Residents Achieve a High Patient Satisfaction in Pre-Anesthetic Patient Assessment. An Observational Study

Ulrike Reuter¹, Babette Jurack¹, Nils Engelmann², Thilo Busch¹, Joerg Schnoor^1*

¹Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany.
²Department of Anaesthesiology, King’s College Hospital Clinics, Abu Dhabi, UAE.

DOI: 10.4236/ojanes.2014.411039                

Abstract

A physician’s empathetic attitude is regarded as an important influencing factor towards patient satisfaction. However, physicians’ self-assessed empathy declines during medical school and through residency, which may limit patient satisfaction in the doctor-patient contact. In conse-quence, we hypothesized that residents might fail in generating high levels of patient satisfaction. We conducted an observational study in the setting of a pre-anesthetic assessment center, Univer-sity Hospital Leipzig, Germany. Patient satisfaction was measured using the overall ZUF-8 score (8 - 32 points; increasing with patient satisfaction). Data were collected by questionnaires (ZUF-8 items, additional satisfaction items, and items of organizational and logistical processes). Key items for patient satisfaction as primary endpoints were defined. Statistical evaluation was performed in dependency of the anesthesiologists’ level of training (residents vs. consultants) by using the Mann-Whitney-U test or the chi square test, as required. Statistical significance was accepted for p < 0.05. In total, 2565 patients were assessed for eligibility. 986 patients met the criteria of inclusion. 978 questionnaires were submitted with 517 questionnaires being excluded because of missing values. Finally, 461 questionnaires could be analysed. Both residents and consultants achieved a high level of patient satisfaction. The ZUF-8-scores were comparable between the groups (p = 0.91), whilst the quality of consultation was rated slightly better by patients being assessed by residents (p = 0.047). The results in additional satisfaction items were comparable between the groups. We found a trend in residents assessing to be rated more friendly. Residents are able to generate a high level of patient satisfaction which is comparable to that of consultants with scores ranging between “good” and “very good”. Small albeit significant differences in favor of residents underline the quality of their performance in pre-anesthetic patient assessment.

Keywords

Patient Satisfaction, Pre-Anesthetic Patient Education, ZUF-8 Questionnaire, Physicians’ Educational Level

