Determinants of patient satisfaction during cataract surgery under local anaesthesia: A cross-sectional study in a Ghanaian teaching hospital

Patient satisfaction during cataract surgery

Abstract

Objective: To assess determinants of patient satisfaction with Manual Small-Incision Cataract Surgery (MSICS) under Local Anaesthesia (LA) at a Ghanaian teaching hospital.
Methods: We conducted a descriptive cross-sectional study of 220 adults who underwent MSICS under LA between July and December 2023. We collected data on demographics, Postoperative Day One (POD1) VA, intraoperative pain, communication quality and satisfaction via a structured and pretested questionnaire. The questionnaire included Likert-scale items on communication quality (two questions), pain (0–10 scale), and satisfaction (4-point scale), as well as an open-ended item for patient feedback. We identified independent predictors of satisfaction by multivariable logistic regression analyses, reporting Odds Ratios (OR) and 95% Confidence Intervals (CI). We employed the Hosmer-Lemeshow goodness-of-fit test and statistical significance set at p < 0.05.
Results: Mean age was 61.2 ± 10.3 years, and 63% were female. On POD1, 29% of eyes achieved good vision (≥6/18), 88.2% attained >6/60, and 12% had poor vision (<6/60). Overall, 72% of patients were satisfied. Most reported no intraoperative pain; none reported severe pain. In bivariate analysis, satisfaction was higher among those without pain (79% vs. 54%, p < 0.001) and those reporting good communication (78% vs. 57%, p = 0.001). On multivariable logistic regression, absence of intraoperative pain independently predicted satisfaction (adjusted OR: 2.97, 95% CI: 1.48–5.98, p = 0.002), as did good communication (adjusted OR: 2.38, 95% CI: 1.22–4.67, p = 0.011). Visual acuity outcome, gender, and preoperative anxiety were not significant predictors.
Conclusion: Patient satisfaction after MSICS under LA was high and independently associated with pain control and quality of communication, but not with unaided VA on POD1. Addressing intraoperative comfort and
patient-centred communication should be prioritised to optimise cataract surgical care quality.