Patient satisfaction with anaesthesia services and associated factors at the University of Gondar Hospital, 2013: a cross-sectional study

Enhanced perioperative communication elevates patients' understanding, perception, and satisfaction for anesthesia services: Insights from a survey study

Background and Aims

Anesthesiologists' services extend to many critical areas of any healthcare setup. However, there needs to be more understanding among the public regarding their crucial role. Preanesthesia evaluation (PAE) visits can disseminate information about anesthesiologists and services. We aimed to evaluate patient's knowledge and the impact of interview-based surveys on increasing knowledge about anesthesiologists and anesthesia services.

Methodology

It was a single-center, cross-sectional survey involving 550 patients aged 18-65 undergoing elective surgeries. Pre- and postoperative interviewer-assisted questionnaires were administered to assess patients' baseline knowledge and perception of anesthesia and anesthesiologists. Statistical analysis focused on demographic, educational, and previous anesthesia exposure among subgroups; a P-value <0.05 was considered significant.

Results

Less than half comprehended anesthesia's role as a specialist in inducing unconsciousness. 55.3% were unaware of general anesthesia, and 69.6% were unaware of regional anesthesia as a technique. Higher education and previous anesthesia exposure correlated with better awareness with regard to the perioperative role of anesthesiologists and their fields of work (P < 0.05). The postoperative survey indicated good satisfaction with anesthesiologists' services, which might be attributable to the survey-based interaction.

Conclusion

A significant need for more understanding regarding anesthesia and anesthesiologists' roles still prevails. Interview-based effective communication during PAE visits, perioperative period, and shared decision-making (SDM) improves patients' knowledge, comprehension, and satisfaction.

Comparing quality of recovery and satisfaction between spinal anesthesia and nerve block in orthopedic below-knee surgery: A prospective controlled trial

BACKGROUND

Postoperative quality of recovery (QoR) and patient satisfaction have gained increasing significance in medical services. This study aimed to compare these 2 parameters between 2 types of regional anesthetics (spinal anesthesia and combined sciatic-femoral nerve block) in orthopedic lower knee surgery.

METHODS

A total of 101 patients were classified into 2 groups (combined sciatic-femoral nerve block, group N; spinal anesthesia, group S) according to patient preference. In group N, sciatic and femoral nerve blocks were performed on the popliteal and groin regions, respectively, under ultrasound guidance. Spinal anesthesia was performed in group S. The primary outcomes were QoR and patient satisfaction. QoR was measured using the Korean translation of the QoR-15K. Patient satisfaction was assessed using an 11-point Likert scale (0-10) and a dichotomous question addressing anesthesia preferences for future surgeries.

RESULTS

The physical independence of the postoperative QoR-15K was significantly higher in group N than in group S (14.2 vs 12.0, P = .04). On the 11-point Likert scale, group N scored 8.8, and group S scored 7.8 (P = .001). In the dichotomous question, 93.8% of the group N and 52.8% of the group S answered that they would like to choose the same anesthesia method for the next surgery (P < .001). In addition, fewer participants in group N complained of backache than those in group S, and the time to first urination after anesthesia was shorter in group N than in group S (P = .004, <.001, respectively).

CONCLUSION

Combined sciatic-femoral nerve block may provide better physical independence and satisfaction than spinal anesthesia in orthopedic below-knee surgeries.

Patient satisfaction with post-operative surgical services and associated factors at Addis Ababa City government tertiary hospitals' surgical ward, cross-sectional study, 2022

Introduction

patient satisfaction is an attitude resulting from a person's general orientation towards the total experience of health care. The study was done with the aim of evaluating post-operative patient satisfaction level with the quality of service provided at the surgical wards; determining how much factors related to physicians, nursing, laboratory, and information provision service influence satisfaction level; and determining factors impacting patient satisfaction level.

Methods

a hospital-based quantitative cross-sectional study design was conducted in six Addis Ababa City Government tertiary hospitals from November 4th to December 13th, 2022. Patients who had major operations done at the government hospitals from November 21st to December 5th, 2022, were included in the study population. A pre-tested, structured, and Amharic-version questionnaire was used to interview patients. A bivariate and multivariate logistic regression model was used to identify the variables that had an association with the dependent variable. P-values less than 0.05 were considered statistically significant.

