title: What determines patient satisfaction with cataract care under topical local anesthesia and monitored sedation in a community hospital setting?
abstract: The Iowa Satisfaction with Anesthesia Scale (ISAS) is a reliable and valid tool to measure patient satisfaction with monitored anesthesia care. We used the ISAS to discover determinants of patient satisfaction with cataract care under topical local anesthesia and monitored sedation in a small community hospital. The ISAS (scored 1 to 6) was administered to 306 patients immediately after cataract surgery. All patients received topical local anesthesia and IV sedation administered by an anesthesiologist. Patient satisfaction was high: mean ISAS was 5.6 (sd 0.46; range: 3.3-6.0). The incidence of intraoperative and postoperative pain was 13% and 37%; other adverse events were infrequent (<5%). In multivariable logistic regression, significant predictors of satisfaction were postoperative pain (odds ratio [OR]: 4.84; 99% confidence interval [CI]: 2.21, 10.60), surgeon (OR: 0.21; 99% CI: 0.05, 0.91), and preoperative anxiety (OR: 1.17; 99% CI: 1.03, 1.34). ISAS mean scores (OR = 0.28; 99% CI: 0.13, 0.59) and preoperative anxiety (OR = 1.12; 99% CI: 0.99, 1.28) emerged as significant predictors of low rating of quality of experience. Our results indicate that the ISAS can be used to track patient satisfaction with monitored cataract care. Pain during and after cataract surgery is common and is a major reason for lower patient satisfaction with their cataract care.
authors.affiliation: *North Bay General Hospital, North Bay, and Department of Anesthesia, Faculty of Medicine, University of Toronto, Toronto; †Centre for Research in Women's Health, Sunnybrook & Women's College Health Sciences Centre and the Department of Health Policy, Management & Evaluation, University of Toronto, Toronto; and ‡North Shores District Health Council, North Bay, Ontario, Canada.
authors.forename: Donald
authors.initials: D
authors.lastname: Fung
authors.forename: Marsha M
authors.initials: MM
authors.lastname: Cohen
authors.forename: Susan
authors.initials: S
authors.lastname: Stewart
authors.forename: Andy
authors.initials: A
authors.lastname: Davies
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia; D000772:Anesthesia, Local; D002387:Cataract Extraction; D016292:Procedural Sedation; D003625:Data Collection; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires