Evidence Based Practice and Quality Assurance
Background and Goal of Study: Current measures of patient satisfaction in anesthesia care show an incorrect high satisfaction. In our study we tried to develop and validate a questionnaire that ought to detect patient dissatisfaction correctly.
Methods: Following the protocol of the psychiometric design 192 items concerning the process of care could be identified. These were reduced to 72 anesthesia relevant items by excluding redundant and not anesthesia related items using sumscores of questionnaires and interviews. After a pilot questionnaire consisting of 57 questions, reduction of items was made using a missing value analysis and probing questions. The final questionnaire was refined after a re-presentative test using statistical methods like Split-Half-, Chi2-, T-Test/Transformation, Cronbachs-α, Pearson-, Spearmans-Correlation etc. The final instrument consists of 39 questions, 32 concerning anesthesia related care in 5 dimensions. The questions are answered using a 4 scale likert response format and are presented in chronological order of anesthesia care.
Results and Discussion: Until today, the final questionnaire was given to more than 350 patients 36 hours after discharge of the recovery room or ICU respectively. 84% of patients returned the questionnaire of which 77% were completed. Patients female:male ratio was 51:49, mean age was 52 (15-92). The mean time for answering the questionnaire was 12 (8-23) minutes. Assessment of internal testreliability using cronbachs-α was 0.82 for the questionaire, the dimension information gain was the only below 0.7 Cronbachs-α (0.67). Younger Patients (<50 years) were significant more dissatified (p < 0.0005). Unsatisfied patients complained mosty about somatic disturbances (pain, thirst) and anxiety. Significant confounder were fear and the delay of the procedure in the dimension of anxiety (p < 0,005). The more satisfied group of patients reached a total sumscore of 77% while the more dissatisatisfied group only 49%.
Conclusion: Compared to the previously used instruments with our psychometric designed questionnaire were found a lower satisfaction which more likely represent the “true patient satisfaction”, leaving room for improvement of perianesthesia care even in the group satisfied patients.
1 Bauer M, Bach A. Anästh Intensivmed 1999; 40: 627-637.
2 Fung D, Cohen MM. Anaesth. Analg. 1998; 87: 1089-1098.