[Patient dissatisfaction with anesthetic care].
BACKGROUND
The evaluation of services by patients is an essential component of quality improvement in anesthesiology. Therefore, it is important to identify the factors for patient dissatisfaction.


METHODS
We retrospectively studied 9974 consecutive patients who had received spinal or general anesthesia for elective surgery between 1999 and 2002. Pre-anesthetic, intra-anesthetic and post-anesthetic variables were recorded and patient satisfaction was assessed using direct interviews at the post-anesthetic clinic. Qualitative data on dissatisfaction were obtained by asking patients' reasons for dissatisfaction.


RESULTS
348 of the 8843 respondents (3.9%) had dissatisfaction with anesthesia. The rates of dissatisfaction were higher in women than in men and in spinal anesthesia than in general anesthesia, and were observed mostly in the patients aged from 20 to 39 years. Qualitative data show that the common reasons for dissatisfaction with anesthesia were spinal anesthesia as the most dissatisfactory factor, followed by epidural anesthesia, postoperative pain, vomiting/nausea and memory of tracheal extubation. However, other various factors were associated with dissatisfaction.


CONCLUSIONS
It is difficult for anesthesiologists to satisfy all patients, because patients' senses of values were varied. However, we conclude that anesthesiologists can improve the quality of anesthesia by enlightenment of the patient about anesthesia, and moreover, by better peri-anesthetic management for dissatisfactory factors with anesthesia.
Nakahashi
Kazuyoshi
K
Department of Anesthesiology, Nara Medical University, Kashihara 634-8522.
Motozu
Yoshiko
Y
Sasaoka
Noriyuki
N
Hirai
Katsuji
K
Kitaguchi
Katsuyasu
K
Furuya
Hitoshi
H
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000767:Anesthesia, Epidural / Q000523:psychology; D000768:Anesthesia, General / Q000523:psychology*; D000775:Anesthesia, Spinal / Q000523:psychology; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology