Postpartum Quality of Recovery & Maternal Satisfaction After C/S

Study Overview
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Brief Summary
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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.

Official Title
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Relationship Between Patient Reported Postpartum Quality of Recovery and Maternal Satisfaction After Cesarean Delivery: A Prospective Observational Study

Conditions
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Quality of Recovery, Maternal Satisfaction

Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of Recovery Score (ObsQoR-11) | 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 | 5 Minutes | 
| Maternal Satisfaction Scale for Cesarean Section (MSSCS) | 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. | 5 Minutes | 
| Satisfaction with Received Care | First open ended question assessing: What aspects of your care were you most satisfied with? | 1 Minute | 
| Dissatisfaction with Received Care | Second open ended question assessing: What aspects of your care were you most dissatisfied with? | 1 Minute | 
| Improvement of Satisfaction | Third and last open ended question assessing: Do you have any suggestions on what would improve your satisfaction? | 1 Minute | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Obstetric History: Gravidity and Preterm | Total frequency of gravidity and preterm | 1 Minute | 
| Patient Age | Patient age in years | 1 Minute | 
| Gestational Age | Gestational age in total weeks and days | 1 Minute | 
| Patient Height | Patient height measured in centimeters | 1 Minute | 
| Patient Weight | Patient weight measured in kilograms | 1 Minute | 
| Outcome of Delivery | Result of singleton, twins, or other | 1 Minute | 
| Neonatal APGARs | APGAR scores at 1 minute and minutes | 1 Minute | 
| Neonatal Birthweight | Neonatal birthweight measured in grams | 1 Minute | 
| Patient ASA Status | American Society of Anesthesiologists (ASA) physical status classification system ranging from 1 to 6 | 1 Minute | 
| Pregnancy Medical Conditions | Including: pregnancy induced HTN, pre-eclampsia, gestational diabetes, anemia, hyperemesis, cholestasis, and other. | 1 Minute | 
| Medical Conditions Outside Pregnancy | Including any medical conditions that do not constitute a pregnancy medical condition | 1 Minute | 
| Neuraxial Agents | Neuraxial agents and dosage administered prior and during the cesarean section procedure. | 1 Minute | 
| Intraoperative Anxiolytics | Intraoperative anxiolytics drug and dose administered prior and during the cesarean section procedure. | 1 Minute | 
| Anesthesia Procedure Start | Time in military time format | 1 Minute | 
| Urgency of Cesarean Delivery | Classified as: scheduled, STAT, P1, or P2 | 1 Minute | 
| Indication for Cesarean Delivery | Reason for cesarean delivery | 1 Minute | 
| Labour Onset | Indicated as: spontaneous, augmented, or induction of labour | 1 Minute | 
| Labour Length | Length of hours for both first stage and second stage | 1 Minute | 
| Pain Relief During Labour | Indicated as: epidural/CSE/DPE, Entonox, M&G, or other | 1 Minute | 
| Intraoperative Complications | Indicated as: hypotension, shivering, nausea, vomiting, itch, failed neuraxial, or other. | 1 Minute | 
| Intraoperative Blood Loss | Blood loss measured in milliliters. | 1 Minute | 
| Postoperative Complications | Any medical complication indicated after the caesarean delivery. | 1 Minute |