Patient Satisfaction with Anaesthesia Care at a Tertiary Hospital: Elective vs. Emergency Cases – A Cross-Sectional Study

Sediba Virginia Tjale; Dorinka Nel

doi:10.51168/4x0k6e75

Authors

Dr. Sediba Virginia Tjale Chris Hani Baragwanath Academic Hospital, Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand
Dr. Dorinka Nel Chris Hani Baragwanath Academic Hospital, Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand

DOI:

https://doi.org/10.51168/4x0k6e75

Keywords:

anaesthesia, elective, emergency, Patient satisfaction, perioperative care

Abstract

Background
Patient satisfaction is a crucial measure of perioperative care quality, reflecting clinical outcomes and experiences, particularly in resource-constrained public hospitals. This study examined satisfaction levels among patients undergoing elective and emergency surgery at a South African tertiary hospital, addressing a gap in comparative data.

Methods
We conducted a cross-sectional study of 124 elective and 124 emergency surgical patients. We evaluated satisfaction with anaesthesia care 12–24 hours postoperatively using the Leiden Perioperative Patient Satisfaction questionnaire in English and isiZulu. Statistical analyses included one-sample t-tests and Mann-Whitney U tests to compare satisfaction levels.

Results
We included 248 patients: 124 elective and 124 emergency surgical patients. The mean age was 44.8 years (SD 15.3); 63.7% were male, and 87.5% were Black African. Overall satisfaction with information was high, with all information items scoring above 4 on a 5-point scale. Elective patients reported higher satisfaction with information than emergency patients (mean composite score 4.50 [SD 0.50] vs 4.03 [SD 0.82]. Most participants reported little or no postoperative pain (70.2%), sore throat (87.5%), back pain (91.9%), or vomiting (96.0%). Emergency patients reported significantly greater cold (p=0.009), hunger (p=0.049), and thirst (p=0.005) and had higher discomfort-and-needs scores than elective patients (mean rank 135.58 vs 113.42; p=0.015). Satisfaction with general and personal care was high in both groups; however, elective patients reported higher satisfaction with general care (mean 4.41 [SD 0.48] vs 4.27 [SD 0.38]; p=0.02) and personal care (mean 3.94 [SD 0.67] vs 3.69 [SD 0.71]; p=0.021) than emergency patients.

Conclusion
The study found high patient satisfaction with anaesthesia care and highlighted the need to improve communication and attention to basic comfort needs for emergency patients.

Recommendation

Structured perioperative communication and protocols to address warmth, hydration, and nutritional needs should be implemented, particularly for emergency surgical patients, to reduce discomfort and improve patient-centred anaesthesia.

Author Biographies

Dr. Sediba Virginia Tjale, Chris Hani Baragwanath Academic Hospital, Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand

BSc, BHSc (Hons), MBBCh, DipPEC (SA), DA (SA) is an anaesthesia registrar at Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa. She completed her undergraduate qualifications at the University of the Witwatersrand and is currently undertaking specialist training. Her interests include regional anaesthesia, cardiac anaesthesia and critical care. She is involved with teaching and training of junior doctors and medical students rotating in anaesthesia in the Witwatersrand circuit
Dr. Dorinka Nel, Chris Hani Baragwanath Academic Hospital, Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand

has an MBChB from the University of Pretoria, as well as a Diploma and Fellowship in Anaesthesiology from the Colleges of Medicine of South Africa. She is currently a senior consultant at the Department of Anaesthesia at Chris Hani Baragwanath Academic Hospital and affiliated with the School of Clinical Medicine at the University of the Witwatersrand. She is an examiner for the College of Anaesthesia and has been an external examiner for the MMed(Anaes). She regularly supervises postgraduate students on their research projects for Master degrees in anaesthesia. She is an anaesthetic assessor for the National Committee on the Confidential Enquiry of Maternal Deaths (NCCEMD). Her interests include obstetric anaesthesia, patient safety, patient outcomes, and critical incident analysis.

