Mindful endoscopy: holistically supporting patients through awake examinations of the path of swallowing

Awake procedures such as aerodigestive endoscopies can be distressing. As a result, definitive diagnostic assessments often require sedation or general anaesthesia, limiting ability to identify early-stage cancers.

To create a process and a team to deliver mindful endoscopy, in order to support patients through awake procedures, thereby extending the scope of definitive assessments in outpatient settings.

The mindful endoscopy team, consisting of an endoscopist and endoscopy support practitioners (ESPs) was created. Nurse-led mindfulness comprised patient education on a range of relaxation methods just before the start of the procedure, and holistic and proactive patient support within a clear structure during it. Patient experience of awake oral and pharyngolaryngeal endoscopy (180 procedures) and transnasal panendoscopy (70 procedures) were recorded using the Gastrointestinal Endoscopy Satisfaction Questionnaire.

Overall, 92.4% of patients were satisfied or very satisfied with their awake endoscopies and 96.4% indicated that they would be happy or very happy to undergo the same procedure undertaken by the same team again. At a mean follow-up of 14 months, 12 cancers had been detected and no cancers had been missed.

Perioperative mindfulness reliably extended the scope of definitive aerodigestive endoscopies, away from operating theatres and sedation facilities, and into outpatients. The potential of mindful endoscopy needs to be urgently explored to more broadly support the NHS elective recovery plan.