Are we providing patient-centered care? Preferences about paracentesis and thoracentesis procedures

Abstract

Procedures performed at the bedside are as safe and less expensive than Interventional Radiology (IR) procedures. Patient preferences regarding location are rarely taken into account. Therefore, in this study we compared patient satisfaction with bedside and IR paracentesis and thoracentesis procedures, and identified reasons for patient location preferences. We performed a cross-sectional survey of medical inpatients undergoing paracentesis or thoracentesis procedures at a tertiary care academic medical center. The survey had eight domains: overall experience, pain control, expertise, courtesy, bedside manner of the physician, time required, explanation of risks/benefits, comfort and privacy. Patients were also asked about their preference for procedure location. Two hundred and twenty surveys (162 paracentesis and 58 thoracentesis) were completed on 152 patients. Patient satisfaction was similar for bedside and IR procedures across all domains. A location preference was expressed in 151 surveys (68.6%). Thirty-five of 108 responses (32.4%) from patients with a paracentesis expressed a preference for bedside procedures while 73/108 (67.6%) responses expressed a preference for IR. Twenty-eight of 43 responses (65.1%) from patients with a thoracentesis expressed a preference for bedside procedures while 15/43 (34.9%) responses expressed a preference for IR. Comfort was listed as the most common reason for preferring the bedside while specialized equipment and safety were the most common reasons for preferring IR. Patients are equally and highly satisfied with bedside and IR paracentesis and thoracentesis procedures. Because both approaches are safe and effective, clinicians should pursue informed discussions with patients when a choice is available.

Keywords

• patient-centered care
• patient satisfaction
• thoracentesis
• paracentesis