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Patient satisfaction with anesthesia services

Sylvie Le May, RN MSc^*,, Jean-François Hardy, MD, Marie-Christine Taillefer, BSc and Gilles Dupuis, PhD

From the Department of Anesthesiology,
^* Faculty of Medicine and the Faculty of Nursing, University of Montreal, and the
Department of Psychology, Université du Québec à Montréal, Montreal, Canada.

Address correspondence to: Dr Jean-François Hardy, Department of Anesthesiology, Faculty of Medicine, University of Montreal, C.P. 6128, succursale Centre-Ville, Montreal, Quebec, H3C 3J7, Canada. E-mail: jean-francois.hardy{at}umontreal.ca

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.

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