Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018




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Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
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Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2023 | Month : January | Volume : 17 | Issue : 1 | Page : UC10 - UC16 Full Version

Patient Satisfaction with Anaesthesia: Perioperative Questionnaire versus Face-to-face Survey


Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/60521.17251
Mathew George, N Kiran, M Ravi

1. Postgraduate Student, Department of Anaesthesia, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. 2. Professor, Department of Anaesthesia, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. 3. Professor and Head, Department of Anaesthesia, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.

Correspondence Address :
Dr. N Kiran,
Professor, Department of Anaesthesia, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar-563103, Karnataka, India.
E-mail: mathewp94.mg@gmail.com

Abstract

Introduction: Factors favouring patient satisfaction in anaesthesia are availability of services based on Institutional facilities, mutual between with anaesthesiologist and patients, skill of healthcare experts and patient requirements. When one wishes to improve response rates and raise the calibre of the data captured, face-to-face surveys are among the greatest methods for gathering data. It can be challenging to quantify subject satisfaction in anaesthesia, since subjective indications vary by person, culture and background. Patients rating of their own satisfaction can estimate the care given during procedure, which cannot be easily assessed in any other way.

Aim: To assess patient satisfaction regarding the care provided during anaesthesia and to find out whether dissatisfactions are better elicited through face-to-face interviews or questionnaire.

Materials and Methods: This cross-sectional study was conducted on patients undergoing surgery under general or regional anaesthesia at Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India, from November 2021 to February 2022. Estimated sample size was 74. As per American Society of Anaesthesiologist (ASA) grades 1 and 2, adults in the age group of 18–65 years were divided into two groups using chits. In group A, face-to-face interview was done on postoperative day 2 by anaesthesiology resident. In group B, questionnaire was given on postoperative day 2 by anaesthesiology resident. The questions on anaesthesia-related dissatisfaction were posed in a semi-dichotomous scale (no/yes-mild, moderate, severe); the questions on satisfaction with anaesthesia care were given on a 4-item scale (extremely satisfied/satisfied/neutral/dissatisfied). The data was analysed by using Statistical Package for the Social Sciences (SPSS) software version 22.0, and R environment version 3.2.2 and Microsoft word and Excel have been used to generate graphs and tables.

Results: Patient population included in study was 74, among which 63 (85.1%) patients were extremely satisfied with the care given by Anaesthesia Department in general, 7 (9.5%) were satisfied, 4 (5.4%) were neutral, and no one were dissatisfied. Among questionnaire group 36 (97.3%) patients were extremely satisfied with anaesthesia care in general, while 27 (73%) of face-to-face group were extremely satisfied with anaesthesia care in general. Among anaesthesia related dissatisfactions 65 (87.8%) of patients did not complain of postoperative nausea and vomiting. In the present study, 52 (70.3%) patients were extremely satisfied with pain relief after surgery.

Conclusion: Face-to-face interview identifies more patients who report lower degree of satisfaction with anaesthesia, it can be concluded that, interviewing is better suited for detecting quality problems with anaesthesia care than written questionnaire.

Keywords

American society of anaesthesiologist, Interview, Patient care, Patient gratification

Patient satisfaction is an indicator of the security and quality of services provided by healthcare team. It incorporates a comprehensive approach to determine, how well the patient’s perceptions about the quality provided by healthcare provider have been met (1). Patient satisfaction is dependent on a variety of aspects, like service availability and convenience, which are influenced by Institutional facilities, interpersonal connections, technical skill of healthcare providers, patient expectations and preferences. Due to the intricate nature of satisfaction, questionnaires should include numerous items to evaluate certain events. The design of a patient satisfaction questionnaire demands a gradual psychometric strategy and confirmation in reality (2). There are many ways to estimate patient care and satisfaction, including postoperative visits and questionnaires. Face-to-face surveys improve response rate and raise the caliber of data captured. Face-to-face surveys being frequently used to gather data for projects that are assumed to be accurate (3).

Patients rating of their own satisfaction can estimate the care given during procedure which cannot be easily assessed in any other way. It improves and deepens the relationship between the patient and the anaesthesiologist as well as the standard of anaesthesia care given to the patient. Patients mostly have problems in analysing the quality of anaesthesia care independently from the overall care during treatment. Cultural and socio-economic factors are known to influence patient satisfaction (4). The significance of quality control in the operating theatre, including anaesthesia care should not be compromised. The perioperative patient care system can be enhanced by ensuring patient safety, employing techniques that can strengthen clinical decisions in the operating theatre, and applying innovative techniques for minimising perioperative complications (5).

