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It is possible to measure and improve patient satisfaction with anesthesia?
No full textSatisfaction cannot be considered as an objective indicator of the quality of anesthesia care, but it remains the best way to assess the outcome from the point of view of the patient. Patient satisfaction offers the opportunity for evaluating nontechnical aspects of medical care, in particular interpersonal relationships arising from specific episodes of care. Satisfaction is usually defined as the result of the comparison between expectations and perceived outcome. If improving patient satisfaction with anesthesia becomes one of the aims of a health service, anesthetists have to consider that when patients have an improved anesthesia experience, their expectations are exceeded, which in turn increases the expectations for subsequent anesthetics. A continuous quality improvement process is needed to maintain patient satisfaction at the highest level
Emotional and interpersonal factors are most important for patient satisfaction with anaesthesia
No full textBACKGROUND: Questionnaires to evaluate patient satisfaction with anaesthesia mainly consider physiological aspects. This study was performed to identify the items of value for patients having anaesthesia (pilot phase) and to validate the questionnaire built on these findings in a new group of inpatients. METHODS: In the pilot phase, 100 surgical patients were interviewed and asked whether each of the 23 items selected by a panel of providers was relevant (score 1) and to rank these from 1 (additional score 6) to 5 (additional score 2). The resulting 10-item final instrument was administered to 219 consecutive inpatients by interview, after recent anaesthesia, asking them how much of each item they received (item received) and the level of satisfaction with the same item, using Numerical Rating Scales (range 0-10). RESULTS: In the pilot phase, gender, age, education and surgery did not influence the score enough to change the first 10 rank-ordered items. The 219 patients subsequently studied did not differ from those missing the questionnaire administration. The patients aged less than 55 years showed lower satisfaction scores than those aged 55 years or more (P = 0.019). In all items, except 'feeling anxious/frightened', the item received was significantly associated with the satisfaction reported. 'Kindness/regard of caregivers' together with 'information given by anaesthetist' and 'feeling safe' predicted 47% of the variance in total patient satisfaction. CONCLUSIONS: Inpatients value highly those elements of care that pertain to emotional and interpersonal relationships
Analgesia, sedation, and memory of intensive care
No full textPURPOSE: The purpose of this article was to investigate the relationship between analgesia, sedation, and memory of intensive care. PATIENTS AND METHODS: One hundred fifty-two adult, cooperative intensive care unit (ICU) patients were interviewed 6 months after hospital discharge about their memory of intensive care. The patient was considered to be cooperative when he/she was aware of self and environment at the interview. The patients were grouped as follows: A (45 patients) substantially no sedation, B (85) morphine, and C (22) morphine and other sedatives. RESULTS: The patients having no memory of intensive care were 38%, 34%, and 23% respectively, in the three groups. They were less ill, according to SAPS II (P <.05), and had a shorter ICU stay (P <.01). Group C patients were more seriously ill according to SAPS II, duration of mechanical ventilation, and length of stay in ICU and in hospital (P <.001). The incidence of factual, sensation, and emotional memories was not different among the three groups. Females reported at least one emotional memory more frequently than males (odds ratio 4.17; 95% CI 10.97-1.59). CONCLUSIONS: The patients receiving sedatives in the ICU are not comparable with those receiving only opiates or nothing, due to the different clinical condition. The lack of memory of intensive care is present in one third of patients and is influenced more by length of stay in ICU than by the sedation received. Sedation does not influence the incidence of factual, sensation, and emotional memories of ICU admitted patients. Females have higher incidences of emotional memories than males
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