Cross-cultural adaptation and validation of the Iowa satisfaction with anesthesia scale for use in Brazil: a cross-sectional study
Adaptação transcultural e validação da Escala de Satisfação com Anestesia de Iowa para uso no Brasil: um estudo transversal⁎
Nicole Morem Pilau Moritz, José Eduardo Moritz, Gabriel Oscar Cremona Parma, Franklin Dexter, Jefferson Traebert
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.
Keywords
Resumo
Introdução
A Escala de Satisfação com Anestesia de Iowa (ISAS) foi desenvolvida para avaliar a satisfação de pacientes submetidos à sedação com cuidados anestésicos monitorados. Este estudo teve como objetivo adaptar transculturalmente o instrumento ISAS e avaliar a aceitabilidade, validade e confiabilidade da versão brasileira proposta (ISAS-Br).
Métodos
O processo de adaptação transcultural envolveu tradução, síntese, retrotradução, revisão por comitê de especialistas, pré-teste e revisão final do ISAS-Br. Foi realizado um estudo transversal envolvendo 127 indivíduos adultos submetidos a cirurgias ambulatoriais com sedação moderada/profunda. A aceitabilidade, confiabilidade e validade de construto da escala foram avaliadas.
Resultados
O processo de adaptação transcultural não exigiu alterações significativas na versão final da escala. O ISAS-Br demonstrou excelente aceitabilidade, com taxa de conclusão de 99% e tempo médio de conclusão de 4,6 minutos. A análise fatorial exploratória revelou três fatores: bem-estar emocional, conforto físico e alívio da ansiedade, com respectivos valores de coeficiente de confiabilidade composto de 0,874, 0,580 e 0,428. A confiabilidade teste-reteste do ISAS-Br, medida pelo coeficiente de correlação intraclasse, foi de 0,67 (intervalo de confiança de 95% [IC95%] 0,42 a 0,83), e o gráfico de Bland-Altman mostrou concordância satisfatória entre as medidas.
Conclusão
A versão brasileira proposta da ISAS passou por adaptação transcultural com sucesso de acordo com padrões internacionais. Demonstrou boa aceitabilidade e confiabilidade, no que diz respeito à avaliação da estabilidade temporal. Entretanto, o ISAS-Br apresentou baixa consistência interna para alguns fatores, indicando que este instrumento carece de sensibilidade para avaliar a satisfação de pacientes profundamente sedados. Novos estudos são necessários para explorar as hipóteses levantadas com base no conhecimento de suas propriedades psicométricas.
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References
1. Fleisher LA. Quality anesthesia medicine measures, patients decide. Anesthesiology. 2018;129:1063−9.
2. Chin J, Mcgrath M, Lokken E, Upegui CD, Prager S, Micks E. Ketamine compared with fentanyl for surgical abortion: a randomized controlled trial. Obs Gynecol. 2022;140:461−9.
3. Heidegger T, Husemann Y, Nuebling M, et al. Patient satisfaction with anaesthesia care: development of a psychometric questionnaire and benchmaking among six hospitals in Switzerland and Austria. Br J Anaesth. 2002;89:863−72.
4. Heidegger T, Saal D, Nubling M. Patient satisfaction with anaes- € thesia - part 1: satisfaction as part of outcome ‒ and what satisfies patients. Anaesthesia. 2013;68:1165−72.
5. Nubling M, Saal D, Heidegger T. Patient satisfaction with anaes- € thesia ‒ part 2: construction and quality assessment of questionnaires. Anaesthesia. 2013;68:1173−8.
6. Schiff JH, Fornaschon AS, Frankenhauser S, Schiff M, SnyderRamos SA, Martin E, et al. The Heidelberg Peri-anaesthetic Questionnaire ‒ development of a new refined psychometric questionnaire. Anaesthesia. 2008;63:1096−104. 7. Williams MR, Ward D, Carlson D, et al. Evaluating patient-centered outcomes in clinical trials of procedural sedation, part 1 efficacy: sedation consortium on endpoints and procedures for treatment, education, and research recommendations. Anesth Analg. 2017;124:821−30.
8. Williams MR, McKeown A, Dexter F, et al. Efficacy outcome measures for procedural sedation clinical trials in adults: an ACTTION systematic review. Anesth Analg. 2016;122:152−70.
9. American Society of Anesthesiologists. Distinguishing monitored anesthesia care (“MAC”) from moderate sedation/analgesia (conscious sedation) [Internet]. www.asahq.org [last update 2018 Oct 17; cited 2021 Sep 7]. Available at: https://www. asahq.org/standards-and-guidelines/statement-on-distinguishing-monitored-anesthesia-care-from-moderate-sedation-analgesia.