Results

a total of 287 patients participated in the research, providing a response rate of 95%. Of the total participants, 144 were males (50.8%) and 143 were females (49.5%). The overall patient satisfaction level with surgical ward service is 96.2%. The level of patient satisfaction with nursing services is 94.8%, with physician's services it is 98.6%, with the facility it is 92.3%, and with the provision of information about post-operative complications it is 69.7%. Those who have above-first-degree educational status are less satisfied (66.7%) than patients with other levels of educational status. Only the patients' residency showed a small level of association (r= 0.145, p=0.014) with overall patient satisfaction with surgical ward service among the demographic components. The two variables that are strongly correlated with patient satisfaction are the adequacy of the time ward nurses spent with patients during evaluation and treatment (r = 0.503, p = 0.000) and adequate nurses' response to patients' calls (r = 0.498, p = 0.000). Post-operative patient satisfaction with surgical ward nursing service, physician service, hospital facilities, and the provision of information about post-op complications explain about 40.9 percent of the variation in the overall patient satisfaction with post-op care provided at the surgical ward. Patient satisfaction with nursing service has more significant effect with overall patient satisfaction than the other variables (β = 0.266, p =0.0002).

Conclusion

post-operative patients at Addis Ababa City Government Tertiary Hospitals expressed a very high degree of satisfaction with the care they received in the surgical wards. The study also found that patients were generally less satisfied with the information they were given on drugs, side effects, and available treatment options. Another factor identified in the study that caused unhappiness was the unavailability of some pharmacy and laboratory services.

Patients' knowledge and perception of anesthesia and the anesthetists: Cross-sectional study

Background

Anesthesiology was misconceived as a behind the screen specialty. Despite significant advancements in its scope, anesthesia remains have a poor public image, clients are not even aware of an anesthetist as a medically qualified health professional, particularly in underdeveloped countries. There has been very little study done on the public's awareness of anesthesia in Ethiopia. This study was conducted to assess the level of patients' knowledge and perception of anesthesia and the anesthetists.

Methods

Institution-based, cross-sectional study was conducted from January to May 2021, at the University of Gondar comprehensive specialized hospital, Ethiopia. Consenting participants were asked to answer a standard questionnaire in a personal interview to assess their knowledge about anesthesia and the anesthetist. Descriptive statistic was used to explain the study participants with study variables and to describe their perception about anesthesia and anesthetists. Binary logistic regression analysis was performed to identify the association between the level of knowledge and independent variables. The strength of the association between the independent variables and the level of knowledge was presented by an adjusted odds ratio and 95% Confidence Interval.

Results

A total of 307 study participants were included in this study with a response rate of 100%. Of these 113 (36.8) were males and 194 (63.2) were females. Two hundred twenty (71.7%) study participants answered less than half of the questions correctly and had a poor level of knowledge the rest 87 (28.3%) had a good level of knowledge and the mean knowledge score was1.72 ± 0.45. Previous anesthesia exposure (p value = 0.001) and occupation (p value = 0.022) of participants had statistically significant association with the level of knowledge.

Conclusion

and recommendation: We have found that patients had very limited (poor) knowledge and perception regarding anesthesia and the role of anesthetists. Anesthetists should do a complete pre-anesthetic assessment which helps them to achieve good patient recognition.

Noise in the operating room during induction of anesthesia: impact of a quality improvement initiative

PURPOSE

Noise in the operating room (OR) is common and associated with negative effects on anesthesiologists, surgeons, and patient outcomes. Induction of anesthesia is among the loudest perioperative periods. Despite its critical nature, there is little data on noise levels during induction, associated patient and anesthesiologist satisfaction, and the effects of noise reduction strategies.

METHODS

We conducted a two-part prospective interventional quality improvement project on the care of adult patients receiving general anesthesia for elective noncardiac surgery. For part A, we measured average and peak noise (dB[A]) levels during anesthesia induction in N = 100 cases and administered a satisfaction questionnaire to anesthesiologists. We then applied a multidisciplinary educational program to OR personnel on active noise reduction strategies and subsequently collected data during N = 109 cases in a post-intervention phase. For part B, we administered satisfaction questionnaires to N = 100 patients pre- vs postintervention, respectively.

RESULTS

Median [interquartile range] noise levels throughout induction were 66.0 [62.5-68.6] dB(A) preintervention vs 63.5 [60.1-65.4] dB[A] post-intervention (Hodges-Lehmann estimator of the difference, - 2.7 dB[A]; 95% confidence interval [CI], - 4.0 to - 1.5; P < 0.001). Peak noise levels during induction were 87.3 [84.0-90.5] dB(A) preintervention and 86.2 [81.8-89.3] dB(A) postintervention (Hodges-Lehmann estimator of the difference, - 1.8 dB[A]; 95% CI, - 3.3 to - 0.3; P = 0.02). Noise-related anesthesiologist satisfaction postintervention was significantly improved in multiple domains, including assessment of noise having distracted anesthesiologists. Patient satisfaction was high pre-intervention and did not significantly improve further.

