Validation of Newcastle ENDOPREM for assessing patient experience with colonoscopy: a multicenter prospective study

Abstract

Patient experience is a key quality indicator for colonoscopy, yet standardized assessment tools are lacking in China. The Newcastle ENDOPREM scale has shown promise internationally but requires validation in China. To translate, adapt, and preliminarily evaluate the psychometric properties of the Chinese version of the Newcastle ENDOPREM (ENDOPREM-CN) to assess colonoscopy patient experience in Chinese patients. This dual-center prospective study followed forward-backward translation principles and cognitive interviewing for adaptation. From April 2024 to April 2026, 296 patients undergoing colonoscopy completed the ENDOPREM-CN. Reliability and validity were assessed, and factors influencing experience were analyzed. Of 301 patients, 296 completed the ENDOPREM-CN. Positive experience was high (98.3%). Phase-specific findings showed 64.2% pre-procedure anxiety, 70.6% unpleasant bowel preparation taste, and, in terms of the post-procedure, 40.9% discomfort and 67.6% result concern. Total scale reliability was good (Cronbach’s α = 0.86, KMO = 0.83); phase reliability ranged from excellent (before test, α = 0.93) to poor (bowel preparation, α = 0.41). Multivariate regression analysis identified factors including adequate information provision and anxiety about abnormal results (both P < 0.01) before the test, better-than-expected bowel preparation taste ( P < 0.01), endoscopist gender preference ( P = 0.05) and explanation about the procedure perceived right to terminate, embarrassment, discomfort frequency during the test (all P < 0.01), explanation of the results and clarity on next steps (both P < 0.01) after the tes t were associated with overall experience. The ENDOPREM-CN shows acceptable overall reliability for measuring Chinese colonoscopy patients’ experiences. Our findings underscore the importance of better patient communication, respecting patients’ right to terminate procedures, and clear post-procedure results and follow-up to improve patient experience.