AHMET ATLAS, Aysun YILMAZLAR, Bilçin TAK

Anestezi uygulamasında hasta memnuniyet düzeyini nasıl yükseltebiliriz?

Amaç: Hastalarımızın anestezi bakımı konusunda memnuniyet düzeylerini saptamak, yeni bir anestezi bakım modeli ile memnuniyet düzeylerinin arttırılıp arttırılamayacağı amaçlanmıştır. Gereç ve Yöntem: Etik kurul onayı alındıktan sonra Uludağ Üniversitesi Tıp Fakültesi Ameliyathanesi’nde Eylül 2007-Eylül 2008 tarihleri arasında, elektif olarak operasyona alınan ASA I-II toplam 100 hasta çalışmaya dahil edildi. Hastalar randomize olarak iki gruba ayrıldı. Grup A hastalarının ilk değerlendirmeleri anestezist tarafından anestezi polikliniğinde yapıldı. Preoperatif vizit, ameliyathanedeki takip ve postoperatif vizitleri aynı anestezist tarafından gerçekleştirildi. Postoperatif vizit sırasında hastalara soru formu doldurtuldu. Grup B hastaları anestezi polikiniğinde, preoperatif vizitte, ameliyathanede ve ameliyat sonrası vizitlerde farklı anestezistler tarafından değerlendirildi. Postoperatif vizitte aynı soru formu doldurtuldu. ‹statistiksel değerlendirmede SPSS Windows 13 ve Pearson Ki-kare testi kullanıldı. Bulgular: Üniversitemizde yürütülen anestezi bakımı uygulamasında, hastaların anestezistlerini tanımadıklarını, yeterince soru sorma ve endişelerini aktarma fırsatı bulamadıklarını saptadık. Yeni anestezi bakım modeli ile takip edilen hastaların anestezistlerini tanıdıklarını, soru sorma ve endişelerini aktarma fırsatı bulduklarını belirledik. Her iki gruptaki hastalar için poliklinikte kendisini değerlendiren anestezistin ameliyatına girmesinin önemli olduğunu bulduk. Sonuç: Anestezi bakımı sürekliliğini sağlayan bu yeni model ile hastaların anestezi bilgisinin ve memnuniyetinin artacağı düşüncesindeyiz.

How can we enhance patients’ satisfaction in anaesthesia care?

Objective: The purpose of this study is to find out the satisfaction degree of the patient and to search whether a new anaesthesic care model can enhance patients’ satisfaction. Methods: After approval of Local Ethical Committee, ASA I-II 100 patients included in the study who have been electively operated between September 2007- September 2008 in Uludag University Medical Hospital. The patients have been divided into two groups randomly. The patients in Group A have been examined in the anesthesia policlinic for the first time by an anesthesia physician. After this step, the same physician has informed them about the anesthesia management during the surgical procedure and answered their questions. Also the same physician has made the preoperative evaluation, administered their anesthesia in the operating room and made the postoperative visit. On the otherside, patients in Group B have experienced the current anaesthesia care. In other words, different anesthesists have examined these patients in the anaesthesia policlinic for the first time, administered their anesthesia in the operating room and made the postoperative visit. During the postoperative visit, patients’ feedback has been obtained and the data has been used to evaluate the patients’ satisfaction. For the evaluation process, the software named SPSS for Windows 13 has been used and specifically Pearson’s Chi-square test has been applied. Results: In the current anaesthesia care, patients state that they do not recognize the anesthesia physician. As a consequence, they do not have enough opportunity to ask their questions and express their concerns to their physicians. Therefore, they want the same anesthesia physician administer their anaesthesia in the operating room. On the other hand, patients in the new model state that they have chance to know their physicians better, ask their questions and express their concerns. Conclusions: We believe that this new model providing continuity on anaesthesia care by the same physician will improve the patients’ satisfaction with anaesthesia care and their knowledge about anaesthesia.

