Delphi study to develop a core outcome set for inpatient pain assessment after cesarean delivery

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-09-01 DOI:10.1016/j.accpm.2025.101556

S. Ciechanowicz , B. Carvalho , J.S. Berger , P. Duch , P. Flood , R. Ffrench-O’Carroll , H. Sviggum , S. Hakimi , D. Jethava , M. Mieszkowski , A. Merriam , S. Osmundson , U. Ituk , J. Wagner Kovacec , P. Sultan

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引用次数: 0

Abstract

Background

Studies of cesarean delivery pain report different outcomes, restricting data pooling. This study aimed to develop a core outcome set for inpatient postoperative pain assessment after cesarean delivery to use for research and clinical practice, using the Delphi consensus methodology.

Methods

A scoping review identified 37 initial outcomes, with 2 additional outcomes developed from a patient focus group. These were rated in a two-round Delphi survey process completed by a panel consisting of authors of studies identified from a scoping review (n = 9), supplemented with other experts (n = 5) and patients with recent lived experience of post cesarean delivery pain (n = 7). Scores were collected usinga 1−5 Likert scale, 1–2 being ‘critical for inclusion’; 3 being ‘important but not critical’, and 4–5 of ‘limited importance/invalid’. Outcomes were included if recommended by ≥70% of stakeholders after voting. A third-round virtual meeting determined domains, and several further rounds of online surveys finalizedthe specific measures.

Results

Round one included 14 experts and 7 patients (100% response). Round two included 12 experts and 4 patients (76% response). The virtual meeting was attended by 11 experts and 3 patients (67%), and the 4 online surveys were completed by 67%, 52%, 67%, and 76%. The final domains included pain intensity: at rest, movement-evoked, and pain relief; pain interference; total consumption of opioids; and maternal adverse effects. 12 measures for domains were agreed upon. Getting out of a hospital bed was selected as the most relevant functional activity for movement-evoked pain after cesarean delivery.

Conclusions

This core outcome set may be applied to future research and clinical practice initiatives to evaluate post cesarean delivery pain.

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德尔菲研究为剖宫产后住院患者疼痛评估制定一个核心结局集。

背景：剖宫产疼痛的研究报告了不同的结果，限制了数据汇集。本研究旨在采用德尔菲共识方法，为剖宫产术后住院患者疼痛评估制定一套核心结果集，用于研究和临床实践。方法：范围评估确定了37个初始结果，另外2个结果来自焦点小组。在两轮德尔菲调查中对这些结果进行评分，该调查由焦点小组完成，该小组由范围综述研究的作者（n = 9）、其他专家（n = 5）和近期生活经验的患者（n = 7）组成。得分在1-5分的李克特量表上，1-2分是“关键的包容性”；3是“重要但不关键”，4-5是“有限重要/无效”。如果投票后有超过70%的利益相关者推荐，则纳入结果。第三轮虚拟会议确定了域名，并进一步进行了几轮在线调查，确定了具体措施。结果：第一轮专家14人，患者7人。第二轮包括12名专家和4名患者（76%应答）。参加虚拟会议的专家11人，患者3人（67%），完成4项在线调查的焦点组比例分别为67%、52%、67%、76%。最后一个领域包括疼痛强度：休息时、运动诱发时和疼痛缓解时；疼痛干扰;阿片类药物总消费量；以及母体的不良影响。就12项域名措施达成一致。结论：下床是剖宫产后运动诱发疼痛最相关的功能活动。这一核心结果集可以应用于未来的研究和临床实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anaesthesia Critical Care & Pain Medicine ANESTHESIOLOGY-

CiteScore

6.70

自引率

5.50%

发文量

150

审稿时长

18 days

期刊介绍： Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.