Patient satisfaction with anesthesia services

  • Sylvie Le May
  • Jean-François Hardy
  • Marie-Christine Taillefer
  • Gilles Dupuis
General Anesthesia

Abstract

Purpose: The evaluation of services by patients is an essential component of continuous quality improvement in anesthesiology. Little is known, however, about how to achieve this objective. Our goal was to conduct a systematic review of all available studies on patient satisfaction with anesthesia services, thereby ascertaining the present level of knowledge in this field and suggesting ways of improving current measurement methodologies.

Source: We reviewed relevant major data banks - Medline, Dissertation Abstract, Psyclit and Cochrane -between 1980 and 2000 and bibliographies from primary sources. We used the following keywords for our search: quality improvement, anesthesia, quality, patient perceptions, consumer satisfaction, continuous quality improvement, outcome measures.

Principal findings: The review yielded 14 pertinent studies. Studies were divided into two groups (A & B), according to the quality of the psychometric evaluation (tests performed to verify the reliability and validity of an instrument). While all studies reported high levels of patient satisfaction with anesthesia services, many used methods of questionable value. None of the 14 studies controlled for any confounding variables, such as social desirability. Four studies had seriously biased their data collection and the majority of the studies lacked rigour in the development of the instrument used to measure patient satisfaction. Only one study presented a definition of the concept measured, and none provided a conceptual model of patients’ satisfaction with anesthesia services.

Conclusion: The currently available studies of patient satisfaction are of questionable value. Only rigorous methods and reliable instruments will yield valid and clinically relevant findings of this important issue in anesthesiology.

Résumé

Objectif: L’évaluation de la qualité des services, par les patients, est une composante essentielle de l’amélioration de la qualité des services en anesthésiologie. Cependant, nos connaissances dans ce domaine sont limitées. Nous proposons une évaluation systématique de la littérature sur ce sujet dans le but d’améliorer la méthodologie reliée à la mesure de ce concept.

Source des références: Nous avons procédé à une revue systématique de plusieurs banques de données -Medline, Dissertation Abstract, Psyclit, et Cochrane - pour la période de 1980 à 2000 ainsi que les bibliographies des références primaires. Les mots-clés suivants ont été utilisés: amélioration de la qualité, anesthésie, qualité, perceptions des patients, satisfaction de la clientèle, amélioration continue de la qualité, mesure des résultats.

Principaux résultats: La revue systématique de la littérature a permis de recenser 14 études pertinentes. Elles ont été divisées en deux groupes (A & B) selon la qualité de l’évaluation psychométrique (vérification de la fidélité et de la validité des instruments). Toutes ces études présentent des taux élevés de satisfaction des patients à l’égard des services anesthésiques. Cependant, les méthodes choisies pour l’évaluation de la satisfaction des patients présentent des biais importants. Aucune de ces études n’a présenté de moyens de contrôle des variables confondantes telles que la désirabilité sociale. Il y a présence de biais dans la collecte de données de quatre études et la majorité démontre peu de rigueur dans le développement de l’instrument utilisé. Une seule étude a fourni une définition du concept mesuré et aucune n’a proposé de cadre conceptuel.

Conclusion: Les études publiées à ce jour sur la satisfaction des patients sont d’une valeur douteuse. Il est essentiel d’employer des méthodes rigoureuses ainsi que des instruments fiables, afin de générer des résultats valides et cliniquement pertinents sur ce domaine important en anesthésiologie.

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Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Sylvie Le May
    • 1
    • 3
  • Jean-François Hardy
    • 3
  • Marie-Christine Taillefer
    • 2
  • Gilles Dupuis
    • 2
  1. 1.Faculty of Medicine and the Faculty of NursingUniversity of MontrealMontrealCanada
  2. 2.the Department of PsychologyUniversité du Québec à MontréalMontrealCanada
  3. 3.Department of Anesthesiology, Faculty of MedicineUniversity of MontrealMontrealCanada

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