Satisfaction measures in pediatric anesthesia and perioperative care

Abstract

Patient satisfaction is routinely used to assess the quality of care in medicine. In the field of anesthesia, research has been primarily directed toward developing satisfaction measures in adults with little attention paid to the pediatric population. Satisfaction in pediatric anesthesia and perioperative care is poorly understood. We have identified existing satisfaction measures in pediatric perioperative care and examined their similarities and differences. A search of relevant published trials up to January 2021 identified 17 studies using 14 unique satisfaction measures of perioperative care in children. Eleven of these assessed satisfaction multidimensionally while three assessed overall satisfaction of parents with their child's anesthesia. Of the six dimensions of satisfaction identified, all were duplicated to some degree across studies. The dimensions were: "staff rapport and communication" and "anesthetic and nursing quality of care" in eight satisfaction measures; "information giving" in seven measures; "postoperative symptom control" in six; "hospital experience" in five; and "involvement in decision-making" in three. The most important items from the parents' perspective were: "staff rapport and communication;" "information giving;" and "decision-making". No study examined all dimensions of satisfaction. Although all studies questioned parents, only three asked satisfaction questions of the child. No study was analyzed the child's direct responses. In three studies, parental involvement in decision-making was reported to be important as a satisfaction measure of their child's perioperative care. Of the few existing satisfaction measures evaluated, there is no accepted standard in current practice. Future studies identifying the important determinants of satisfaction in pediatric perioperative care, perhaps also using a Delphi approach with parents, might allow for the development of a patient-focused standardized measure in this setting.

Keywords: adolescent; anesthesia; audit; child; measurement; outcomes; quality improvement; satisfaction.