10. Hobaika A, Diniz M, Castro C. Cuidados anestesicos monitora- dos em anestesia ambulatorial. Rev Med Minas Gerais. 2005;15:37−40.
11. Dexter F, Aker J, Wright W. Development of a measure of patient satisfaction with monitored anesthesia care. Anesthesiology. 1997;87:865−73.
12. Capuzzo M, Landi F, Bassani A, Grassi L, Volta CA, Alvisi R. Emotional and interpersonal factors are most important for patient satisfaction with anaesthesia. Acta Anaesthesiol Scand. 2005;49:735−42.
13. Caljouw MAA, Van Beuzekom M, Boer F. Patient’s satisfaction with perioperative care: development, validation, and application of a questionnaire. Br J Anaesth. 2008;100:637−44.
14. Auquier P, Pernoud N, Bruder N, Simeoni MC, Auffray JP, Colavolpe C, et al. Development and validation of a perioperative satisfaction questionnaire. Anesthesiology. 2005;102:1116−23.
15. García LFJ, Capera ADR. Validation to spanish of the Iowa Satisfaction with Anesthesia Scale (ISAS) for monitored anesthesia care in ophthalmic surgery. Rev Colomb Anestesiol. 2014;42:272−80.
16. Falempin A-S, Pereira B, Gonnu-Levallois S, et al. Transcultural validation of a french version of the Iowa Satisfaction with Anesthesia Scale (ISAS-F). Can J Anesth. 2020;67:541−9.
17. Barnett S, Alagar R, Grocott M, Giannaris S, Dick J, Moonesinghe S. Patient-satisfaction measures in anesthesia. Anesthesiology. 2013;119:452−78.
18. Chanthong P, Abrishami A, Wong J, Herrera F, Chung F. Systematic review of questionnaires measuring patient satisfaction in ambulatory anesthesia. Anesthesiology. 2009;110:1061−7.
19. Candiotti KA, Bergese SD, Bokesch PM, Feldman MA, Wisemandle W, Bekker AY. Monitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, multicenter trial. Anesth Analg. 2010;110:47−56.
20. Fung D, Cohen M, Stewart S, Davies A. Can the Iowa satisfaction with anesthesia scale be used to measure patient satisfaction with cataract care under topical local anesthesia and monitored sedation at a community hospital? Anesth Analg. 2005;100: 1637−43.
21. Dexter F, Candiotti KA. Multicenter assessment of the iowa satisfaction with anesthesia scale, an instrument that measures patient satisfaction with monitored anesthesia care. Anesth Analg. 2011;113:364−8.
22. Anthoine E, Moret L, Regnault A, Sbille V, Hardouin JB. Sample size used to validate a scale: a review of publications on newly - developed patient reported outcomes measures. Health Qual Life Outcomes. 2014;12:1−10.
23. Wild D, Grove A, Martin M, et al. Principles of good practice for the translation and cultural adaptation process for patientreported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Heal. 2005;8:94−104.
24. Mokkink LB, Prinsen CA, Patrick D, et al. COSMIN study design checklist for patient-reported outcome measurement instruments [Internet]. COSMIN 2019 [cited 2021 Sep 7]. Available on: https://www.cosmin.nl/wp-content/uploads/COSMIN-studydesigning-checklist_final.pdf. 25. Terwee CB, Bot SDM, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34−42.
26. Valentini F, Damasio BF. Average variance extracted and com- posite reliability: reliability coefficients. Psicol Teor Pesqui. 2016;32:1−7.
27. Chadha RM, Dexter F, Brull SJ. Lack of recall after sedation for cataract surgery and its effect on the validity of measuring patient satisfaction. Korean J Anesthesiol. 2020;73:319−25.
28. Fung D, Cohen M. What do outpatient value most in their anesthesia care. Can J Anaesth. 2001;48:12−9.
29. Capuzzo M, Alvisi R. Is it possible to measure and improve patient satisfaction with anesthesia? Anesth Clin. 2008;26:613−26.
30. American Society of Anesthesiologists. Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia [Internet]. www.asahq.org [last update 2019 Oct 23; cited 2021 Sep 7]. Available at: https://www.asahq. org/standards-and-guidelines/statement-on-continuum-ofdepth-of-sedation-definition-of-general-anesthesia-and-levelsof-sedation-analgesia.
Submitted date:
07/23/2023
Accepted date:
11/04/2023
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