Anesthesia-related care dissatisfaction: a cohort historical study to reveal related risks
Insatisfação com os cuidados anestésicos: análise de coorte histórica para determinar os fatores de risco relacionados
Chie Okuda, Satoki Inoue, Masahiko Kawaguchi
Abstract
Background
Most previous reports have used questionnaires to investigate patient satisfaction regarding anesthesia-related care. We retrospectively investigated the dissatisfaction rate for anesthesia and the contributing factors for it using a questionnaire including anesthesia-related adverse events and a simplified patient satisfaction scale.
Methods
This is a retrospective review of an institutional registry containing 21,606 anesthesia cases. We conducted multivariate logistic analysis in 9,429 patients using the incidence of dissatisfaction as a dependent variable and other covariates, including items of anesthesia registry and a postoperative questionnaire, as independent variables to investigate factors significantly associated with the risk of dissatisfaction with anesthesia.
Results
In the study population, 549 patients rated the anesthesia service as dissatisfactory. Multivariate analysis identified the preoperative presence of coexisting disease [odds ratio (OR), 1.29; 95% confidence interval (CI), 1.05–1.59], combination of regional anesthesia (OR, 1.44; 95% CI, 1.10–1.88), self-reported awareness (OR, 1.99; 95% CI, 1.29–3.06), postoperative nausea and vomiting (PONV) (OR, 1.54; 95% CI, 1.25–1.90), occurrence of nightmares (OR, 1.96; 95% CI, 1.52–2.53), and the number of days taken to visit a postoperative anesthesia consultation clinic (OR, 1.01; 95% CI, 1.00–1.02) to be independently associated with dissatisfaction with anesthesia service.
Conclusions
Patients with coexisting disease, undergoing a combination of regional anesthesia, with self-reported awareness, experiencing PONV, suffering from nightmares, and who took longer to visit a postoperative anesthesia consultation clinic tended to rate our anesthesia service as dissatisfactory. Although the exact reasons for the factors contributing to dissatisfaction are unknown, this study suggests that there is room to improve our service.
Keywords
References
1 Emk Walker, M. Bell, Tm Cook, et al. Central SNAP-1 Organisation; National Study Groups. Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study Br J Anaesth., 117 (2016), pp. 758-766
2 T. Heidegger, D. Saal, M. Nübling Patient satisfaction with anaesthesia - Part 1: satisfaction as part of outcome - and what satisfies patients Anaesthesia., 68 (2013), pp. 1165-1172
3 J.E. Ware, R.D. Hays Methods for measuring patient satisfaction with specific medical encounters Med Care., 26 (1988), pp. 393-402
4 R. Goldwag, A. Berg, D. Yuval, et al. Predictors of patient dissatisfaction with emergency care Isr Med Assoc J., 4 (2002), pp. 603-606
5 K.A. Eagle, P.B. Berger, H. Calkins, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery-executive summary a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Circulation., 105 (2002), pp. 1257-1267
6 P. Peduzzi, J. Concato, E. Kemper, et al. A simulation study of the number of events per variable in logistic regression analysis J Clin Epidemiol., 49 (1996), pp. 1373-1379
7 A. Macario, M. Weinger, S. Carney, et al. Which clinical anesthesia outcomes are important to avoid? The perspective of patients Anesth Analg, 89 (1999), pp. 652-658
8 J.-P. Van Besou, W. Harrop-Griffith, E.P. O’Sullivan Chapter 1 Foreword J.J. Pandit, T.M. Cook (Eds.), NAP5 5th National Audit Project of The Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland. Accidental Awareness during General Anaesthesia in the United Kingdom and Ireland, The Royal College of Anaesthetists, London (2014), pp. 9-10
9 J.J. Pandit, J. Andrade, D.G. Bogod, et al. Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors Anaesthesia., 69 (2014), pp. 1089-1101
10 K. Leslie, H. Skrzypek, M.J. Paech, et al. Dreaming during anesthesia and anesthetic depth in elective surgery patients: a prospective cohort study Anesthesiology., 106 (2007), pp. 33-42
11 K. Leslie, J. Sleigh, M.J. Paech, et al. Dreaming and electroencephalographic changes during anesthesia maintained with propofol or desflurane Anesthesiology., 111 (2009), pp. 547-555
12 A. Takechi, S. Inoue, M. Kawaguchi Anaesthesia management by residents does not alter the incidence of self-reported anaesthesia awareness: A teaching hospital-based propensity score analysis Anaesth Crit Care Pain Med., 38 (2019), pp. 63-68
13 C.F.I.I.I. Reynolds, R.M. O’Hara, C.M. Morin, et al. Nightmare Disorder The DSM-5 Task Force. Diagnostic and Statistical Manual of Mental Disorders (5th ed.), American Psychiatric Association, Virginia (2013), pp. 404-407
14 K. Mattarozzi, F. Sfrisi, F. Caniglia, et al. What patients’ complaints and praise tell the health practitioner: implications for health care quality. A qualitative research study Int J Qual Health Care., 29 (2017), pp. 83-89
15 T. Montini, A.A. Noble, H.T. Stelfox Content analysis of patient complaints Int J Qual Health Care., 20 (2008), pp. 412-420
16 J.S. Lavado, D. Gonçalves, L. Gonçalves, et al. General or regional? Exploring patients’ anaesthetic preferences and perception of regional anaesthesia Rev Esp Anestesiol Reanim., 66 (2019), pp. 199-205
17 N.K. Bheemanna, S.R.D. Channaiah, P.K.V. Gowda, et al. Fears and Perceptions Associated with Regional Anesthesia: A Study from a Tertiary Care Hospital in South India Anesth Essays Res., 11 (2017), pp. 483-488
18 D. Saal, T. Heidegger, M. Nuebling, et al. Does a postoperative visit increase patient satisfaction with anaesthesia care? Br J Anaesth., 107 (2011), pp. 703-709
19 M. Capuzzo, G. Gilli, L. Paparella, et al. Factors predictive of patient satisfaction with anesthesia Anesth Analg., 105 (2007), pp. 435-442
20 G.A. Mashour, M.S. Avidan Intraoperative awareness: controversies and non-controversies Br J Anaesth, 115 (Suppl 1) (2015), pp. 20-26
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