Analysis and Improvement of Factors Affecting Satisfaction of Patients with Postoperative Patient-Controlled Analgesia.

Abstract

Patient-controlled analgesia (PCA) is widely used for postoperative pain management, yet patient satisfaction remains influenced by multiple clinical and educational factors. Identifying modifiable determinants may help optimize postoperative analgesic care. To evaluate postoperative pain management and satisfaction with postoperative PCA, identify factors associated with patient satisfaction, and propose improvement strategies. A total of 887 patients who underwent surgery and received postoperative PCA between January 2023 and April 2024 were retrospectively enrolled. Satisfaction was assessed using a 5-point Likert scale, and patients were classified into high-satisfaction (very satisfied/satisfied) and low-satisfaction (neutral/dissatisfied/very dissatisfied) groups. Clinical characteristics were compared, and independent predictors of low satisfaction were identified using multivariable logistic regression. Internal validation was performed using 5,000 nonparametric Bootstrap resamples. Among 887 patients, 852 (96.05%) reported high satisfaction, and 35 (3.95%) low satisfaction. Moderate-to-severe pain, insufficient preoperative communication, inadequate postoperative follow-up education, poor PCA awareness, and lower satisfaction with PCA button use were more common in the low-satisfaction group (all p <0.05). Multivariable analysis identified moderate-to-severe pain (Odds ratio (OR) = 2.704, 95% confidence interval (CI): 1.158-6.319), insufficient preoperative communication (OR = 2.078, 95% CI: 1.002-4.310), poor PCA awareness (OR = 3.062, 95% CI: 1.164-8.052), and inadequate postoperative education (OR = 3.300, 95% CI: 1.263-8.621) as independent predictors of low satisfaction. Satisfaction with PCA button use was significant only in univariate analysis. Bootstrap validation demonstrated generally consistent effect directions, although confidence intervals for several variables remained wide. Pain intensity, preoperative communication, postoperative education, and PCA awareness are key determinants of postoperative PCA satisfaction. Improving perioperative patient education, communication, and pain control may enhance patient experience and optimize postoperative pain management.