One of the main components of patient satisfaction is improving communication skills with the patients. It measures the relevance of the information given, may reduce patient anxiety while rising patient satisfaction and so enhances the quality of the service (6). Only few researches have been conducted regarding patient satisfaction with the anaesthesia care using questionnaire and face-to-face surveys in India. Therefore, the present study was aimed to assess patient satisfaction and dissatisfactions with anaesthesia care in general. The secondary objective was to assess the level of patient satisfaction regarding the care provided during anaesthesia using questionnaire and face-to-face interview.

Material and Methods

This cross-sectional study was conducted in the Department of Anaesthesiology at Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India, from November 2021 to February 2022. Approval from the Institutional Ethics and Scientific Committee was obtained (DMC/KLR/IEC/369/2021-22 dated 30/09/2021). Written informed consent was obtained from all the patients.

Inclusion criteria: Adults in the age group of 18-65 years undergoing elective surgery under general or regional anaesthesia, under physical status American Society of Anaesthesiologist (ASA) grade I and II were included in the study (7).

Exclusion criteria: Patients with associated head injury, psychiatric patients, terminally ill, patients not willing to take part in the study were excluded from the study.

Sample size calculation: The sample size was calculated using the proportion of people who were very satisfied with the anaesthesia department (74%), as reported in a survey by Bauer M et al., considering an alpha error of 10% with 95% confidence interval (8). The sample size estimated was 74.

n=Z2a/2P(1-P)/ E2
z-1.96
P-74 E-10

Z- Standard normal distribution for the desired confidence interval.
n- Sample size
P- Prevalence
E- Error

Study Procedure

Detailed preanaesthetic assessment of all patients was done on the previous day. Patients were clearly explained about the regional and general anaesthesia procedures. Subjects were nil per oral for six hours before procedure. Ranitidine150 mg was given to patient two hours before shifting to operation theatre and after shifting, intravenous line was secured, monitors attached and baseline vital parameters were recorded. Warmer was attached to prevent hypothermia. Intraoperatively patients were stabilised either under regional or general anaesthesia. Patients were shifted to post anaesthesia recovery room and were assessed on postoperative day 2. Same set of questions were included in both groups. All the 74 patients were allocated into two groups based using chits.

Group A: Resident from Department of Anaesthesiology asked anaesthesia care related questions on postoperative day 2. Patients responded to surveys conducted in-person (face-to-face) based on their observations. Resident filled questionnaire based on replies given by patient. After completing proforma containing questionnaire, handed over to Anaesthesiology Department.

Group B: Questionnaires form was directly given to patients either in English or native language based on their preference on postoperative day 2 by anaesthesiology resident. Patients were asked to fill the questionnaire and give it back to corresponding ward nurse in their wards. After completing proforma containing questionnaire, ward nurse handed over proforma to Anaesthesiology Department.

Questionnaire

The questionnaire involved information on age, sex, education, satisfaction and dissatisfaction regarding anaesthesia care. Questionnaire was created to gauge patient satisfaction and unhappiness with anaesthetic services overall. The Bauer’s patient satisfaction questionnaire’s questions were revised based on Indian standards (8). Modified questionnaire was made after discussing with all authors. Senior faculty who helped in formulating questionnaire had >15 years of experience in the Department of Anaesthesiology. A pilot study was conducted among 10 patients using modified questionnaire. Since the results of the pilot study were appropriate, the main study was executed.

The questionnaire contained two aspects of the anaesthesia care in general. The first aspect was patient satisfaction with anaesthesia care. A set of 10 questions were designed for the assessment of satisfaction with anaesthesia care and the responses were evaluated on a 4-item scale with reponses recorded as extremely satisfied, satisfied, neutral and dissatisfied. The 4-item scale was revised from Bauer questionnaire (8). Patient was asked to reply for questions based on their satisfaction level.

The second aspect of the questionnaire assessed dissatisfactions with anaesthesia care in general. Another set of 10 questions were designed for the assessment of dissatisfaction with anaesthesia care. The questions on anaesthesia-related dissatisfaction were posed in a semi-dichotomous scale (no/yes-mild, moderate, severe). If a patient had complaints of dissatisfaction, it was classified into mild, moderate and severe using revised Bauer questionnaire (8). Mild, moderate, severe was used to access the grade of dissatisfaction. For example, if patients complained of postoperative nausea and vomiting. If the patient had only nausea, then considered mild. If the patient had nausea and single episode of vomiting graded as moderate. If the patient had nausea with more than one episode of vomiting its graded as severe. Similarly other dissatisfaction questions were classified into mild, moderate and severe. Patient himself was asked to grade into mild, moderate and severe based on dissatisfaction. If the patient did not complain of dissatisfaction, it was marked “no” in the questionnaire.

