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Determinants of women's dissatisfaction with anaesthesia care in labour and delivery.

Publication ,  Journal Article
Yurashevich, M; Carvalho, B; Butwick, AJ; Ando, K; Flood, PD
Published in: Anaesthesia
September 2019

Patient-centred care and factors associated with patient satisfaction with anaesthesia have been widely studied. However, the most important considerations in the setting of obstetric anaesthesia are uncertain. Identification of, and addressing, factors that contribute to patient dissatisfaction may improve quality of care. We sought to identify factors associated with < 100% satisfaction with obstetric anaesthesia care. At total of 4297 women treated by anaesthetists provided satisfaction data 24 h after vaginal and 48 h after caesarean delivery. As 78% of women were 100% satisfied, we studied factors associated with the dichotomous variable, 100% satisfied vs. < 100% satisfied. We evaluated patient characteristics and peripartum factors using multivariable sequential logistic regression. The following factors were strongly associated with maternal dissatisfaction after vaginal delivery: pain intensity during the first stage of labour; pain intensity during the second stage of labour; postpartum pain intensity; delay > 15 min in providing epidural analgesia and postpartum headache (all p < 0.0001). Pruritus (p = 0.005) also contributed to dissatisfaction after vaginal delivery, whereas non-Hispanic ethnicity was negatively associated with dissatisfaction (p = 0.01). After caesarean delivery, the intensity of postpartum pain (p < 0.0001), headache (p = 0.001) and pruritus (p = 0.001) were linked to dissatisfaction. Hispanic ethnicity also had a negative relationship with dissatisfaction after caesarean delivery (p = 0.005). Thus, inadequate or delayed analgesia and treatment-related side-effects are associated with maternal dissatisfaction with obstetric anaesthesia care. Development of protocols to facilitate identification of ineffective analgesia and provide an appropriate balance between efficacy and side-effects, are important goals to optimise maternal satisfaction.

Duke Scholars

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Published In

Anaesthesia

DOI

EISSN

1365-2044

Publication Date

September 2019

Volume

74

Issue

9

Start / End Page

1112 / 1120

Location

England

Related Subject Headings

  • Retrospective Studies
  • Pregnancy
  • Patient Satisfaction
  • Labor, Obstetric
  • Labor Pain
  • Humans
  • Female
  • Delivery, Obstetric
  • Anesthesiology
  • Anesthesia, Obstetrical
 

Citation

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Yurashevich, M., Carvalho, B., Butwick, A. J., Ando, K., & Flood, P. D. (2019). Determinants of women's dissatisfaction with anaesthesia care in labour and delivery. Anaesthesia, 74(9), 1112–1120. https://doi.org/10.1111/anae.14756
Yurashevich, M., B. Carvalho, A. J. Butwick, K. Ando, and P. D. Flood. “Determinants of women's dissatisfaction with anaesthesia care in labour and delivery.Anaesthesia 74, no. 9 (September 2019): 1112–20. https://doi.org/10.1111/anae.14756.
Yurashevich M, Carvalho B, Butwick AJ, Ando K, Flood PD. Determinants of women's dissatisfaction with anaesthesia care in labour and delivery. Anaesthesia. 2019 Sep;74(9):1112–20.
Yurashevich, M., et al. “Determinants of women's dissatisfaction with anaesthesia care in labour and delivery.Anaesthesia, vol. 74, no. 9, Sept. 2019, pp. 1112–20. Pubmed, doi:10.1111/anae.14756.
Yurashevich M, Carvalho B, Butwick AJ, Ando K, Flood PD. Determinants of women's dissatisfaction with anaesthesia care in labour and delivery. Anaesthesia. 2019 Sep;74(9):1112–1120.
Journal cover image

Published In

Anaesthesia

DOI

EISSN

1365-2044

Publication Date

September 2019

Volume

74

Issue

9

Start / End Page

1112 / 1120

Location

England

Related Subject Headings

  • Retrospective Studies
  • Pregnancy
  • Patient Satisfaction
  • Labor, Obstetric
  • Labor Pain
  • Humans
  • Female
  • Delivery, Obstetric
  • Anesthesiology
  • Anesthesia, Obstetrical