References

1. Ambulkar R, Patel A, Patil S, Savarkar S. Patient satisfaction with anaesthesia services in a tertiary care cancer centre. (SAY study). J Anaesthesiol Clin Pharmacol [Internet]. 2022 Jan;38(1):111–7. Available from: http://dx.doi.org/10.4103/joacp.joacp_187_20

2. Gebremedhn EG, Chekol WB, Amberbir WD, Flatie TD. Patient satisfaction with anaesthesia services and associated factors at the University of Gondar Hospital, 2013: a cross-sectional study. BMC Res Notes [Internet]. 2015 Aug 26;8(1). Available from: http://dx.doi.org/10.1186/s13104-015-1332-4

3. Barnett SF, Alagar RK, Grocott MPW, Giannaris S, Dick JR, Moonesinghe SR. Patient-satisfaction measures in anesthesia. Anesthesiology [Internet]. 2013 Aug;119(2):452–78. Available from: http://dx.doi.org/10.1097/aln.0b013e3182976014

4. Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth [Internet]. 2000 Jan;84(1):6–10. Available from: http://dx.doi.org/10.1093/oxfordjournals.bja.a013383

5. Sinbukhova E, Lubnin A. A comprehensive analysis of patient satisfaction with anesthesia. Saudi J Anaesth [Internet]. 2019 Oct;13(4):332–7. Available from: http://dx.doi.org/10.4103/sja.sja_249_19

6. Teshome D, Mulat Y, Fenta E, et al. Patient satisfaction and its associated factors towards peri-operative anesthesia service among surgical patients: A cross-sectional study. Heliyon [Internet]. 2022 Mar;8(3):e09063. Available from: http://dx.doi.org/10.1016/j.heliyon.2022.e09063

7. Pozdnyakova A, Tung A, Dutton R, Wazir A, Glick DB. Factors affecting patient satisfaction with their anesthesiologist: An analysis of 51,676 surveys from a large multihospital practice. Anesth Analg [Internet]. 2019 Oct;129(4):951–9. Available from: http://dx.doi.org/10.1213/ane.0000000000004256

8. Kindler CH, Szirt L, Sommer D, Häusler R, Langewitz W. A quantitative analysis of anaesthetist–patient communication during the pre‐operative visit. Anaesthesia [Internet]. 2004 Dec 13;60(1):53–9. Available from: http://dx.doi.org/10.1111/j.1365-2044.2004.03995.x

9. Jaju R, Varshney S, Bihani P, Paliwal N, Karim HMdR, Bhuyan D. Enhanced peri-operative communication elevates patients’ understanding, perception, and satisfaction for anesthesia services: Insights from a survey study. Saudi J Anaesth [Internet]. 2024 Jun 4;18(3):376–87. Available from: http://dx.doi.org/10.4103/sja.sja_104_24

10. Alnashri YM, Alfaqih OY, Buhaliyqh MA, et al. Patient satisfaction and its predictors with peri-operative anesthesia care at two general hospitals in southwestern Saudi Arabia. Cureus [Internet]. 2023 Jan 16; Available from: http://dx.doi.org/10.7759/cureus.33824

11. Fetene MB, Bayable SD, Wendimu ES, et al. Peri-operative patient satisfaction and its predictors following surgery and anesthesia services in North Shewa, Ethiopia. A multicenter prospective cross-sectional study. Ann Med Surg (Lond) [Internet]. 2022 Apr;76. Available from: http://dx.doi.org/10.1016/j.amsu.2022.103478

12. Andemeskel YM, Elsholz T, Gebreyohannes G, Tesfamariam EH. Patient satisfaction with peri-operative anesthesia care and associated factors at two National Referral Hospitals: a cross-sectional study in Eritrea. BMC Health Serv Res [Internet]. 2019 Sep 18;19(1). Available from: http://dx.doi.org/10.1186/s12913-019-4499-x

13. Walker EMK, Bell M, Cook TM, Grocott MPW, Moonesinghe SR. Patient-reported outcome of adult peri-operative anaesthesia in the United Kingdom: a cross-sectional observational study. Br J Anaesth [Internet]. 2016 Dec;117(6):758–766r. Available from: http://dx.doi.org/10.1093/bja/aew381