PDF

___

1. Shevde K, Panagopoulos G. A Survey of 800 patients knowledge, attitudes, and concerns regarding anesthesia. Anesth Analg 1991;73:190-8.
2. Şekerci S, Akpek E, Göktuğ A ve ark. Hasta ve yakınları ile toplumun farklı kesimlerinin anestezi ve uygulamaları konusundaki bilgi ve davranışları. Anestezi Dergisi 2001;9:48-51.
3. Ceyhan A, Başar H, İnan N ve ark. Türk toplumu anestezi hakkinda neler biliyor, neler bilmiyor? Sendrom 2000;12:75-9.
4. Chew ST, Tan T, Tan SS. A survey of patients knowledge of anaesthesia and perioperative care. Singapore Med J 1998;39:399-402.
5. Miller KM, Wysocki T, Cassady JF, et al. Validation of Measures of parents' preoperative anxiety and anesthesia knowledge. Anesth Analg 1999;88:251-7.
6. Hume MA, Kennedy B, Asbury AJ. Patient knowledge of anaesthesia and perioperative care. Anaesthesia 1994;49: 715-18.
7. Badner NH, Nielson WR, Munk S, et al. Preoperative anxiety detection and contributing factors. Can J Anaesth 1990;37: 444-7.
8. Domar AD, Everett LL, Keller M. Preoperative anxiety. Is predictable entity? Anesth Analg 1989;69:763-7.
9. Kain ZN, Wang MS, Caramico LA, et al. Parental desire for perioperative information and informed consent: A two- phase study. Anesth Analg 1997;84:299-306.
10. Lonsdale M, Hutchison GL. Patients' desire for information about anaesthesia, Scottish and Canadian attitudes. Anaesthesia 1991;46:410-2.
11. Önsüz MF, Topuzoğlu A, Cöbek UC ve ark. İstanbul’da bir tıp fakültesi hastanesinde yatan hastaların memnuniyet düzeyi. Marmara Medical Journal 2008;21;33-49.
12. Uzun E, Güney M, Oral B, Özsoy M, Mungan T. Kadın hastalıkları ve doğum servisi: Verilen hizmetlerle ilgili hasta memnuniyeti ve etki eden faktörler. Uzmanlık Sonrası Eğitim ve Güncel Gelişmeler Dergisi 2006;3:167-71.
13. Tükel B, Acuner AM, Önder ÖR, Üzgül A. Ankara Üniversitesi İbn-i Sina Hastanesi’nde yatan hasta memnuniyeti. Ankara Hastanesi Tıp Fakültesi Dergisi 2004;57:205-14.
14. Sarp N, Tükel B. İbn-İ Sina Hastanesi’nde hasta memnuniyeti araştırması. Ankara Üniversitesi Tıp Fakültesi Mecmuası 1999;52:147-51.
15. Leigh JM, Walker J, Janaganathan P. Effect of preoperative anaesthetic visit on anxiety. Br Med J 1977;2:987-9.
16. Waisel DB, Truog RD. The benefits of explanation of the risks of anesthesia in day surgery patient. J Clin Anesth 1995;7:200-4.
17. Gaskey NJ. Evaluation of the effect of a preoperative anesthesia videotape. AANA J 1987;55:341-5.
18. Engiz O. Sağlık Hizmetlerinde Hasta Tatmini, Hastane Yöneticiliği. Edit (Hayran O, Sur H). Ankara, Nobel Tıp Kitapevleri Ltd ,1997:61-87.
19. Hepner LD, Bader AM, Hurtwitz S, Gustafson M. Patient satisfaction with preoperative assessment in a preoperative assessment testing clinic. Anesth Analg 2004; 98:1099-1105.
20. Myles PS, Hunt JO, Moloney JT. Postoperative 'minor' complications. Comparison between men and women. Anaesthesia 1997;52:300-6.
21. Heidegger T, Husemann Y, Nuebling M, et al. Patient satisfaction with anaesthesia care: development of a psychometric questionnaire and benchmarking among six hospitals in Switzerland and Austria. Br J Anaesth 2002;89:863-72.
22. Mackenzie JW. Daycase anaesthesia and anxiety: A study of anxiety profiles amongst patients attending a day bed unit. Anaesthesia 1991; 44:437-40.
23. Hall JA, Dornan MC. What patient like about their medical care and how often they are asked: A meta-analysis of the satisfaction literature. Soc Sci Med 1988; 27:935-9.
24. Kratz A. Preoperative education: Preparing patients for a positive experience. J Post Anesth Nurs 1993;8:270-5.
25. Hering K, Harvan J, D’Angelo M, Jansinski D. The use of a computer website prior to scheduled surgery (A pilot study): Impact on patient information, acquisition, anxiety level, and overall satisfaction with anesthesia care. AANAJ 2005;73:29-33.
26. Kain ZN, Caramico LA, Mayes LC, et al. Preoperative preparation programs in children: A comparative examination. Anesth Analg 1998; 87:1249-55.
27. McGraw T. Preparing children for the operating room: Psychological issue. Can J Anaesth 1994;41:1094-1103.
28. Clifton PJ. Expectations and experiences of anaesthesia in a District General Hospital. Anaesthesia 1984;39:281-5.
29. Van Wijk MG, Smalhout B. A postoperative analysis of the patient’s view of anaesthesia in a Netherlands’ teaching hospital. Anaesthesia 1990;45:679-82.
30. Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg 2000; 90:706-12.
31. Keep PJ, Jenkins JR. As others see us. The patient's view of the anaesthetist. Anaesthesia 1978;33: 43-5.
32. Besler MP, Yalman A, Çelik M. SSK hastalarının anestezi bilgisi ve yazılı bilgilendirmenin önemi. Göztepe Tıp Dergisi 2004;19:132-6.
33. Bacon DR, Lema MJ, Yearly CK. For all the world to see: anesthesia at the 1939 New York World’s Fair. J Clin Anesth 1993;5:252-8
34. Capuzzo M, Gilli G, Paparella L, et al. Factors predictive of patient satisfaction with anesthesia. Anesth Analg 2007;105:435-42.
35. Farnill D, Inglis S. Patients' desire for information about anaesthesia, austuralian attitudes. Anaesthesia 1994;49:162-4.
36. Myles PS, Williams DL, Hendrata M, Anderson H, Weeks MA. Patient satisfaction after anaesthesia and surgery: result of a prospective survey of 10811 patients. Br J Anaesth 2000;84:6-10.
37. Wu CL, Naqibuddin M, Fleisher LA. Measurement of patient satisfaction as an outcome of regional anaesthesia and analgesia: A systematic review. Reg Anaesth Pain Med 2001; 26:196-208.
38. Klafta JM, Roizen MF. Current understanding of patients’ attitudes toward and preparation for anaesthesia: A review. Anesth Analg 1996; 83:1314-21.
39. Whitty PM, Shaw IH, Goodwin DR. Patient satisfaction with general anaesthesia. Anaesthesia 1996;51:327-32.
40. Fleisher LA, Lam J, Pearlman A, et al. Disseminating information using an Anesthesiology Consultan Report: Impact on patient perceptions of quality of care. J Clin Anesth 1999; 11:380-5.
41. Kırbıyık S, Doğan M, Kişioğlu AN, Öztürk M. SDÜ Hastanesi polikliniklerine başvuranların hastane hizmetlerinden memnuniyet durumları. SDÜ Tıp Fakültesi Dergisi 2000;7:32-6.