Patient satisfaction perspectives when undergoing an invasive extra capsular cataract extraction with an intra ocular lens implant while consciously sedated

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2004
Authors
Foster, Fred O.
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Abstract
Problem: Patient's perspectives regarding health care rendered when undergoing an invasive procedure while consciously sedated has not been explored. Research is needed to provide patient's perception of satisfaction before, during and following an invasive extra capsular cataract extraction (ECCE) with an intra ocular lens implant (IOLI) while consciously sedated. Purpose: The purpose of this study was to construct and introduce a psychometrically reliable and valid instrument to measure a patient's level of satisfaction when undergoing an ECCE with an IOLI while consciously sedated; and to conduct and present a pilot study of its' reliability. Method: An integrative review of the literature (ROL) was conducted to identify factors thought to be associated with satisfaction, and a content valid instrument (Patient Satisfaction Survey [PaSS]) was generated. Two professional nursing experts instrument construction then evaluated the instrument for face validity. Psychometric analysis of the PaSS's reliability included: (a) determination of frequencies (numbers and mean scores; (b) factor reduction analysis using SPSS 10; (c) determination of estimates of reliability (coefficient alpha); and (d) inter item (question and concept) reliability (Cronbach alpha) measures. Factors that were hypothesized to relate to satisfaction were analyzed using: (a) frequencies (numbers, percents, means [preoperative, intraoperative, and postoperative] and standard deviations; and (b) potential association with scores. The results were then compared to findings in the ROL. Sample: A post-procedure PaSS was given to 500 patients just prior to discharge to be used to evaluate patient perceived satisfaction of care when undergoing an ECCE with an IOLI while consciously sedated. Patients willing to participate completed and returned this survey to their clinic nurse the day following their surgery with no identifiable data on it. The clinic nurse routed these surveys to the primary researcher. Three hundred nine survey forms were returned between May 1, 2003 and December 31, 2003 of which 305 are included in this study. Analysis: Content validity was assured using themes generated from an integrative ROL review and expert opinion. Data collected retrospectively from 305 PaSS forms were analyzed using concept factor reduction; estimates of reliability; inter item reliability; and frequencies; along with comparing these findings with the ROL. Results: Content and face validity were confirmed. The presence of 2 factors and 2 themes were revealed. A Pearson correlation coefficient of p ≥ 0.689 was significant at p ≥ 0.01 for factor variable reliability. Internal consistency of questionnaire findings were found to be p ≥ 0.91, or highly significant by Cronbach alpha measures. Conclusion: The PaSS is valid and reliable, it measures these concepts consistently. The five concepts identified in the ROL were not confirmed by the analysis; but rather the responses suggest that the scale should focus primarily on the factor themes of 'caring' and 'comfort.' No subject determinants were identified as in the ROL. The scale did not demonstrate discriminate validity.
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Mode of access: World Wide Web.
Thesis (Ph. D.)--University of Hawaii at Manoa, 2004.
Includes bibliographical references (leaves 86-97).
Electronic reproduction.
Also available by subscription via World Wide Web
xv, 97 leaves, bound ill. 29 cm
Keywords
Patient satisfaction -- West (U.S.), Cataract -- Surgery -- West (U.S.), Cataract -- Patients -- West (U.S.), Conscious sedation -- West (U.S.)
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electronic resource
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Theses for the degree of Doctor of Philosophy (University of Hawaii at Manoa). Nursing; no. 4476
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