14. Geremew K, Kotisso B, Bekele D. Trends of communicating peri-operative findings for patients and caregivers, and its effect on patient satisfaction in Tikur Anbessa Hospital, Addis Ababa, Ethiopia: a prospective cross-sectional study 2024. J BioMed Res Rep [Internet]. 2025 Apr 18;7(5):1–10. Available from: http://dx.doi.org/10.59657/2837-4681.brs.25.156

15. Makoko UM, Modiba LM, Nzaumvila DK. Satisfaction with spinal anaesthesia for Caesarean section at Tembisa Hospital, South Africa: a cross-sectional study. S Afr Fam Pract [Internet]. 2018 Nov 13;61(2):39–47. Available from: http://dx.doi.org/10.1080/20786190.2018.1531585

16. Mathews C, Firfiray L. Quality of anaesthesia care in elective surgery at a Western Cape academic hospital in South Africa: a peri-operative patient satisfaction survey. SAJAA [Internet]. 2023 Nov;29(6):209–15. Available from: http://dx.doi.org/10.36303/sajaa.3009

17. Caljouw MAA, van Beuzekom M, Boer F. Patient’s satisfaction with peri-operative care: development, validation, and application of a questionnaire. Br J Anaesth [Internet]. 2008 May;100(5):637–44. Available from: http://dx.doi.org/10.1093/bja/aen034

18. Jlala HA, Caljouw MA, Bedforth NM, Hardman JG. Patient satisfaction with peri-operative care among patients having orthopedic surgery in a university hospital. Local Reg Anesth [Internet]. 2010 Jul;49. Available from: http://dx.doi.org/10.2147/lra.s11381

19. Baig UA, Shafiq F. A survey related to patients’ satisfaction about anaesthetic care at a tertiary care center in Pakistan. Pak J Med Sci [Internet]. 2025 Nov 3;41(11):3234–9. Available from: http://dx.doi.org/10.12669/pjms.41.11.11811

20. Flierler WJ, Nübling M, Kasper J, Heidegger T. Implementation of shared decision making in anaesthesia and its influence on patient satisfaction. Anaesthesia [Internet]. 2013 May 8;68(7):713–22. Available from: http://dx.doi.org/10.1111/anae.12196

21. Suh WS, Lee CK. Impact of shared-decision making on patient satisfaction. J Prev Med Public Health [Internet]. 2010;43(1):26. Available from: http://dx.doi.org/10.3961/jpmph.2010.43.1.26

22. Taylor LJ, Rivet EB, Kapadia MR. Communicating with patients about surgery. JAMA [Internet]. 2025 Jun 3;333(21):1920. Available from: http://dx.doi.org/10.1001/jama.2025.2195

23. Villalona S, Boxtha C, Webb WA, Cervantes C, Wilson JW. “If at least the patient could not be forgotten about”: communication in the emergency department as a predictor of patient satisfaction. J Patient Exp [Internet]. 2020 Oct 9;7(6):1015–21. Available from: http://dx.doi.org/10.1177/2374373520957123

24. Alshehri A, Alomar Y, Mohammed G, et al. A survey on postanesthetic patient satisfaction in a university hospital. Saudi J Anaesth [Internet]. 2015;9(3):303. Available from: http://dx.doi.org/10.4103/1658-354x.158499

25. Alsaif A, Alqahtani S, Alanazi F, Alrashed F, Almutairi A. Patient satisfaction and experience with anesthesia: A multicenter survey in Saudi population. Saudi J Anaesth [Internet]. 2018 Apr;12(2):304–10. Available from: http://dx.doi.org/10.4103/sja.sja_656_17

26. Drzymalski D, Liu E, Calderon M, Jung J. Predictors of patient satisfaction with anesthesia using the Press Ganey patient satisfaction survey. Anaesthesiol Intensive Ther [Internet]. 2026 Jan 30;58(1):10–6. Available from: http://dx.doi.org/10.5114/ait/216697