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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Article info
Publication history
Published online: March 29, 2022
Accepted:
March 9,
2022
Received:
January 12,
2022
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated they meet the journal’s requirements for authorship.
Identification
Copyright
© 2022 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
