Study on The exploration of satisfaction, length of stay and related factors among anesthesia cesarean patients in Swaziland

Background although health services are one of the priorities of Swaziland government through the Ministry of Health, little has been done to ascertain Patient satisfaction and length of stay specifically on anesthesia delivery. Patient satisfaction and length of stay are known indicators to measure or assess patient quality of care from anesthesia outcome.
Objectives This study want to determine and explore factors influencing patient satisfaction and key drivers of length of stay among cesarean sections as a general view of anesthesia delivery in Swaziland through;
1. Exploring the level of patient’s satisfaction,
2. Exploring the effects of patients’ factors on their satisfaction.
3. Exploring the length of stay of patients who received anesthesia
4. Exploring the effects of patients’ factors on their length of stay (LOS)
Methods and Results Eighty post cesarean section patients are recruited into this study from two major hospitals in Swaziland, 40 patients each. A questionnaire Quality of Recovery 40 (QoR40), is used to determine patient satisfaction in five dimensions; pain, comfort, physical independence, patient support, and emotions. Also all fourteen nurse anesthetists from both hospitals are recruited to fill a questionnaire to determine factors hindering or influencing anesthesia delivery in their settings. The result from all 80 questionnaires revealed that 98% of the questions were all answered with no missing data. Thirteen of the 14 nurse anesthetists returned the questionnaire. Using analysis of variances (ANOVA) and independent t-test analysis were used to determine significant differences among the variables. Multiple regression analysis to predict factors that either influence patient satisfaction or LOS. On the significant differences, satisfaction dimensions results were mostly significant with a low mean of comfort and support domain for Mbabane government hospital (MGH), 0.029 (p<0.05), also low mean score for patients on anti-retroviral drugs (ARV’s), 0.011(p<0.05), especially on comfort and emotions aspects. Patients receiving general anesthesia had both significance on satisfaction of all dimensions but support, and significant LOS; 0.001and 0.004 respectively. Intubation patients also had 0.001 and for LOS, 0.001. Patients older than 40 years had a low mean significance of satisfaction in comfort and physical independence and high average LOS. Predicting factors that influence the dependent variables, type of hospital was a consistent predictor, whilst other factors like intubation of patients, technique used, history of medical condition, and diagnoses had a varyingly significant among the dimensions of satisfaction.
Conclusions the study concluded a significant need of anesthesia patient satisfaction evaluation as well as more research on other possible factors that might influence anesthesia. Mostly of these factors are known in the pool of knowledge as far as studies from various countries are concerned, though factors of concern are patients done cesarean section (C/S) with human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) diagnosis. All these factors compromising patient satisfaction and LOS indicate an urgent need of safety and quality guidelines or protocols in the service of anesthesia delivery in Swaziland.