The Patient AS EDUcator in Anesthesia: Exploring the Patients' Experience During Routine Cesarean Delivery

NCT06368570 | Completed

• 1 other identifier: 24-04
• Study Type: observational
• Target: 25
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to explore the experience that the patient has as they undergo a routine Cesarean Delivery (CD). The indication for undergoing a routine CD varies amongst patients, but usually there is either an obstetric or medical reason for requiring a planned delivery of an infant via CD. Similarly, the experience of the CD varies significantly between patients as there are many patient, surgical and anesthetic factors that interact to create the unique experience each patient has. This study aims to explore the patients' perspective and learn about their preferences, concerns and suggestions regarding their experience of CD and to then use this information to enhance the quality of future anesthesia care for elective CD. Patients who have undergone a routine CD will be approached the day following their delivery, while their recollection of their experience is still fresh, and given the opportunity to participate in the study, which will involve the completion of a questionnaire as well as an interview lasting approximately 20-25 minutes. In addition to interviewing the patients, the study will also involve several interviews of obstetricians, anesthesiologists and nurses with the goal of seeing how the patients' experiences compare to the providers' perspective of the care they are delivering. Following the gathering of this information and identification of potential improvements in current practice a follow up study will be performed aiming to implement changes and improve the quality of anesthesia care during elective CD.

Conditions

Well-Being, Psychological

Keywords

cesarean delivery; patient experience; neuraxial anesthesia

Outcome Measures

Primary Outcomes (2)

• Patient questionnaire

  Patients will be asked to rate their experience of having a cesarean delivery with neuraxial anesthesia, in terms of satisfaction and their experience with any discomfort. Some questions are yes/no, some are on a scale from 1-10, where 1 = not at all and 10 = totally agree, and some are open-ended. The questionnaire will take approximately 10 minutes to complete.

  Following scheduled c-section delivery, and prior to hospital discharge (at approximately 48 hours postpartum).

• Patient interview

  Patients will be interviewed in person by a member of the research team and asked open ended questions. Interviews will be recorded, transcribed and coded for themes. Responses are not reported on any scale. The interview will take approximately 30 minutes to complete.

  Following scheduled c-section delivery, and prior to hospital discharge (at approximately 48 hours postpartum).

Study Arms (1)

Cesarean delivery with neuraxial anesthesia.

Patients who have a scheduled cesarean delivery with neuraxial anesthesia.

Other: Interview

Interventions

Interview OTHER

Patients will be interviewed by the research team to learn about their experience of Cesarean delivery with neuraxial anesthetic

Also known as: Interview questions

Cesarean delivery with neuraxial anesthesia.

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Patients who deliver by scheduled cesarean section with neuraxial anesthesia at Mount Sinai Hospital.

You may qualify if:

• aged 18 years or older
• ASA Physical Classification Score II or III
• elective CD (i.e. scheduled between 7am - 5pm) as per institutional standards (see below)
• patients who underwent the additional procedure of tubal ligation, salpingectomy or myomectomy (of uterine fibroid \<4cm) at the time of CD will be included as these are considered minor additional procedures

You may not qualify if:

• under 18 years of age
• unable to answer questions due to a language barrier or their mental state
• BMI at the time of delivery that falls in the super-morbidly obese category (BMI \> 55m-2)
• Patients who have underwent preterm delivery (under 37 weeks gestation), had a multiple gestation pregnancy or if there was presence of a significant fetal anomaly
• Anesthetic technique that significantly deviates from the institutional standards (see below\*) including patients who underwent elective CD under epidural or dural puncture epidural (DPE) technique
• Performance of myomectomy with fibroid size \>4cm at the time of CD
• Patients who underwent emergent CD as well as those who had contraindicated or failed neuraxial anesthesia and required general anesthesia for or during their CD will also be excluded.
• Institutional standards: spinal or combined spinal and epidural (CSE) with the standard dose of 1.8mL heavy bupivacaine 0.75% combined with intrathecal morphine 100-150 micrograms and fentanyl 10-15 micrograms. Administration of crystalloid co-loading at 10-15mL/kg following establishment of neuraxial and vasopressors (phenylephrine, norepinephrine or ephedrine) to maintain systolic blood pressure at baseline. Routine administration of acetaminophen (PR), ketorolac (IV), dexamethasone and ondansetron, unless contraindicated.

Sponsors & Collaborators

• Samuel Lunenfeld Research Institute, Mount Sinai Hospital: lead

Study Sites (1)

Mount Sinai Hospital

Toronto, Ontario, M5G1X5, Canada

Location

MeSH Terms

Conditions

Psychological Well-Being

Interventions

Interviews as Topic

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Officials

• Sabine Nabecker, MD

  MOUNT SINAI HOSPITAL

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 11, 2024
• First Posted: April 16, 2024
• Study Start: April 25, 2024
• Primary Completion: June 19, 2024
• Study Completion: June 19, 2024
• Last Updated: February 26, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)