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Patient Satisfaction with Informed Consent for Cesarean and Operative Vaginal Delivery

Published:March 29, 2022DOI:https://doi.org/10.1016/j.jogc.2022.03.010

      Abstract

      Objective

      To evaluate patient satisfaction with the informed consent process for elective cesarean delivery (CD), emergency CD, and operative vaginal delivery (OVD).

      Methods

      A cross-sectional, survey-based study was conducted among patients on the postpartum floor of our institution. Patients were approached after delivery to complete a previously pilot-tested questionnaire, based on validated literature. One hundred eighty-four surveys were included in the analysis. Levels of patient satisfaction were compared across modes of delivery using χ2 tests of independence. Secondary objectives included evaluating the relationship between satisfaction scores and the patient’s recall of the consent process and emotional state during the consent process.

      Results

      A significant association was found between patient satisfaction with the consent process and mode of delivery (P < 0.001). Those in the elective and emergency CD groups were significantly more likely to express high rates of satisfaction compared with those in the OVD group (odds ratio [OR] 9.03; 95% CI 2.80–29.10 and OR 3.97; 95% CI 1.34–11.76, respectively). High levels of satisfaction were significantly more common among those who had greater recall of the consent process (OR 25.2; 95% CI 7.34–87.04) and those who reported low levels of distress during the process (OR 15.1; 95% CI 4.70–48.66).

      Conclusion

      Informed consent during OVD is associated with lower rates of patient satisfaction compared with CD. Efforts are needed to improve the consent process for OVD to increase patient satisfaction and promote patient-centred care.

      Résumé

      Objectif

      Évaluer la satisfaction des patientes à l’égard du processus de consentement éclairé pour la césarienne planifiée, la césarienne d’urgence et l’accouchement assisté.

      Méthodologie

      Une étude transversale a été menée par sondage auprès de patientes de l’unité post-partum de notre établissement. Les patientes ont été approchées après l’accouchement pour répondre à un questionnaire fondé sur la littérature validée, lequel a préalablement été soumis à un essai pilote. Au total, 184 sondages ont été analysés. Le degré de satisfaction des patientes a été comparé pour chaque mode d’accouchement au moyen de tests d’indépendance du χ2. Les objectifs secondaires étaient d’évaluer la relation entre les scores de satisfaction et le rappel par la patiente du processus de consentement et de son état émotionnel pendant le processus.

      Résultats

      Une association significative a été observée entre la satisfaction de la patiente par rapport au processus de consentement et le mode d’accouchement (p < 0,001). Le taux de satisfaction était significativement plus élevé dans les groupes césarienne planifiée et césarienne d’urgence comparativement au groupe accouchement assisté (rapport de cotes [RC] : 9,03; intervalle de confiance [IC] à 95 % : 2,80–29,10 et RC : 3,97; IC à 95 % : 1,34–11,76 respectivement). Un niveau de satisfaction élevé était significativement plus commun chez les patientes qui se souvenaient bien du processus de consentement (RC : 25,2; IC à 95 % : 7,34–87,04) et chez celles qui ont rapporté un faible niveau de détresse pendant le processus (RC : 15,1; IC à 95 % : 4,70–48,66).

      Conclusion

      Le processus de consentement éclairé en cas d’accouchement assisté est associé à un plus faible taux de satisfaction des patientes qu’en cas de césarienne. Des efforts supplémentaires sont nécessaires pour améliorer le processus de consentement pour les accouchements assistés afin d’améliorer la satisfaction des patientes et favoriser les soins axés sur la patiente.

      Keywords

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