Parental satisfaction with ambulatory surgery

Abstract

Problem: Patient satisfaction is an important aspect of modern health care. Few studies have specifically addressed parental satisfaction with pediatric ambulatory surgery and no validated surveys exist. Methods: Parents of children aged 6 months to 12 years completed the AmbSurg Survey, an 18-item self-administered measure of satisfaction using a 7-point scale. Additional data collected included casemix variables and validated measures of child health-related quality of life (PedsQL 4.0 survey), positive response bias (Marlowe-Crowne Social Desirability Scale), and satisfaction with the decision to have surgery (Satisfaction with Decision Scale). Approximately 2 to 4 weeks after surgery, parents rated the degree of clinical change in their child and their satisfaction with this change. Results: We enrolled 152 parents (median age, 35) and children (median age, 4.8). Seven items were eliminated from the AmbSurg Survey because they were unclear, unimportant, or had poor test-retest reliability. The final 11-item survey had good test-retest reliability (r = .73), internal consistency (alpha = .88), and construct validity (r = .32 to .59). Factor analysis revealed subscales relating to medical care (4 items), nursing care (2 items), and communication (5 items). Survey scores were significantly associated with surgeon used, parental anxiety, child general quality of life, and parental satisfaction with the decision to have surgery. Stepwise regression, however, identified satisfaction with decision as the only significant predictor (35% of variance). AmbSurg Survey scores did not correlate with clinical change or satisfaction with change reported by parents after a median 24 days. Conclusion: Parent satisfaction with their child’s ambulatory experience can be measured efficiently with the AmbSurg survey, and correlates with satisfaction reported about the initial decision to undergo surgery. Significance: The AmbSurg Survey is a valid and reliable 11-item measure of parental satisfaction with ambulatory surgery. The ease of use and clinically relevant subscales make the survey ideal for practice audit, quality assurance endeavors, and health services research. Support: None reported.