Quality of recovery and maternal satisfaction after caesarean delivery: a mixed-methods prospective cohort study

IF 2.6 3区 医学 Q2 ANESTHESIOLOGY
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Abstract

Background

Patient satisfaction and quality of recovery (QoR) are important patient-reported outcomes and quality metrics. The relationship between these two outcomes is complex, with studies showing a weak correlation between them in the non-obstetric population. We sought to evaluate the correlation between patient satisfaction and QoR scores in the obstetric population after caesarean delivery. As secondary aims, we aimed to determine the influence of urgency of procedure and mode of anaesthetic on patient satisfaction and QoR scores as well as determining drivers of satisfaction and dissatisfaction.

Methods

Women were invited to complete the Maternal Satisfaction Scale for Caesarean Section (MSCS) and Obstetric Quality of Recovery Score (ObsQoR-11) questionnaires at 24 h after caesarean delivery. Correlations were analysed using Spearman’s rank tests. Qualitative data were analyzed using thematic content analysis.

Results

Data were collected from 300 women. There was a significant but weak positive correlation between ObsQoR-11 and MSCS scores (r = 0.31, P < 0.001). Correlation was significantly influenced by mode of anaesthesia (P < 0.001) and urgency of procedure (P = 0.005), with greater satisfaction amongst patients receiving spinal anaesthesia and those undergoing scheduled caesarean deliveries for a given QoR score. Quality of communication, interactions with staff and aspects of the postpartum physical environment were significant determinants of satisfaction and dissatisfaction.

Conclusion

Maternal satisfaction and obstetric QoR are distinct entities with a weak correlation between the two variables. Urgency of procedure and mode of anaesthesia are significant predictors of the correlation between satisfaction and quality of recovery scores. Many of the drivers of satisfaction were modifiable including quality of communication and a comfortable physical space for postpartum recovery.

剖腹产后的恢复质量和产妇满意度:一项混合方法前瞻性队列研究
患者满意度和康复质量(QoR)是重要的患者报告结果和质量指标。这两种结果之间的关系很复杂,研究显示在非产科人群中它们之间的相关性很弱。我们试图评估剖腹产后产科人群中患者满意度和 QoR 评分之间的相关性。作为次要目的,我们旨在确定手术的紧迫性和麻醉方式对患者满意度和 QoR 评分的影响,以及确定满意和不满意的驱动因素。我们邀请产妇在剖腹产后 24 小时内填写剖腹产产妇满意度量表 (MSCS) 和产科恢复质量评分 (ObsQoR-11) 问卷。相关性采用斯皮尔曼秩检验进行分析。定性数据采用主题内容分析法进行分析。数据收集自 300 名产妇。ObsQoR-11和MSCS评分之间存在明显但微弱的正相关(=0.31,<0.001)。相关性受麻醉方式(< 0.001)和手术紧迫性(= 0.005)的明显影响;在给定的 QoR 分数下,接受脊髓麻醉和预定剖腹产的患者的满意度更高。沟通质量、与医护人员的互动以及产后物理环境的各个方面是决定满意度和不满意度的重要因素。产妇满意度和产科质量评分是两个不同的变量,两者之间的相关性很弱。手术的紧急程度和麻醉方式是预测产妇满意度的重要因素。许多影响满意度的因素都是可以改变的,包括沟通质量和产后恢复的舒适物理空间。
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来源期刊
CiteScore
4.70
自引率
7.10%
发文量
285
审稿时长
58 days
期刊介绍: The International Journal of Obstetric Anesthesia is the only journal publishing original articles devoted exclusively to obstetric anesthesia and bringing together all three of its principal components; anesthesia care for operative delivery and the perioperative period, pain relief in labour and care of the critically ill obstetric patient. • Original research (both clinical and laboratory), short reports and case reports will be considered. • The journal also publishes invited review articles and debates on topical and controversial subjects in the area of obstetric anesthesia. • Articles on related topics such as perinatal physiology and pharmacology and all subjects of importance to obstetric anaesthetists/anesthesiologists are also welcome. The journal is peer-reviewed by international experts. Scholarship is stressed to include the focus on discovery, application of knowledge across fields, and informing the medical community. Through the peer-review process, we hope to attest to the quality of scholarships and guide the Journal to extend and transform knowledge in this important and expanding area.
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