COMMENTARY

Patient Satisfaction With Anesthesia Care

Alex Macario, MD, MBA

Disclosures

August 06, 2013

Patient-Satisfaction Measures in Anesthesia: Qualitative Systematic Review

Barnett SF, Alagar RK, Grocott MP, Giannaris S, Dick JR, Moonesinghe SR
Anesthesiology. 2013;119:452-478

Study Summary

Measuring a patient's satisfaction with medical care, and in particular with anesthesia care, would seem to be straightforward. One could just ask, "How satisfied are you with the anesthesia care?"

It turns out that measuring patient satisfaction in a valid and reliable manner is more complicated. The goal of this study was to systematically review the scientific literature published between 1980 and 2012 to identify properly developed questionnaires that accurately assess patient satisfaction.

Barnett and colleagues determined that of the more than 3211 articles that used patient satisfaction with anesthesia as an outcome measure, only 71 (2.2%) were multidimensional, involving some sort of formal psychometric development process. These 71 studies used 34 different patient satisfaction measures.

For example, the correct way to develop a patient satisfaction survey would be to include elements such as:

Gathering patient opinions on which components of satisfaction should be included in survey questions;

Testing a pilot questionnaire and making the changes deemed necessary;

Retesting on a separate group of patients;

Addressing biases such as social desirability (answering the questions simply to please the investigator rather than giving their true opinion);

Measuring the time taken to complete the questionnaire; and

Assessing the response rate; different routes of administration (email, paper, phone call) can affect the response rate.

The investigators determined that the appropriate survey instrument for assessing patient satisfaction depends on the patient population (eg, children vs parents, parturients), the type of care provided (monitored anesthesia/sedation; general/regional vs local), and the goal of the survey (eg, assess just the preanesthesia visit). Each of these areas of interest requires a different questionnaire.

For example, if the goal was to assess patient satisfaction with general or regional anesthesia, the survey should assess the following:

Information given by the anesthesia provider;

Attention to the patient;

Kindness/regard of caregivers;

Demands promptly answered;

Feeling of well-being;

Pain at the site of surgery;

Feeling safe;

Feeling relaxed;

Feeling anxious or frightened; and

Vomiting/nausea.

Moreover, language matters. Studies are completed in many different countries; a survey that is valid in one language is not necessarily valid when translated into another language, in part because of cultural differences.

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