Huang Jingying, Yang Jin, Han Mengbo, Xue Zihao, Xu Miaomiao, Qi Haiou, Chen Jiaojiao, Xue Caiya, Wang Yuting
Postanesthesia Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int J Nurs Stud. 2025 Jan;161:104930. doi: 10.1016/j.ijnurstu.2024.104930. Epub 2024 Oct 14.
Patient Reported Experience Measures (PREM) have become a critical component in assessing healthcare quality from the patient's perspective. Accurate and reproducible assessment tools are essential for generating robust and reliable results for evaluating peri-anesthesia patient experiences, identifying associated factors, and assessing the impact of healthcare interventions. However, there is currently no systematic review that consolidates all existing peri-anesthesia PREMs and evaluates their psychometric properties.
To identify and assess the psychometric properties of PREMs for peri-anesthesia patients.
Systematic review of measurement properties following the COSMIN guidelines.
Systematic searches were conducted in China National Knowledge Infrastructure, Wanfang, PubMed, Embase, Web of Science, CINAHL, and PsycINFO databases from January 1, 1993, to April 15, 2024. Studies reporting on the development and/or validation of any PREMs for use in the peri-anesthesia period were considered eligible. The measurement properties extracted included data on the item development process, content validity, structural validity, internal consistency, cross-cultural validity, reliability, hypothesis testing and responsiveness. For the same PREM across different studies, reliability coefficients were analyzed using a meta-analysis. The quality assessment, rating of measurement properties, synthesis, and modified grading of the evidence were carried out following the COSMIN methodology for systematic reviews.
A total of 26 studies encompassing 16 PREMs were included. Among them, the Patient Satisfaction with Perioperative Anesthetic Care questionnaire (PSPACq), Perception of Quality in Anesthesia (PQA), Sindhvananda General Anesthesia Satisfaction questionnaire, and Daycare Anesthesia Satisfaction (DAS) demonstrated moderate to high-quality evidence of adequate content validity and internal consistency, resulting in strong recommendations. Five PREMs exhibited high-quality evidence of inadequate structural validity and internal consistency, receiving a "not recommended" status. The remaining PREMs were weakly recommended.
This systematic review identified PSPACq and PQA as effective tools for assessing peri-anesthesia experiences in surgical patients, suitable for both research and clinical use. Future studies should focus on thoroughly evaluating the measurement properties of these two PREMs, as many aspects remain underexplored. A high risk of bias was noted in other PREMs, particularly in content validity, structural validity, and reliability, which increases uncertainty in the evidence base.
This study's protocol has been registered at PROSPERO under the registration number CRD42024537900.
患者报告体验测量（PREM）已成为从患者角度评估医疗质量的关键组成部分。准确且可重复的评估工具对于生成用于评估围麻醉期患者体验、识别相关因素以及评估医疗干预影响的强大而可靠的结果至关重要。然而，目前尚无系统评价整合所有现有的围麻醉期PREM并评估其心理测量特性。
识别并评估围麻醉期患者PREM的心理测量特性。
按照COSMIN指南对测量特性进行系统评价。
于1993年1月1日至2024年4月15日在中国知网、万方、PubMed、Embase、Web of Science、CINAHL和PsycINFO数据库中进行系统检索。纳入报告任何用于围麻醉期的PREM的开发和/或验证的研究。提取的测量特性包括项目开发过程、内容效度、结构效度、内部一致性、跨文化效度、信度、假设检验和反应度的数据。对于不同研究中的同一PREM，使用荟萃分析分析信度系数。按照COSMIN系统评价方法进行质量评估、测量特性评级、证据综合和证据的修改分级。
共纳入26项研究，涉及十六种PREM。其中，围手术期麻醉护理患者满意度问卷（PSPACq）、麻醉质量感知（PQA）、信德瓦南达全身麻醉满意度问卷和日间手术麻醉满意度（DAS）显示出中等至高质量的证据，证明内容效度和内部一致性充足，因此得到强烈推荐。五种PREM显示出高质量的证据，表明结构效度和内部一致性不足，被列为“不推荐”状态。其余PREM得到弱推荐。
本系统评价确定PSPACq和PQA是评估手术患者围麻醉期体验的有效工具，适用于研究和临床应用。未来研究应专注于全面评估这两种PREM的测量特性，因为许多方面仍未得到充分探索。在其他PREM中发现存在较高的偏倚风险，尤其是在内容效度、结构效度和信度方面，这增加了证据基础的不确定性。
本研究方案已在PROSPERO注册，注册号为CRD42024537900。
