Day surgery: development of a questionnaire for eliciting patients' experiences

OBJECTIVE--To develop a single, short, acceptable, and validated postal questionnaire for assessing patients' experiences of the process and outcome of day surgery. DESIGN--Interviews and review of existing questionnaires; piloting and field testing of draft questionnaires; consistency and validity checks. SETTING--Four hospitals, in Coventry (two), Swindon, and Milton Keynes. PATIENTS--373 patients undergoing day surgery in 1990. MAIN MEASURES--Postoperative symptoms, complications, health and functional status, general satisfaction, and satisfaction with specific aspects of care. RESULTS--Response rates of 50% were obtained on field testing draft questionnaires preoperatively and one week and one month after surgery. 28% of initial non-responders replied on receiving a postal reminder, regardless of whether or not a duplicate questionnaire was sent; a second reminder had little impact. Many patients who expressed overall satisfaction with their care were nevertheless dissatisfied with some specific aspects. Outcome and satisfaction were related to three aspects of case mix; patient's age, sex, and type of operative procedure. The final questionnaire produced as a result of this work included 28 questions with precoded answers plus opportunities to provide qualitative comments. Several factors (only one, shorter questionnaire to complete, fewer categories of nonresponders, and administration locally) suggested that a response rate of at least 65% (with one postal reminder) could be expected. CONCLUSION--A validated questionnaire for day surgery was developed, which will be used to establish a national comparative database.