QuReS: Postpartum Quality of Recovery & Maternal Satisfaction After C/S
Study Details
Study Description
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.
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Study Design
Outcome Measures
Primary Outcome Measures
- 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?"
- Improvement of Satisfaction [1 Minute]
Third and last open ended question assessing: "Do you have any suggestions on what would improve your satisfaction?"
Secondary Outcome Measures
- Obstetric History: Gravidity and Preterm [1 Minute]
Total frequency of gravidity and preterm
- 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
- 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 Agents [1 Minute]
Neuraxial agents and dosage administered prior and during the cesarean section procedure.
- Intraoperative Anxiolytics [1 Minute]
Intraoperative anxiolytics drug and dose administered prior and during the cesarean section procedure.
- 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.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Fluent English speaker
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Older than 19 years of age
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Received a cesarean delivery
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Received a cesarean delivery 24-48 hours prior to time of recruitment
Exclusion Criteria:
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Non-English speaker
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Below the age of 19 years
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Did not receive a cesarean delivery
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Received a cesarean delivery more than 48hrs after time of recruitment
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | BC Women's Hospital | Vancouver | British Columbia | Canada | V6H 3N1 |
Sponsors and Collaborators
- University of British Columbia
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Barnett SF, Alagar RK, Grocott MP, Giannaris S, Dick JR, Moonesinghe SR. Patient-satisfaction measures in anesthesia: qualitative systematic review. Anesthesiology. 2013 Aug;119(2):452-78. doi: 10.1097/ALN.0b013e3182976014. Review.
- Berning V, Laupheimer M, Nübling M, Heidegger T. Influence of quality of recovery on patient satisfaction with anaesthesia and surgery: a prospective observational cohort study. Anaesthesia. 2017 Sep;72(9):1088-1096. doi: 10.1111/anae.13906. Epub 2017 May 16.
- Bowyer A, Jakobsson J, Ljungqvist O, Royse C. A review of the scope and measurement of postoperative quality of recovery. Anaesthesia. 2014 Nov;69(11):1266-78. doi: 10.1111/anae.12730. Epub 2014 Jun 2. Review.
- Brooks H, Sullivan WJ. The importance of patient autonomy at birth. Int J Obstet Anesth. 2002 Jul;11(3):196-203.
- Camann W. Pain, Pain Relief, Satisfaction and Excellence in Obstetric Anesthesia: A Surprisingly Complex Relationship. Anesth Analg. 2017 Feb;124(2):383-385. doi: 10.1213/ANE.0000000000001676.
- Ciechanowicz S, Howle R, Heppolette C, Nakhjavani B, Carvalho B, Sultan P. Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery. Int J Obstet Anesth. 2019 Aug;39:51-59. doi: 10.1016/j.ijoa.2019.01.010. Epub 2019 Feb 2.
- Ciechanowicz S, Setty T, Robson E, Sathasivam C, Chazapis M, Dick J, Carvalho B, Sultan P. Development and evaluation of an obstetric quality-of-recovery score (ObsQoR-11) after elective Caesarean delivery. Br J Anaesth. 2019 Jan;122(1):69-78. doi: 10.1016/j.bja.2018.06.011. Epub 2018 Jul 31.
- Cook K, Loomis C. The Impact of Choice and Control on Women's Childbirth Experiences. J Perinat Educ. 2012 Summer;21(3):158-68. doi: 10.1891/1058-1243.21.3.158.
- Heidegger T, Saal D, Nübling M. Patient satisfaction with anaesthesia - Part 1: satisfaction as part of outcome - and what satisfies patients. Anaesthesia. 2013 Nov;68(11):1165-72. doi: 10.1111/anae.12347. Epub 2013 Aug 8. Review.
- Kingsley C, Patel S. Patient-reported outcome measures and patient-reported experience measures. BJA Education. 2017;17(4):137-44.
- Linda D. Results of the National Maternity Experience Survey 2020 2020 [Available from: https://yourexperience.ie/maternity/national-results/.
- Morgan PJ, Halpern S, Lo J. The development of a maternal satisfaction scale for caesarean section. Int J Obstet Anesth. 1999 Jul;8(3):165-70.
- Myles PS, Reeves MD, Anderson H, Weeks AM. Measurement of quality of recovery in 5672 patients after anaesthesia and surgery. Anaesth Intensive Care. 2000 Jun;28(3):276-80.
- Porter M, van Teijlingen E, Chi Ying Yip L, Bhattacharya S. Satisfaction with cesarean section: qualitative analysis of open-ended questions in a large postal survey. Birth. 2007 Jun;34(2):148-54.
- Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995 May 1;152(9):1423-33.
- H21-01082