High level of patient satisfaction and comfort during diagnostic urological procedures performed by urologists and residents

Abstract

Objective. The aim of this study was to investigate how patients experience diagnostic urological procedures performed by urologists, junior residents and senior residents, and to assess the influence of procedure-related factors on patient experiences. Methods. Data were collected during 222 procedures: 84 transrectal ultrasound-guided prostate biopsies (TRUSP; urologists n = 39, residents n = 45) and 138 urethrocystoscopies (UCS; urologists n = 44, residents n = 94) in six hospitals. Patient experiences were assessed using a questionnaire focusing on pain, comfort and satisfaction (visual analogue scale, 0–10) and communication aspects on a four-point Likert scale. Clinical observations were made to identify influencing factors. Results. Median values for patient experiences across procedures were 10 (range 5–10) for patient satisfaction, 2 (0–9) for pain and 8 (0–10) for comfort. Generalized estimating equations revealed no significant differences between urologists, senior residents and junior residents in terms of experienced patient comfort, satisfaction or pain. Procedural time was longer for residents, but this did not correlate significantly with patient-experienced comfort (p = 0.3). In UCS, patient comfort and satisfaction were higher in the supine position for male and female patients, respectively (p < 0.01). In TRUSP, local anaesthesia resulted in a significant decrease in pain (p = 0.002) and an increase in comfort (p = 0.03). Finally, older patients experienced less pain and gave higher comfort and satisfaction responses than younger patients. Conclusions. Patients expressed high levels of satisfaction and comfort during diagnostic urological procedures. Experiences were not affected by the level of training, suggesting highly developed interpersonal and communication skills for residents in an early stage of residency training. Patients demonstrated significant preferences for local anaesthesia in TRUSP and performance of UCS in the supine position over the lithotomy position.

Keywords:

• Non-technical skills
• patient experience
• patient satisfaction
• resident
• transrectal ultrasound-guided prostate biopsy
• urethrocystoscopy

Acknowledgements

The authors gratefully acknowledge Malou Kuppen for her efforts in data collection, Lisette van Hulst for editorial assistance, and all patients, residents and urologists for their participation in this study.

Declaration of interest

The authors A.H. de Vries, E. Lesterhuis, L.M. Verweij, B.M.A. Schout, H.J.R. van der Horst, J. Leppink, E.L. Koldewijn and C. Wagner declare that they have no conflicts of interest or financial ties to disclose.