Exploring the Willingness and Understanding of Digital Rectal Examinations in Assessing Anorectal Conditions Among Saudi Patients in the Western Region of Saudi Arabia

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Abstract
Background: A digital rectal examination (DRE) is a crucial diagnostic examination used to identify various medical conditions by inserting a finger into the patient's rectum to check for abnormalities. Although clinically significant, DRE can be challenging, especially for first-time patients. Reasons for refusal often include misunderstandings about the examination, fear of the way the test is done, and feelings of embarrassment. This study seeks to explore the views, opinions, and perceptions of individuals in the Western region of Saudi Arabia towards DRE. The objective is to guide interventions and improve healthcare practices related to anorectal conditions in this population. Method: In this cross-sectional study, we used a validated questionnaire, which was translated from English into Arabic, before distributing it to the target population. The target population included adults older than 18 years residing in the Western region of Saudi Arabia. Although our initial sample size was determined to be 385, we successfully recruited a larger sample of 1,147 participants. Data were statistically analyzed using IBM SPSS Statistics software for Windows, version 22 (IBM Corp., Armonk, NY). Results: A total of 1,087 eligible participants completed the study questionnaire. Among them, 480 participants (44.2%) demonstrated a good overall awareness and understanding of DRE, while the majority, 607 (55.8%), had poor awareness. University-educated participants exhibited better awareness, with 363 (47.7%) showing good overall awareness compared to 103 (35.2%) of those with only secondary education, a statistically significant difference. Furthermore, 269 (46.7%) of students had a good awareness of DRE compared to 55 (34.8%) of unemployed participants. Notably, 218 (58.4%) of individuals working or studying in the medical field had a good awareness of DRE, compared to 207 (37.2%) in non-medical fields. Conclusion: The majority of individuals showed limited knowledge regarding DRE. The findings suggest increasing public understanding and raising awareness of and importance of DRE for improving healthcare outcomes.

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