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Barbosa, C.D., Balp, M.M., Kulich, K., Germain, N. and Rofail, D.A. (2012) A Literature Review to Explore the Link between Treatment Satisfaction and Adherence, Compliance, and Persistence. Patient Preference and Adherence, 6, 39-48. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262489
[2]	Becker, R., Döring, C., Denecke, A. and Brosz, M. (2011) Expectation, Satisfaction and Clinical Outcome of Patients after Total Knee Arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 19, 1433-1441. http://link.springer.com/article/10.1007%2Fs00167-011-1621-y http://dx.doi.org/10.1007/s00167-011-1621-y
[3]	Schnoor, J., Heydebreck, K., Schuster, S. and Kaisers, U.X. (2012) Patient’s Satisfaction within the Scope of Outdoor Anaesthesia and Surgery. Gesundheitökonomie & Qualitätsmanagement, 17, 192-197. http://dx.doi.org/10.1055/s-0031-1299116
[4]	Kim, S.S., Kaplowitz, S. and Johnston, M.V. (2004) Effects of Physician Empathy on Patient Satisfaction and Compliance. Evaluation and the Health Professions, 27, 237-251. http://ehp.sagepub.com/content/27/3/237.long http://dx.doi.org/10.1177/0163278704267037
[5]	DeMaria Jr., S., DeMaria, A.P., Silvay, G. and Flynn, B.C. (2011) Use of the BATHE Method in the Preanesthetic Clinic Visit. Anesthesia & Analgesia, 113, 1020-1026. http://dx.doi.org/10.1213/ANE.0b013e318229497b
[6]	Soltner, C., Giquello, J.A., Monrigal-Martin, C. and Beydon, L. (2011) Continuous Care and Empathic Anaesthesiologist Attitude in the Preoperative Period: Impact on Patient Anxiety and Satisfaction. British Journal of Anaesthesia, 106, 680-686. http://bja.oxfordjournals.org/content/106/5/680.full.pdf+html http://dx.doi.org/10.1093/bja/aer034
[7]	Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M.R., Wirtz, M., Woopen, C., Haramati, A. and Scheffer, C. (2011) Empathy Decline and Its Reasons: A Systematic Review of Studies with Medical Students and Residents. Academic Medicine, 86, 996-1009. http://dx.doi.org/10.1097/ACM.0b013e318221e615
[8]	Mandel, E.D. and Schweinle, W.E. (2012) A Study of Empathy Decline in Physician Assistant Students at Completion of First Didactic Year. Journal of Physician Assistant Education, 23, 16-24.
[9]	Schmidt, J., Lamprecht, F. and Wittmann W.W. (1989) Satisfaction with Inpatient Management. Development of a Questionnaire and Initial Validity Studies. Psychotherapie, Psychosomatik, Medizinische Psychologie, 39, 248-255.
[10]	Attkisson, C.C. and Zwick, R. (1982) The Client Satisfaction Questionnaire. Psychometric Properties and Correlations with Service Utilization and Psychotherapy Outcome. Evaluation and Program Planning, 5, 233-237. http://dx.doi.org/10.1016/0149-7189(82)90074-X
[11]	Schmidt, J., Lamprecht, F., Nübling, R. and Wittmann, W.W. (1994) Evaluation of Change by Patients and Staff and Specialist Physicians in Psychosomatic Rehabilitation—A Catamnestic Comparison. Psychotherapie, Psychosomatik, Medizinische Psychologie, 44, 108-114.
[12]	Schnoor, J., Reuter, U., Engelmann, N. and Burkhardt, U. (2013) Balance of Concerns: Satisfactory Pre-Anaesthetic Patient Education and the Extent of Patient Worries. Open Journal of Anesthesiology, 3, 402-407. http://dx.doi.org/10.4236/ojanes.2013.39085
[13]	Schmidt, J. and Wittmann, W.W. (2002) ZUF-8 Fragebogen zur Messung der Patientenzufriedenheit. In: Brähler, E., Schumacher, J. and Strauß, B., Eds., Diagnostische Verfahren in der Psychotherapie, Hogrefe, Göttingen, 392-396.
[14]	Hannöver, W., Dogs, C.P. and Kordy, H. (2000) Patient Satisfaction—A Measure for Success of Treatment? Psychotherapeut, 45, 292-300. http://journals.ohiolink.edu/ejc/article.cgi?issn = 09356185&issue = v45i0005&article = 0292_psamfsot
[15]	Beattie, M., Lauder, W., Atherton, I. and Murphy, D.J. (2014) Instruments to Measure Patient Experience of Health Care Quality in Hospitals: A Systematic Review Protocol. Systematic Reviews, 3, 4. http://dx.doi.org/10.1186/2046-4053-3-4
[16]	Aust, H., Eberhart, L.H., Kalmus, G., Zoremba, M. and Rüsch, D. (2011) Relevance of Five Core Aspects of the Pre-Anesthesia Visit: Results of a Patient Survey. Der Anaesthesist, 60, 414-420. http://link.springer.com/article/10.1007%2Fs00101-010-1828-1 http://dx.doi.org/10.1007/s00101-010-1828-1
[17]	Williams, B., Coyle, J. and Healy, D. (1998) The Meaning of Patient Satisfaction: An Explanation of High Reported Levels. Social Science and Medicine, 47, 1351-1359. http://www.sciencedirect.com/science/article/pii/S0277953698002135 http://dx.doi.org/10.1016/S0277-9536(98)00213-5
[18]	Herschbach, P. (2002) The “Well-Being Paradox” in Quality-of-Life Research. Psychotherapie, Psychosomatik, Medizinische Psychologie, 52, 141-150. http://dx.doi.org/10.1055/s-2002-24953
[19]	Gruyters, T. and Priebe, S. (1994) Evaluation of Psychiatric Treatment by Patients: Results and Problems of Systematic Research. Psychiatrische Praxis, 21, 88-95.
[20]	O’Malley, P.G., Omori, D.M., Landry, F.J., Jackson, J. and Kroenke, K. (1997) A Prospective Study to Assess the Effect of Ambulatory Teaching on Patient Satisfaction. Academic Medicine, 72, 1015-1017. http://dx.doi.org/10.1097/00001888-199711000-00023
[21]	Matthews, D.A., Sledge, W.H. and Lieberman, P.B. (1987) Evaluation of Intern Performance by Medical Inpatients. American Journal of Medicine, 83, 938-944. http://dx.doi.org/10.1016/0002-9343(87)90655-3
[22]	West, C.P. and Shanafelt, T.D. (2007) The Influence of Personal and Environmental Factors on Professionalism in Medical Education. BMC Medical Education, 7, 29. http://www.biomedcentral.com/content/pdf/1472-6920-7-29.pdf http://dx.doi.org/10.1186/1472-6920-7-29
[23]	Bauer, J. (2005) Warum ich fühle was du fühlst. Intuitive Kommunikation und das Geheimnis der Spiegelneurone. Hoffmann und Campe, Hamburg.
[24]	Chen, D.C., Pahilan, M.E. and Orlander, J.D. (2010) Comparing a Self-Administered Measure of Empathy with Observed Behavior among Medical Students. Journal of General Internal Medicine, 25, 200-202. http://link.springer.com/article/10.1007%2Fs11606-009-1193-4 http://dx.doi.org/10.1007/s11606-009-1193-4
[25]	Hepner, D.L., Bader, A.M., Hurwitz, S., Gustafson, M. and Tsen, L.C. (2004) Patient Satisfaction with Preoperative Assessment in a Preoperative Assessment Testing Clinic. Anesthesia & Analgesia, 98, 1099-1105. http://dx.doi.org/10.1213/01.ANE.0000103265.48380.89
[26]	Thompson, D.A., Yarnold, P.R., Williams, D.R. and Adams, S.L. (1996) Effects of Actual Waiting Time, Perceived Waiting Time, Information Delivery, and Expressive Quality on Patient Satisfaction in the Emergency Department. Annals of Emergency Medicine, 28, 657-665. http://www.sciencedirect.com/science/article/pii/S0196064496700902 http://dx.doi.org/10.1016/S0196-0644(96)70090-2
[27]	Camacho, F., Anderson, R., Safrit, A., Jones, A.S. and Hoffmann, P. (2006) The Relationship between Patient’s Perceived Waiting Time and Office-Based Practice Satisfaction. North Carolina Medical Journal, 67, 409-413.
[28]	Anderson, R.T., Camacho, F.T. and Balkrishnan, R. (2007) Willing to Wait? The Influence of Patient Wait Time on Satisfaction with Primary Care. BMC Health Services Research, 7, 31. http://www.biomedcentral.com/1472-6963/7/31 http://dx.doi.org/10.1186/1472-6963-7-31