The Pediatric Anesthesia Parent Satisfaction (PAPS) Questionnaire: A Focused Review of its Development, Validation,...

Patient satisfaction has become a central metric in evaluating healthcare quality. However, its use in pediatric anesthesia is less explored due to unique challenges in reporting satisfaction by a pediatric surgical patient. As a result of this, parental satisfaction is utilized as a validated proxy. To fill the gap of not having a validated tool for parent satisfaction, the Pediatric Anesthesia Parent Satisfaction (PAPS) questionnaire was developed, based on the American Society of Anesthesiologists Committee on Practice Management recommended questions. The tool was developed following a rigorous, expert, and parent-informed development process. This focused review attempts to summarize the available literature on the PAPS questionnaire, covering its development, psychometric validation, cross-cultural adaptation, and clinical application. Four articles meeting the inclusion criteria were identified. The original 17-item instrument demonstrated acceptable internal consistency (Cronbach's alpha above 0.7) and a three-factor structure involving physical symptoms, communication, and professionalism, with a pronounced ceiling effect. Two translations achieved excellent psychometric performance (Cronbach's alpha 0.937 and 0.96, respectively), confirming the instrument's cross-cultural robustness. Clinical application revealed consistently high satisfaction in high-income settings (more than 95%), with lower satisfaction observed only in one study (77.7%). The reasons for higher satisfaction were non-anxious parental status, male sex, urban residence, employment, and sedative premedication. Across all settings, postoperative symptom management and parental preparation for induction and emergence emerged as consistent areas for improvement. We conclude that PAPS is a globally applicable, psychometrically effective tool with considerable scope for improvement for continuous quality improvement in pediatric anesthesia care.