CONCLUSION

In this quality improvement project, average noise levels during induction of anesthesia, anesthesiologist satisfaction, and anesthesiologists' perceived ability to perform were improved following a multidisciplinary educational program on noise reduction in the OR.

STUDY REGISTRATION

www.ClinicalTrials.gov (NCT04204785); registered 19 December 2019.

Patient Satisfaction Survey on Perioperative Anesthesia Service in University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021

Background

Patient satisfaction is a crucial component in determining the quality of healthcare in anesthesia services. This study aimed to assess patient satisfaction and associated factors on perioperative anesthesia services.

Methods

Institutional-based cross-sectional study was conducted from May 16 to June 22, 2021, at the University of Gondar Comprehensive Specialized Hospital. Data were entered into Epi-data version 3.1 and exported to STATA version 14.1. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval, and a p value <0.05 was considered as statistically significant.

Results

A total of 398 patients were included in this study with a response rate of 98%. The overall proportion of patients who were satisfied with perioperative anesthesia service was 74% (95% CI: 69–78). Patients who received regional anesthesia were 2.8 times satisfied than those who received general anesthesia (AOR = 2.8, 95% CI: 1.42–5.36). Patients who obtained adequate information was 3.14 times (AOR = 3.14, 95% CI: 1.71–5.74) satisfied than that of the counterpart. Adults who did not feel pain during induction of anesthesia were 2.7 times (AOR = 2.7, 95% CI: 1.43–5.08) satisfied than an adult who felt pain during induction of anesthesia. Conclusion and Recommendations. The overall patients' satisfaction on perioperative anesthesia service was 74%. Patients who underwent operation with regional anesthesia, obtained adequate information about anesthesia, visited by anesthetists after operations, did not have nausea/vomiting, did not feel pain during induction, and patients who did not feel pain immediately after operation were satisfied than the counterparts. We recommended that the anesthetists must give attention to reduce the factors that decrease the satisfaction level of the surgical patients.

Predicting factors that determine patients' satisfaction with post-operative pain management following abdominal surgeries at Komfo Anokye Teaching Hospital, Kumasi, Ghana

Introduction

Poorly controlled postoperative pain has been known to be characterized by longer post-operative care, longer hospital stays with increased readmission rates, and decreased patient satisfaction. Post-operative pain has been continuously addressed in the past three (3) to four (4) decades and has been shown that 20 to 80% of post-operative patients suffer ineffective pain management.

Objective

The study was aimed at assessing the factors that may predict the satisfaction of patients with early postoperative pain management following abdominal surgeries at the Komfo Anokye Teaching Hospital, Kumasi.

Methodology

A descriptive cross-sectional study was conducted among patients who had undergone abdominal surgeries between October 2019 and December 2019 at the Komfo Anokye Teaching Hospital. Structured questionnaires based on the IPO-Q were used to obtain responses from the patients. Descriptive and Inferential statistical analysis were employed in analyzing the data obtained from the respondents of the study.

Results

138 patients were involved in this study. The mean age of patients in the study was 45.81 (±16.81) years. A higher percentage, 58.7% of the patients were males. 39.1% had completed their tertiary level of education. The majority (50.7%) of the patients had had persistent pain for more than three (3) months. The satisfaction of the patients with the post-operative pain management received was generally high among a significant majority of the patients. Meanwhile, among the factors that influence the satisfaction of the patients with the post-operative pain management received, type of analgesia and pain relief methods (Pearson Coefficient = 0.523, p-value <0.05), patient’s ability to request more pain relief, (Pearson Coefficient = 0.29, p-value <0.05), patient’s access to information about their pain treatment options from the Nurses (Pearson coefficient = -0.22, p<0.05), were the only predictors of satisfaction in patients.

Conclusion

This study found out that patients were generally satisfied with the post-operative pain management offered by their healthcare providers although the degree of satisfaction depended largely on the type of analgesia and pain relief methods, the ability to request for more pain relief, and access to information on pain treatment.

Effect of transcutaneous electrical nerve stimulation on quality of recovery and pain after abdominal hysterectomy

Background and Aims:

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive complementary therapy for postoperative pain management. The effect of TENS on quality of recovery (QoR) and pain treatment in the early postoperative period is not well documented. The aim of this study was to evaluate the effect of TENS on postoperative QoR and pain in patients who had undergone a total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH + BSO).

