Patient satisfaction with anaesthesia care: what is patient satisfaction, how should it be measured, and what is the evidence for assuring high patient satisfaction?

Patient satisfaction is a part of outcome quality. Many theories of satisfaction include patients' expectation. One definition of satisfaction is therefore the degree of congruence between expectation and accomplishment. The involvement of patients as well as experts is therefore an important step in the development of an instrument to measure patient satisfaction. Results of single-item ratings or overall satisfaction surveys are over-optimistic and do not represent the true indication of care. The construction of highly standardized (psychometric) questionnaires should include elements of content validity, criterion and construct validity, reliability and practicability. Based on the few available studies in anaesthesia, patient satisfaction is primarily determined by information and communication. There is great potential for improvement in this area. However, we do not know the best way to continuously improve patient satisfaction with anaesthesia care, or to what extent decisions should be shared between the anaesthetist and the patient.