ABSTRACT
Abstract Background: The Iowa Satisfaction with Anesthesia Scale (ISAS) was developed to assess the satisfaction of patients undergoing sedation with monitored anesthesia care. This study aimed to cross-culturally adapt the ISAS instrument and evaluate the acceptability, validity, and reliability of the proposed Brazilian version (ISAS-Br). Methods: The cross-cultural adaptation process involved translation, synthesis, back-translation, expert committee review, pre-testing, and final review of the ISAS-Br. A cross-sectional study was conducted, involving 127 adult individuals undergoing ambulatory surgeries with moderate/deep sedation. The acceptability, reliability, and construct validity of the scale were assessed. Results: The cross-cultural adaptation process did not require significant changes to the final version of the scale. The ISAS-Br demonstrated excellent acceptability, with a completion rate of 99% and an average completion time of 4.6 minutes. Exploratory factor analysis revealed three factors: emotional well-being, physical comfort, and anxiety relief, with respective composite reliability coefficient values of 0.874, 0.580, and 0.428. The test-retest reliability of the ISAS-Br, measured by the intraclass correlation coefficient, was 0.67 (95% confidence interval [95% CI] 0.42 to 0.83), and the Bland-Altman plot showed satisfactory agreement between the measurements. Conclusion: The proposed Brazilian version of the ISAS underwent successful cross-cultural adaptation according to international standards. It demonstrated good acceptability and reliability, regarding the assessment of temporal stability. However, the ISAS-Br exhibited low internal consistency for some factors, indicating that this instrument lacks sensitivity to assess the satisfaction of deeply sedated patients. Further studies are necessary to explore the hypotheses raised based on the knowledge of its psychometric properties.
ABSTRACT
Resumen Introducción: Las suspensiones quirúrgicas constituyen una problemática compleja en el ámbito de la administración de pabellones, que afecta tanto a pacientes como al personal de pabellón, y que compromete la eficiencia financiera de las instituciones de salud. Existe escasa información acerca de la incidencia y características de las suspensiones quirúrgicas en nuestro país. Objetivo: Caracterizar las suspensiones quirúrgicas en un centro académico chileno, describiendo su incidencia global y por especialidad. Materiales y Métodos: Se incluyó información recopilada de manera prospectiva acerca de la programación y actividad de pabellón, y de una cohorte de pacientes suspendidos de cirugía entre el 1 de enero de 2016 y el 20 de mayo de 2017. Para calcular el porcentaje de suspensiones se utilizaron 3 grupos en base a 6 períodos de 4 semanas. Se aplicó la transformación de doble arcoseno de Freeman-Turkey y el test-t de Student. Resultados: Durante el período del estudio se programaron 11.398 cirugías, de ellas 492 fueron suspendidas. La incidencia de suspensiones de los 3 períodos fue de 4,38% (IC 95% de 3,78% a 5,01%), 4,15% (IC 95% de 3,51% a 4,85%) y 4,10% (IC 95% de 3,50% a 4,74%) respectivamente. Al menos en un 57% de los casos la principal causa de suspensión se identificó como un cambio en la condición médica del paciente. Discusión y Conclusiones: Nuestros resultados muestran, de manera consistente, que las suspensiones se encuentran entre un 3% y un 5%, lo que está dentro de los estándares internacionales, y pueden ser utilizados como un "benchmarking" para comparaciones a nivel nacional.
Introduction: Surgical cancellations are a complex problem in the field of Operating Room Management, affecting patients, staff, including surgeons and anesthetists, and compromising the finances of health institutions. The available information about the incidence and characteristics of surgical cancellations in our country are scarce. Objective: The aim of this article is to characterize the surgical cancellations in a Chilean academic center, describing its global incidence and by specialty. Materials and Methods: Prospective information on surgical schedule and Operating Room activity was included in this cohort study of surgical case cancellations occurring from January 1, 2016 through May 20, 2017. To calculate the percentage of cancellations, 3 groups were used based on 6 periods of 4 weeks. The Freeman-Turkey double-arcsine transformation and Student's t-test were applied. Results: During the study period, 11,398 surgeries were programmed, of which 492 were cancelled. The incidence of cancellations for the 3 periods was 4.38% (95% CI 3.78% to 5.01%), 4.15% (95% CI 3.51% to 4.85%) and 4.10% (95% CI of 3.50% to 4.74%) respectively. In at least 57% of cases the main identifiable cause of cancellation was a change in the patient's medical condition. Discussion and Conclusions: Our results consistently show that the cancellation rates range between 3% and 5%, which is within international standards, and can be used as benchmarking for comparisons at a national level.