Erstellung und Validierung eines Patientenfragebogens zur Erfassung der Zufriedenheit mit anästhesiologischen Leistungen (EFA) - Evaluierter Fragebogen Anästhesie

Changes in Health Economies and legal guidelines require quality assurance measures in Anesthesia. The patient´s satisfaction has become a central con-cern in defining the quality of assessment results. Former instruments focused on somatic complaints, comprised the whole perioperative phase and were created without involving patients. In 2004, the “Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin“ (DGAI) set up a Commission for Quality Management and Economics with the mandate to develop a questionnaire based on former studies to measure the quality of anesthetic services perceived by the patients - “Evaluierter Fragebogen Anästhesie” (EFA), that should be anesthesia specific and fulfill the criteria for test quality such as reliability and validity. Involving patients and their relatives, representatives of different health professionals and experts who evaluated the importance of items in former questionnaires should ensure that all patient specific aspects were properly taken into account in the new questionnaire. The previously huge item pool (n=198) was reduced progressively, so the draft questionnaire (pilot questionnaire) had 53 anesthesia specific items, assigned to eight dimensions. After checking the pilot questionnaire’s comprehensibility by a pretest it was completed by 580 patients at the University Hospital of Marburg and four other hospitals in Germany. It had a four level Likert Scale and an additional section for further comments. All items with low selectivity or difficulty or that were not answered frequently were eliminated, except items that were considered im-portant previously. The final version with 33 items was completed by 468 patients. It had a good internal reliability with a Cronbach´s  of 0.86. It had a rather low patient´s sat-isfaction rate of 76.6% that could show the demand for optimization. Many answers were missing in the section “treatment of postoperative discom-fort”. A possible reason could be that many patients couldn´t answer those questions because they didn´t have any postoperative discomfort. Perhaps this section of the questionnaire should be modified. Actually, the field application was planned to develop the questionnaire on basis of a large number of participants. But after being completed in 2006, it hasn´t been used again and didn´t recognize any improvement, probably due to the mentioned problems. During the last years, there were many efforts worldwide to develop adequate tools, and today there are several questionnaires available for gathering data about patient´s satisfaction with anesthetic services, one of them in Germany.