Postpartum Women
Conditions
Brief summary
Measuring patient-oriented outcomes and satisfaction is important to guide meaningful changes in obstetric anesthesia care. Quality of Recovery (QoR) scores are patient rated measures, which provide a global measure of recovery after surgery. They go beyond the measure of physiological variables to include, physical, cognitive, emotive and functional outcomes. Satisfaction, in addition to QoR scores after anaesthesia is an important quality marker. Measuring satisfaction after the birth of a child is a complex and emotive subject. Understanding the factors that can influence maternal satisfaction may improve patient-centred care. Studies have shown that despite favorable clinical outcomes, many women undergoing caesarean deliveries continue to have poor experience with anaesthesia. These poor experiences go beyond inadequate pain control; many are due to poor communication with clinicians, lack of involvement in decision making, lack of provision of high quality education and information and a feeling of inadequate choice and control relating to decisions of the birth of their babies. In non-obstetric studies, satisfaction after anaesthesia has consistently been shown to be dependent on the information patient has received along with the quality of the communication and the quality of the anaesthetist-patient relationship.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Fluent English speaker * Older than 19 years of age * Received a cesarean delivery * Received a cesarean delivery 24-48 hours prior to time of recruitment
Exclusion criteria
* Non-English speaker * Below the age of 19 years * Did not receive a cesarean delivery * Received a cesarean delivery more than 48hrs after time of recruitment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Improvement of Satisfaction | 1 Minute | Third and last open ended question assessing: Do you have any suggestions on what would improve your satisfaction? |
| Quality of Recovery Score (ObsQoR-11) | 5 Minutes | Quality of recovery will be measured using the obstetric quality of recovery score (ObsQoR-11). This is a 11-item, multidimensional recovery scoring tool, which has been validated in this population |
| Maternal Satisfaction Scale for Cesarean Section (MSSCS) | 5 Minutes | This 22 item questionnaire measures satisfaction with the anaesthetic, needle insertion, side effects and the theatre atmosphere. Items are rated on a 7-point likert scale from strongly disagree to strongly agree. |
| Satisfaction with Received Care | 1 Minute | First open ended question assessing: What aspects of your care were you most satisfied with? |
| Dissatisfaction with Received Care | 1 Minute | Second open ended question assessing: What aspects of your care were you most dissatisfied with? |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Outcome of Delivery | 1 Minute | Result of singleton, twins, or other |
| Neonatal APGARs | 1 Minute | APGAR scores at 1 minute and minutes |
| Neonatal Birthweight | 1 Minute | Neonatal birthweight measured in grams |
| Patient ASA Status | 1 Minute | American Society of Anesthesiologists (ASA) physical status classification system ranging from 1 to 6 |
| Pregnancy Medical Conditions | 1 Minute | Including: pregnancy induced HTN, pre-eclampsia, gestational diabetes, anemia, hyperemesis, cholestasis, and other. |
| Medical Conditions Outside Pregnancy | 1 Minute | Including any medical conditions that do not constitute a pregnancy medical condition |
| Neuraxial Lidocaine | 1 Minute | Neuraxial agents and dosage administered prior and during the cesarean section procedure. |
| Neuraxial Bupivicaine | 1 Minute | dosage administered prior and during the cesarean section procedure. |
| Neuraxial Morphine | 1 Minute | dosage administered prior and during the cesarean section procedure. |
| Neuraxial Fentanyl | 1 Minute | dosage administered prior and during the cesarean section procedure. |
| Obstetric History: Gravidity and Preterm | 1 Minute | Total frequency of gravidity and preterm |
| Anesthesia Procedure Start | 1 Minute | Time in military time format |
| Urgency of Cesarean Delivery | 1 Minute | Classified as: scheduled, STAT, P1, or P2 |
| Indication for Cesarean Delivery | 1 Minute | Reason for cesarean delivery |
| Labour Onset | 1 Minute | Indicated as: spontaneous, augmented, or induction of labour |
| Labour Length | 1 Minute | Length of hours for both first stage and second stage |
| Pain Relief During Labour | 1 Minute | Indicated as: epidural/CSE/DPE, Entonox, M&G, or other |
| Intraoperative Complications | 1 Minute | Indicated as: hypotension, shivering, nausea, vomiting, itch, failed neuraxial, or other. |
| Intraoperative Blood Loss | 1 Minute | Blood loss measured in milliliters. |
| Postoperative Complications | 1 Minute | Any medical complication indicated after the caesarean delivery. |
| Intraoperative Anxiolytics | 1 Minute | Intraoperative anxiolytics drug and dose administered prior and during the cesarean section procedure. |
| Patient Age | 1 Minute | Patient age in years |
| Gestational Age | 1 Minute | Gestational age in total weeks and days |
| Patient Height | 1 Minute | Patient height measured in centimeters |
| Patient Weight | 1 Minute | Patient weight measured in kilograms |
Countries
Canada