PATIENT SATISFACTION WITH ANESTHETIC CARE: WHAT DO WE KNOW?
Creators: name: Falco, Darlene K.
Publisher: name: Zenodo
Year: 2016

description: Patient satisfaction with anesthesia care (PSAC) impacts perceived quality of anesthesia care and may be linked to reimbursement, provider competency evaluations, and litigation. The purpose of this doctoral project was to examine published PSAC evidence in order to conceptualize it, identify modifiable factors related to it, and provide recommendations for providers which may enhance PSAC. Limited to English articles published within the last 20 years, the evidence search for articles focused on those with data and conceptualizations of PSAC and excluded those only addressing PSAC in pediatrics and obstetrics. Multiple sources were searched including Google Scholar, Pubmed, Cinahl, Business (EBSCO), ABI Inform Complete and Science Direct. Publications found included systematic reviews, reports from surveys, reports from qualitative data, and consumer satisfaction articles. From these, articles from 27 quantitative studies, seven qualitative studies, and nine consumer satisfaction commentaries were selected for analysis. Prior patient experiences, colored or mediated by patient emotions, along with the realities of a current experience impacts how patients perceive or remember their overall anesthetic experience. The sum of the anesthetic experience includes the encounter with the anesthetist, the actual anesthesia experience, as well as the postoperative experience. Few measures for PSAC were found. Development and psychometric analysis of PSAC measures varied across studies and often lacked rigor. Despite this, documented iv PSAC was high across all sources of evidence. Modifiable patient dissatisfiers include preoperative anxiety, inadequate anesthesia explanation, long wait times, pain, nausea and vomiting, long surgeries, and anesthesia complications. Studies evaluating patient perioperative experiences document that fear and anxiety related to prior patient experience impacts anticipatory anxiety. Patients desire positive experiences and an emotional connection with anesthesia providers. Developed within this project, the Anesthesia Patient Satisfaction Model shows several modifiable factors that can be addressed by anesthetists. For example, anesthetists must consider the impact of patient emotions as a filter through which anesthesia expectations are formed; emotions such as anxiety and fear require provider attention in order to mitigate patient dissatisfaction. In addition to providing information, setting reasonable expectations for things such as nausea and vomiting, and adequately treating discomfort/pain, anesthesia providers must engage emotionally with patients. Future qualitative research addressing patient experiences with differing types of anesthesia would be insightful in furthering comprehension regarding theses potentially stressful patient experiences. In clinical settings, using a standardized measure of PSAC that includes the emotional component of PSAC may offer a more accurate appraisal of patient experiences. Educators may consider developing anesthesia simulation or role play exercises that use a highly anxious preoperative patient in an effort to effectively prepare providers for addressing these patients before surgery.