Emergency Patient Complaints in Turkish Patients

Research Article

Austin J Nurs Health Care. 2015;2(2): 1020.

Emergency Patient Complaints in Turkish Patients

Senay Karadag Arli1*, Fatma Eti Aslan2 and Sevim Purisa3

1Department of Nursing, Agri Ibrahim Cecen University School of Health, Turkey

2Health Sciences Faculty, Acibadem University, Istanbul, Turkey

3Sevim Purisa is Statistician, Cerrahpasa Medicine Faculty, Biostatistics, Istanbul, Turkey

*Corresponding author: Senay Karadag Arli, Department of Nursing, Agri Ibrahim Cecen University School of Health, Turkey,

Received: May 20, 2015; Accepted: June 03, 2015; Published: June 06, 2015


Purpose: This study was conducted for the purpose of determining emergency patient complaints in Turkish patients.

Materials and Methods: This study, designed as a descriptive and analytic type of research, was conducted between December 9, 2006, and June 30, 2007, with 1514 patients in the emergency department of a private hospital in Istanbul, Turkey. Data collected consisted of 3 measures: (1) a 13-question “Individual Characteristics Form”; (2) a 35-item “Evaluation of Patient Complaints Form,” which utilized a face-to-face interview method; and (3) a “Triage Categories Form,” a 5-tier triage tool used by the emergency department where this study took place.

Results: In this study, 70% of the patients were between 16 and 43 years of age, 57% were female, 76% were triage category 4 (less urgent patients needing to be treated within, at the most, 1 hour), and 62.3% (n = 943) stated that they were “very pleased” with the service they received in the emergency department. However, some of the patients who rated themselves as having a very serious health problem were not satisfied at all with the emergency department. In turn, as the period of time increased before their first emergency intervention was begun, their dissatisfaction with their emergency care increased. Among the ED patient complaints, the most common was “the presence of curtains between the beds in the rooms and the beds being uncomfortable.”

Conclusions: The characteristic need of an ED patient is (a desire to) receive service within a short period. A high percentage of patients with serious health problems waited 5 minutes or extra time before their first emergency intervention was begun. Based on these results, it is recommended that ED physician and nursing leadership create policies and practices that allow emergency interventions to occur as soon as possible upon patient arrival.

Keywords: Emergency patient; Complaints; Satisfaction; Triage


Emergency medical interventions are necessary when the body is unable to adequately respond to disturbances in (physiologic homeostasis and organ failure) bodily functions and integrity that threaten life. The expectations and complaints of ED patients are different from those of patients requesting other elective or planned medical assistance. ED patients often experience increased anxiety related to their perceptions of not receiving the attention they expect. Relatives of the patients typically are anxious because of their fear of the unknown and concern for the well-being of their loved ones. They have expectations of health care personnel that include being given careful attention, smiling faces, Professional appearance, and knowledgeable care. ED patients also may be bothered by waiting, by unnecessary tests, and by having a large number of practitioners examine them [1,2]. However, a limited number of studies reported in the literature have been conducted for the purpose of determining ED patients’ complaints. Examining patient complaints is an approach that indirectly gives information on patient satisfaction. Another reason why the word “complaints/dissatisfaction” was chosen in this study instead of “satisfaction” is because most patients generally give high value to the care they receive, so caring behavior can be a reason for decreasing the sensitivity of caregivers who think given care is okay and interfering with their improvement [3-5].


Design, Participants, and Setting

This study was conducted as a descriptive and analytical type of research for the purpose of determining ED patient complaints in Istanbul between December 9, 2006, and June 30, 2007.


In the literature the dissatisfaction rate in emergency departments is reported to be between 10% and 12.3% [6,7]. Based on these data, a dissatisfaction rate of 10% from emergency departments is considered to be acceptable [6]. The power of a statistical test is the probability that the test will reject a false null hypothesis (ie, that it will not make a type II error). As power increases, the chances of a type II error decrease. The probability of a type II error is referred to as the false-negative rate (β). Therefore, power is equal to 1−β. To calculate the sample size of 1514 for this research, the formulae 1-β = 0.90 in power that is conducted in power analysis, Zβ = 1.282, in a 95% confidence interval, Zα = 1.96, P = .10 (the incidence seen in examined incidents = 10%), (1-p) = 0.90 (the incidence not seen in examined incidents = 90%) and d = 0.025 (possibility of error = 2.5%) were used. Participants in this study were 16 years or older, had a minimum of primary school education, were in the emergency department for at least 2 hours, and had a complete discharge.

Patients with emotional problems and/or altered mental states were excluded from participating in this research.

Data collection

Data were collected with the Evaluation of Patient Complaints Form (EPCF), which has had validity and reliability tested (Cronbach α = 0.884) using a face-to-face interview method [8]. The EPCF is a 35-item questionnaire that assesses the patient’s general satisfaction with the ED physician; medical treatment rendered by the doctor and nurse and nursing care; ED wait time; confidentiality; communicating results to the patient; and comfort with the emergency department’s physical facilities (Table 1) [7,10-12]. It is developed by Karadag and Eti-Aslan in 2008[8,9]. It was filled by patients during discharge from ED, and telephone follow-up and electronic-mail were used in the second step. The scores of it were compared between two steps. In addition, for the purpose of determining the triage category, the Triage Categories Form was used (which is used in the emergency department where the research was conducted).This form includes a 5-category triage system (Table 2). Data were collected by researcher who knows the system of this emergency service.