Patient Satisfaction and Perceived Stress in Digestive Endoscopy

OBJECTIVE: To evaluate patient satisfaction and perceived stress among adults undergoing diagnostic digestive endoscopy in Italy and to examine their associations with sociodemographic, clinical, and procedural factors. BACKGROUND: Patient satisfaction is a key indicator of endoscopy quality and complements technical performance measures. Perceived stress may influence the patient experience, but multicenter evidence combining satisfaction and stress in routine Italian outpatient endoscopy remains limited. METHODS: A multicenter cross-sectional study was conducted in 5 Italian endoscopy units. Adult outpatients undergoing diagnostic digestive endoscopy completed the Endoscopy Customer Satisfaction Questionnaire (ECSQ) and the 10-item Perceived Stress Scale (PSS-10). Sociodemographic, clinical, and procedural data were collected using standardized forms. Satisfaction scores were summarized as medians and interquartile ranges. Group differences were assessed using Mann-Whitney U and Kruskal-Wallis tests, and Spearman rank correlation was used to examine associations among satisfaction, perceived stress, and age. RESULTS: Among 517 patients, overall satisfaction was high across centers and procedure types. Satisfaction was highest before the examination, decreased during the procedure, and increased afterward. Higher perceived stress showed weak but significant negative correlations with satisfaction during the procedure (ρ = -0.09) and after the procedure (ρ = -0.12). No significant associations were found with age, sex, education, smoking habits, symptoms, or type of endoscopy. Lower satisfaction was observed among first-time patients and among those examined in the afternoon versus the morning. CONCLUSIONS: Italian digestive endoscopy services achieved high patient satisfaction, reflecting strong clinical and organizational performance. The modest inverse association between preprocedural perceived stress and satisfaction indicates that patients reporting higher perceived stress also tended to report slightly lower satisfaction. However, this association should not be interpreted as causal because of the cross-sectional study design and the timing of the measurements. First-time and afternoon patients may benefit from enhanced preparation, supportive communication, and targeted interventions.