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.
Study Type
OBSERVATIONAL
Enrollment
300
BC Women's Hospital
Vancouver, British Columbia, Canada
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
Time frame: 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.
Time frame: 5 Minutes
Satisfaction with Received Care
First open ended question assessing: "What aspects of your care were you most satisfied with?"
Time frame: 1 Minute
Dissatisfaction with Received Care
Second open ended question assessing: "What aspects of your care were you most dissatisfied with?"
Time frame: 1 Minute
Improvement of Satisfaction
Third and last open ended question assessing: "Do you have any suggestions on what would improve your satisfaction?"
Time frame: 1 Minute
Obstetric History: Gravidity and Preterm
Total frequency of gravidity and preterm
Time frame: 1 Minute
Patient Age
Patient age in years
Time frame: 1 Minute
Gestational Age
Gestational age in total weeks and days
Time frame: 1 Minute
Patient Height
Patient height measured in centimeters
Time frame: 1 Minute
Patient Weight
Patient weight measured in kilograms
Time frame: 1 Minute
Outcome of Delivery
Result of singleton, twins, or other
Time frame: 1 Minute
Neonatal APGARs
APGAR scores at 1 minute and minutes
Time frame: 1 Minute
Neonatal Birthweight
Neonatal birthweight measured in grams
Time frame: 1 Minute
Patient ASA Status
American Society of Anesthesiologists (ASA) physical status classification system ranging from 1 to 6
Time frame: 1 Minute
Pregnancy Medical Conditions
Including: pregnancy induced HTN, pre-eclampsia, gestational diabetes, anemia, hyperemesis, cholestasis, and other.
Time frame: 1 Minute
Medical Conditions Outside Pregnancy
Including any medical conditions that do not constitute a pregnancy medical condition
Time frame: 1 Minute
Neuraxial Lidocaine
Neuraxial agents and dosage administered prior and during the cesarean section procedure.
Time frame: 1 Minute
Neuraxial Bupivicaine
dosage administered prior and during the cesarean section procedure.
Time frame: 1 Minute
Neuraxial Morphine
dosage administered prior and during the cesarean section procedure.
Time frame: 1 Minute
Neuraxial Fentanyl
dosage administered prior and during the cesarean section procedure.
Time frame: 1 Minute
Intraoperative Anxiolytics
Intraoperative anxiolytics drug and dose administered prior and during the cesarean section procedure.
Time frame: 1 Minute
Anesthesia Procedure Start
Time in military time format
Time frame: 1 Minute
Urgency of Cesarean Delivery
Classified as: scheduled, STAT, P1, or P2
Time frame: 1 Minute
Indication for Cesarean Delivery
Reason for cesarean delivery
Time frame: 1 Minute
Labour Onset
Indicated as: spontaneous, augmented, or induction of labour
Time frame: 1 Minute
Labour Length
Length of hours for both first stage and second stage
Time frame: 1 Minute
Pain Relief During Labour
Indicated as: epidural/CSE/DPE, Entonox, M\&G, or other
Time frame: 1 Minute
Intraoperative Complications
Indicated as: hypotension, shivering, nausea, vomiting, itch, failed neuraxial, or other.
Time frame: 1 Minute
Intraoperative Blood Loss
Blood loss measured in milliliters.
Time frame: 1 Minute
Postoperative Complications
Any medical complication indicated after the caesarean delivery.
Time frame: 1 Minute
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