Material and Methods:

Fifty-two patients were randomized into two groups: control (sham TENS treatment) and TENS (TENS treatment). QoR, dynamic pain, and static pain were evaluated after surgery.

Results:

The QoR score was significantly higher in the TENS group as compared with that in the control group (P = 0.029). Pain scores during coughing (dynamic pain) were significantly less in TENS group compared to control group (P <0.001). However, there was no between-group difference in pain scores at rest (static pain) or total analgesic consumption (P = 0.63 or P = 0.83, respectively).

Conclusion:

TENS may be a valuable tool to improve patients' QoR and dynamic pain scores after TAH + BSO.

Does Preoperative Anxiety Decrease with BATHE Method? A Prospective Randomized Study

Introduction

Preoperative anxiety due to anesthesia is a common situation and decreases with preoperative evaluation. The aim of this study is to determine whether utilization of BATHE method further decreases the anxiety scores of patients who are evaluated at an anesthesia clinic for preoperative examination.

Methods

The patients were randomized into "BATHE" and "Control" groups by using the closed envelope technique. State-Trait Anxiety Inventory (STAI) scores were recorded as entrance STAI for all patients. During preoperative evaluation, BATHE method was applied to the BATHE Group whereas it was not applied to the Control Group. Post-examination, STAI scores were recorded as exit STAI and the patients were later asked questions about their contentment.

Results

Data of 463 patients were included in the analysis. Demographic data was similar in the groups. In both groups the exit STAI scores (BATHE: 34.27±10.30, Control: 34.90±9.54) were lower in comparison to the entrance STAI scores (BATHE: 38.21±9.86, Control: 37.09±9.93). The mean gap between the entrance STAI and exit STAI scores of the BATHE (3.94±6.05) and Control groups (2.19±6.14) were statistically significant (p<0.001).

Conclusion

Utilization of BATHE method decreases the anxiety scores of preoperative patients to a greater extent, as measured by STAI index, in comparison to standard preoperative evaluation.

A prospective study on elective surgical inpatient satisfaction with perioperative anaesthesia service at Ayder comprehensive specialized hospital, Mekelle, Ethiopia

BACKGROUND

Patient satisfaction is a subjective and challenging perception, linking physical, expressive, psychological, societal, and cultural factors. Dissatisfaction arises if the patient feels an inconsistency between expected and delivered care. Usually health care satisfactions are very high and according to many studies levels of satisfaction are above 85% and patient's satisfaction in terms of anesthesia is not very different. The aim of this study was to assess patient's satisfaction with perioperative anesthesia service and associated factors.

METHODS

Institution-based cross-sectional study was conducted from December to January, 2017/8 at the Ayder Comprehensive Specialize Hospital. The data were collected using structured interviewer-administered questionnaire prepared to collect data on demographic character of the patients, determinant factors which could affect the patient satisfaction level on anesthesia service. Epi Info version 6 was used to record the data and SPSS version 20 was used for the analysis. Descriptive statistics were used to explore the socio-demographic characteristics of patients; factors possibly related to satisfaction level and overall satisfaction were summarized as frequencies and percentages.

RESULTS

One hundred twenty consecutive patients were originally enrolled in the study that took over 1 Month. The overall proportion of patients who satisfied with anaesthesia services was 88.33%. Nausea and vomiting, pain, shortness of breath and cold were factors which affected patient satisfaction negatively.

CONCLUSION AND RECOMMENDATION

Compared with the other studies done at home and abroad; the overall proportion of patients, in Ayder comprehensive specialized hospital, who responded for satisfaction with perioperative anesthesia service is low. Patient satisfaction level should be determined regularly and all bodies should work to decrease the factors which decrease the satisfaction level.

Areas and factors associated with patients' dissatisfaction with glaucoma care

OBJECTIVE

The aim of this study was to evaluate patients' dissatisfaction with overall and specific aspects of a tertiary glaucoma service and to determine their independent factors, including intraocular pressure (IOP) and visual acuity (VA).

METHODS

Patients, aged ≥21 years, from a specialist glaucoma service in a tertiary eye hospital in Singapore for at least 6 months, were recruited for this cross-sectional study between March and June 2014. All consenting patients completed a 7-area glaucoma-specific satisfaction questionnaire and one item related to satisfaction with overall glaucoma care. We determined the top three areas of dissatisfaction and overall dissatisfaction with the glaucoma service. We also explored the independent factors associated with overall and specific areas of patients' dissatisfaction with their glaucoma care, including VA and IOP by using logistic regression models.