Statistical Analysis

Descriptive and inferential statistical analysis has been carried out in the present study. Results on continuous measurements were presented on mean±Standard Deviation (SD) and results on categorical measurements were presented as frequency and percentages. Significance is assessed at 5% level of significance. Student’s t-test has been used to find the significance of study parameters on continuous scale between two groups on metric parameters. Chi-square/Fisher’s-exact test has been used to find the significance of study parameters on categorical scale between two or more groups, non parametric setting for qualitative data analysis. Fisher’s-exact test used when cell samples are very small. Statistical Package for the Social Sciences (SPSS) software version 22.0 and R environment version 3.2.2 were used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables, etc.

Results

The study had included 74 patients and all of them had given feedback completely regarding patient satisfaction and dissatisfactions towards anaesthesia care in general in both groups. Clarity and a good response rate were ensured by the way the questions were formulated. Age, sex, anaesthesia technique, patient satisfaction and dissatisfactions were all comparable across the two groups. Face-to-face group had 18 females and 19 males and among questionnaire group 19 females and 18 males were present. (Table/Fig 1) depicts gender and educational status of both the groups.

Most of the patients were educated and able to participate in the study genuinely. Group A had more literates with degree qualification compared to Group B and in both the groups, overall, 24 (32.4%) subjects had a degree qualification.

On comparison of age distribution, 15 patients from group A and 12 patients from group B belongs to 30-40 years age group as shown in (Table/Fig 1). Patients were able to freely express their emotions. Group A had younger participant comparing with group B. Patients were able to express their emotion freely and also able to establish good rapport with anaesthesiologist.

A series of 10 questions were used to determine subjects’ satisfaction with anaesthesia in both groups, as indicated in (Table/Fig 2),(Table/Fig 3). About 79.7% expressed extremely satisfied with the anaesthesiologist-patient relationship. None of the patients were dissatisfied you with the information you were given by the anaesthesiologist during pre-anaesthetic evaluation. About 70.3% of group A and 89.2% of group B were extremely satisfied with information given by anaesthesiologist preoperatively. It demonstrates that all patients received thorough preoperative explanations of the operation and anaesthesia protocols. In group A, 64.9% were extremely satisfied with temperature control inside theatre while 89.2% of questionnaire group were extremely satisfied with temperature control inside theatre. There was a significant difference between two groups with p-value <0.05. It emphasises that, group A expressed less satisfaction and they were able to freely express their opinions. Immediately after surgery, 60.8% of patients expressed extreme satisfaction with anaesthesia care. Only 3% of patients were dissatisfied with postoperative evaluation by anaesthesiologist signifies that, they were happy with care and treatment done during procedure as shown in (Table/Fig 2).

Among all patients, 93.2% of patients wants to prefer the same anaesthesiologist. They were satisfied with behaviour and care given by anaesthesiologist. Among patient population 85.1% were extremely satisfied with the care given by Anaesthesia Department in general, 9.5% were satisfied, 5.4% were neutral and no one was dissatisfied with p-value of 0.011. Among questionnaire group, 97.3% were extremely satisfied with anaesthesia care in general while 73% of group A were extremely satisfied with anaesthesia care in general as in (Table/Fig 3).

Anaesthesia related dissatisfactions are assessed using 10 questions as shown in (Table/Fig 4),(Table/Fig 5). Of total, 87.8% of patients who experienced anaesthesia related dissatisfactions did not report experiencing postoperative nausea and vomiting. Postoperative nausea and vomiting was reported by 12.2% of patients (Table/Fig 4). About 2.7% of group B experienced headache following surgery, whereas 21.6% of the group A experienced headaches. In group A, 16% of people complained of being drowsy and none of the patients in group B reported feeling drowsy.

In group A 16% of participants complained of coughing, while none of the respondents to the group B complained of coughing. A p-value of 0.033 suggests a significant difference between group A and B. In group A, 92% patients did not experience breathing difficulty and in group B 95% did not experience breathing difficulty. There was no significant difference between two groups.

Pain at surgical site was complained by 24% of subjects in group A, while none of the subjects in group B as in (Table/Fig 6). 22% of group A patient’s experienced anxiety during procedure, while none of the questionnaire group experienced anxiety. Face-to-face group were able to freely express than questionnaire group.

Discussion

Patient satisfaction has been described as the distinction between patients’ prior expectations and their later perceptions of the healthcare services they received. As a result, an ideal measure of patient satisfaction can provide unique feedback on the quality of practice for medical fields such as anaesthesia. In the study questionnaire and face-to-face surveys were used to access patient satisfaction and dissatisfactions towards anaesthesia care. The current study results revealed that pain at the site of surgery (12.2%), thirst (1.4%), postoperative nausea and vomiting, headache, and pain at the site of surgery were the common dissatisfactions suggested by patients. In a study done by Chalasani SH et al., about 37.3% complained of pain at the site of surgery and 23.30% complained of thirst. More patients complained of pain at the site of surgery in their study (1). In a study done by Ahmad I et al., shivering was noted in 7.9% patients. In the current study, 2.7% of patients complained of shivering. Only few patients complained regarding shivering in both the studies (2). In a study done by Suresh P and Mukherjee A, patients who underwent regional anaesthesia were more satisfied with pain relief and less incidence postoperative nausea and vomiting and similar results were observed in the present study (3).

