Does "patient-reported discomfort" from bronchoscopy differ over time?

Background: The optimal time to assess patient satisfaction with bronchoscopy has not been established. This study aimed to compare patient comfort scores recorded immediately after bronchoscopy with those obtained at follow-up, 7 to 14 days later.

Methods: A total of 240 patients undergoing bronchoscopy were recruited. Immediately after the procedure, patients scored the discomfort they had experienced from 0 (no discomfort) to 4 (severe discomfort). In addition, nursing staff recorded measures of comfort and sedation. At follow-up, patients again scored the discomfort they had experienced during the bronchoscopy.

Results: Complete data were analyzed on 180 patients (75%). The majority of patients tolerated the procedure well, although a significant minority experienced at least moderate discomfort (28.9%). No significant difference was found between the immediate and the follow-up comfort scores (Wilcoxon P=0.79). The comfort score recorded by the nurses was related to both immediate (Spearman 0.22, P<0.01) and follow-up scores (Spearman 0.28, P<0.01) of the patients. A number of variables that may influence patient comfort during bronchoscopy were assessed; only age was found to influence the comfort score. A large number of younger patients (age less than 60) reported a higher immediate discomfort score (χ2=7.69, P<0.05) despite the fact that older patients received lower doses of midazolam (P<0.05). However, the type of samples taken or patient position during the procedure did not influence the comfort score.

Conclusions: The comfort score assessed immediately after the procedure is similar to that recorded at a later date, and it relates to the score assessed by the nursing staff. Younger patients reported higher immediate discomfort.