title: Use of the BATHE method in the preanesthetic clinic visit.
abstract: BACKGROUND
  In the primary care setting, use of the BATHE (Background, Affect, Trouble, Handling, and Empathy) method of interviewing has been shown to increase patient satisfaction. This technique is a brief psychotherapeutic method used to address patients' physical and psychosocial problems. The BATHE technique has not been evaluated in the perioperative setting as a way of improving patient satisfaction. In this study, we sought to determine whether satisfaction could be enhanced by use of the BATHE technique during the preoperative evaluation by anesthesiologists.
  
  
  METHODS
  Fifty cardiac and 50 general surgery patients were interviewed in the preanesthesia clinic (PAC) of an academic hospital. They were randomly enrolled in the BATHE group or the control group and asked to complete an anonymous satisfaction survey after their visit. This survey was modified from current studies and not validated elsewhere. The relative influence of the BATHE condition was examined as it pertained to interview duration, patient satisfaction, and patient report of the BATHE items being asked.
  
  
  RESULTS
  Ninety-two percent of patients approached by the study group voluntarily enrolled. Patients interviewed using the BATHE method reported being asked about all BATHE questions significantly more often than control patients: t(98)=19.10, P=0.001 (95% confidence interval [CI]=2.59, 3.20). Patients in the BATHE group were more satisfied with their visit to the PAC than those in the control group: t(98)=5.37, P=0.001 (95% CI=0.19, 0.41). The use of the BATHE method did not significantly increase the amount of time physicians spent evaluating patients: t(98)=0.110, P=0.912 (95% CI=-1.519, 1.359).
  
  
  CONCLUSIONS
  Use of the BATHE method in an academic medical center's cardiac and general PAC showed promising results in this preliminary study. A validated and fully developed survey instrument is needed before we can convincingly conclude that the BATHE method is an effective way of improving patient satisfaction.
authors.affiliation: Department of Anesthesiology, The Mount Sinai Medical Center, One Gustave Levy Place, Box 1010, New York, NY 10028, USA. samuel.demaria@mountsinai.org
authors.forename: Samuel
authors.initials: S
authors.lastname: DeMaria
authors.forename: Anthony P
authors.initials: AP
authors.lastname: DeMaria
authors.forename: George
authors.initials: G
authors.lastname: Silvay
authors.forename: Brigid C
authors.initials: BC
authors.lastname: Flynn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D000758:Anesthesia; D000776:Anesthesiology; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D006348:Cardiac Surgical Procedures; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011300:Preoperative Care / Q000523:psychology* / Q000706:statistics & numerical data; D012044:Regression Analysis; D018401:Sample Size; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D055815:Young Adult