Development and validation of a perioperative satisfaction questionnaire in regional anesthesia

Abstract

Introduction: Evaluating patient-reported outcomes is complex. These difficulties may explain weaknesses with some existing tools: mainly, they rely on expert instead of patient views or are not metrically sound. The purpose of this study was to develop and validate a multidimensional self-reported questionnaire, specifically assessing the satisfaction of patients undergoing regional anesthesia, Evaluation du Vécu de l'Anesthésie LocoRégionale (EVAN-LR).

Methods: Patients included underwent various surgical procedures under regional anesthesia. The questionnaire structure was identified by principal component factor analyses and interitem, item-dimension, and interdimension correlations. The authors assessed external validity by studying the relationships between potential dimensions of EVAN-LR and validated instruments such as Amsterdam Preoperative Anxiety and Information Scale, State Trait Anxiety Inventory, and specific visual analog scales. Internal consistency reliability was assessed by Cronbach α.

Results: We included 390 patients for the validation phase. The EVAN-LR comprises 19 items, structured in a global index and five dimensions: Attention, Information, Discomfort, Waiting, and Pain. The consequences of staying alert during regional anesthesia were specifically addressed by two items. Female sex was associated with significantly lower Information score. Patients with American Society of Anesthesiologists physical status below 2 had a significantly lower Attention score. Patients older than 55 years showed higher satisfaction scores for most dimensions. EVAN-LR poorly correlated with premedication.

Conclusion: The authors have validated a new measuring tool assessing patient satisfaction within the perioperative period surrounding regional anesthesia. The multidimensional structure of EVAN-LR allows it to be used as a clinical tool for improving anesthesia management.