RESULTS

Of the 518 patients recruited, 438 (84.6%) patients completed the study. Patients' dissatisfaction with the overall glaucoma service was 7.5%. The three areas of glaucoma service with the highest dissatisfaction rates were as follows: 1) explanation of test results (24.8%); 2) explanation of glaucoma complications (23.7%); and 3) advice on managing glaucoma (23.5%). Patients who were dissatisfied with the overall service had a worse mean VA compared with satisfied patients (logarithm of the minimum angle of resolution =0.41±0.43 vs 0.27±0.49, p=0.005), whereas mean IOP remained well-controlled in both the groups (13.55±2.46 mmHg vs 14.82±2.86 mmHg, p=0.014). In adjusted models, factors associated with overall dissatisfaction with glaucoma care included a pre-university education and above (odds ratio [OR] =8.06, 95% CI =1.57-41.27) and lower IOP (OR =0.83, 95% CI =0.71-0.98).

CONCLUSION

Although less than one tenth of glaucoma patients were dissatisfied with the overall glaucoma service, one in four patients were dissatisfied with three specific aspects of care. A lower IOP, ironically, and education level were associated with overall dissatisfaction. Improving patients' understanding of glaucoma test results, glaucoma complications, and disease management may increase patient satisfaction levels.

[The practice of postanesthesia visits - a questionnaire study]

BACKGROUND AND OBJECTIVE

Regular postanesthesia visits allow the detection of anesthesia related complications and increase patient satisfaction. Consequently, the performance of postanesthesia visits has been recommended after certain types of anesthesia. However, no data is available concerning the current practice of postanesthesia visits. Therefore, this study was designed to investigate quantity, organization, contents, significance and problems of postanesthesia visits in Germany.

METHODS

For this prospective closed-design survey, a questionnaire, consisting of 13 questions, was designed and tested for objectivity, reliability and validity. Subsequently, 3955 registered anesthesiologists were contacted via email to answer this survey.

RESULTS

Return rate was 31.4%; 958 questionnaires were included in the study. Only a small portion of patients was estimated to receive a postanesthesia visit (median: 20.0%). In hospitals with a specific postanesthesia visit service, this number was significantly higher (median: 65.0%, p<0.001) vs. no postanesthesia visit service. Postanesthesia visits usually lasted less than 5minutes (60.0%), and were typically conducted on the day of surgery (48.0%), after regular working hours (55.0%). 38.0% of the respondents reported to detect perioperative complications intermittently during their visits. While 98.0% of all respondents believe that postanesthesia visits improve the quality of their own work, 86.0% of the participants complain a lack of time for this task.

CONCLUSIONS

Our survey indicates that current working conditions prevent a regular postanesthesia visit routine. Considering the high appreciation of postanesthesia visits by anesthesiologists, as well as the relevant incidence of postoperative complications detected during these visits, it seems desirable to consider organizational improvements for postanesthesia care.

[Quality in the anesthesia department of San Cecilio Hospital from the professionals' perspective]

OBJECTIVE

To evaluate the quality of the services provided by the anaesthesia department of the San Cecilio Clinical University Hospital, from the health professionals' point of view.

MATERIAL AND METHODS

Location: Andalusia.

PARTICIPANTS

134 health professionals in contact with the hospital anaesthesia department. Tool: self-administered questionnaire, measuring: accessibility, personal treatment, comfort, scientific and technical quality (scale 1 to 5), overall satisfaction (scale 0 to 10), and suggestions for improvement. A descriptive statistical and correlation analysis were performed, including mean differences (by sex, frequency of contact with the anaesthesia department, and unit), as well as a regression model.

RESULTS

The quality of personal treatment received a mean of 4.2 points (SD 0.651), the scientific and technical quality 4.00 points (SD 0.532), accessibility 3.3 (SD 0.795), professional comfort 3.30 (SD 0.988), and patient comfort 2.62 points (SD 1.051). Overall satisfaction obtained a mean of 7.1 points (0 to 10 scale). Women and professionals working in units with less than 10 people had a better general evaluation of the anaesthesia department. The worse perspective was that of staff with daily contact with the anaesthesia department. Among the suggestions for improvement there were: Reducing waiting lists, creating special rooms to give information to families, improving working conditions, training and work satisfaction for staff, and achieving better communication and collaboration between health professionals.

CONCLUSIONS

The internal evaluation shows the need for training strategies and organisational interventions in the anaesthesia department, in order to achieve a better quality and satisfaction for both professionals and patients.