affects the quality of the colonoscopy. Colonoscopy is an essential procedure for postoperative follow-up monitoring of colorectal cancer (CRC) patients. Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel preparation. However, little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.
AIM
To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.
METHODS
Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023. The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients. Colaizzi's seven-step analysis was utilized to organize, code, categorize, summarize, and verify the interview data.
RESULTS
The results of this study were summarized into four themes and eight sub-themes: (1) Inadequate knowledge about bowel preparation; (2) Decreased physiological comfort during bowel preparation (gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents, and hunger caused by dietary restrictions; (3) Psychological changes during different stages of bowel preparation (pre-preparation: Fear and resistance due to previous experiences; during preparation: Irritation and helplessness caused by taking bowel cleansing agents, and post-preparation: Anxiety and worry while waiting for the colonoscopy); and (4) Needs related to bowel preparation (detailed instructions from healthcare professionals; more ideal bowel cleansing agents; and shortened waiting times for colonoscopy).
CONCLUSION
Older adult postoperative CRC patients' knowledge of bowel preparation is not adequate, and they may encounter numerous difficulties and challenges during the process. Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.
Core Tip: Patient experiences during bowel preparation significantly influence compliance and the quality of colonoscopies. Older adult postoperative colorectal cancer patients are particularly prone to poor bowel preparation quality. This study, using a phenomenological methodology with semi-structured interviews, explored the bowel preparation experiences and needs of these patients. Unexpectedly, it revealed that despite prior experience, their knowledge of bowel preparation was still inadequate. They faced substantial physical and psychological challenges, with specific needs identified during the process. This research can inform customized bowel preparation plans for this high-risk group and suggests future studies on the impact of psychological factors on bowel preparation quality.