In the current study, 85.1% were extremely satisfied with the care given by Anaesthesia Department in general. Satisfaction levels were comparatively good. In a study done by Andemeskel YM et al., overall satisfaction level of the patients with perioperative anaesthesia care at the described sites was 68.8% (6). In the present study, 70.3% of participants were very satisfied with the pain relief following surgery, while 12.2% of people reported pain at the surgery site afterward. Authors were able to methodically handle pain at the surgery site. Only 12.2% of patients in the present study, reported having headaches following surgery, 93.2% of patients say they would like to see the same anaesthesiologist again. They were pleased with the anaesthesiologist’s conduct and attention. Postoperative drowsiness was the main complaint. In a study by Bauer M et al., 80% of patients reported feeling sleepy after anaesthesia, however, in the indexed study, only 8.1% of the population reported feeling sleepy following treatment. In the indexed study by Bauer M et al., 15% of the participants mentioned shivering and 6% of all patients reported having severe shivering (8). Only 5.4% of face to face participants in the current study reported postoperative shivering. None of the patients expressed concerns about acute shivering.

According to a study by Bauer M et al., interviews were more effective than written questionnaires for analysing anaesthetic care quality issues (8). In the indexed study, face-to-face survey elicited more patients who report lower levels of satisfaction with anaesthesia. They were able to freely express opinions. About 16.2% of group A patients complained of cough while none of the patients from group B complained of cough. In group A 21.6% of patients complained of anxiety, while none of the patients from group B complained of anxiety. Hence face-to-face survey is more effective in identifying quality issues with anaesthesia care than written questionnaires. In a study done by Bauer M et al., face-to-face survey were better in identifying patients with low degree of satisfaction (8).

Patients rating of their own satisfaction can estimate the care given during procedure which cannot be easily assessed in any other way. In a study done by Bauer M et al., patient rated satisfaction and dissatisfaction towards anaesthesia through scoring system. In the present study also, patients rated satisfaction and dissatisfaction towards anaesthesia care through scoring system. Patients were able to freely express their feeling towards anaesthesia perioperative care in general (8). In a survey conducted by Gebremedhn EG et al., 90.4% of patients said they were satisfied with the anaesthesia services they had received, whereas in the present study, 79.7% of participants were extremely satisfied with the relationship mainatained by anaesthesiologist (9). In a study done by Singh A et al., male uneducated patients had expressed dissatisfaction towards anaesthesia care. Female educated patients were more satisfied (10). The present study could not find a significant difference in satisfaction level between educated and uneducated patients.

In a study done by Droog W et al., 79.8% patients reported being extremely satisfied with their anaesthesia care in general. In the indexed study, 85.1% patients were extremely satisfied with anaesthesia care in general (11). In studies done by Tosuner AV et al., and Gaszynski T et al., providing adequate preoperative information to the patient about regional anaesthesia increased overall satisfaction and will assure the patient feels safe during the perioperative period. In the current study also, proper preoperative information was given to patients regarding anaesthesia (12),(13). The perioperative result would be strongly influenced by the quality of the anaesthetic services provided (14),(15). In the current study, authors were able to assess the factors which affects the patient satisfaction towards perioperative anaesthesia care.

Current study had considered validity, standard, internal consistency, reliability and practicability, when creating highly standardised questionnaires. Rather than using a universal averaged score, the assessment which utilises averaged scores for the aspects is more enlightening.

Limitation(s)

The study did not differentiate between regional and general anaesthesia, accessed only patients’ perspective towards anaesthesia care in general.

Conclusion

Interviewing specific problems identified more patients, who report lower levels of satisfaction with anaesthesia. Face-to-face survey is more effective in identifying quality issues with anaesthesia care, than written questionnaires. Therefore, a face-to-face survey would let the Institutions to highlight the variables that influence patient satisfaction and safety-related problems.

References

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DOI and Others

DOI: 10.7860/JCDR/2023/60521.17251

Date of Submission: Oct 13, 2022
Date of Peer Review: Nov 21, 2022
Date of Acceptance: Dec 08, 2022
Date of Publishing: Jan 01, 2023

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 14, 2022
• Manual Googling: Nov 28, 2022
• iThenticate Software: Dec 07, 2022 (11%)

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