Year-end Sale % OFF 
Abstract
Background False assumptions regarding the generalizability of patients' expectations and preferences across different demographic groups may contribute in part to the increased prevalence of negative peripartum outcomes seen among women of color. The intention of this study was to determine preferences and concerns regarding anesthesia care during cesarean delivery in a largely African-American population and to compare them to those obtained in a prior study conducted in a demographically distinct population. Methods Women presenting for scheduled cesarean delivery or induction of labor completed a preoperative survey requesting demographic information and the opportunity to rank ten common potential anesthetic outcomes in relation to each other from most to least desirable. Participants were also asked about their biggest fear concerning their anesthetic and their preferences and expectations regarding degree of wakefulness, pain, and other adverse events. Those who underwent cesarean delivery were administered a briefer postoperative survey. We tabulated preference rankings and then compared demographic and outcome data to that obtained in a previous study with a demographically dissimilar population. Results A total of 73 women completed the preoperative survey, and 64 took the postoperative survey. Pain during and after cesarean delivery was ranked as least desirable outcomes and fear of paralysis was respondents' principal concern with neuraxial anesthesia. Postoperative concerns were similar to preoperative concerns and did not correlate with the frequency with which specific adverse outcomes occurred. These results were consistent with those from the previous study despite the women in this study being more likely to be younger, unmarried, African-American, and less educated than those in the previous investigation. Conclusions Patient preference rankings and concerns were remarkably similar to those previously demonstrated despite a number of demographic differences between the two populations, suggesting generalizability of these preferences to a broader obstetric population.
Highlights
Medical care in the United States has evolved from emphasizing physician paternalism to stressing patient autonomy
In comparison to the Lucile Packard Children’s Hospital (LPCH) population, our subjects were younger, less likely to be married, more likely to identify as African-American, and received less formal education. ere was a nonsignificant trend toward lower household income. e University of Chicago Medicine (UCM) population was more likely to be multiparous and had experienced both a prior cesarean delivery and spinal or epidural anesthesia
Seven subjects (10%) reported taking prenatal classes, compared to 100% of those in the Stanford population (P < 0.0001). ere was no difference in representation of healthcare workers or women with a history of previous surgery requiring anesthesia
Summary
Medical care in the United States has evolved from emphasizing physician paternalism to stressing patient autonomy. Determining the generalizability of patients’ preferences and concerns is important because false assumptions may lead to communication errors, negatively impact care, and contribute in part to the increased prevalence of negative outcomes among women of color [5]. E intention of this study was to determine preferences and concerns regarding anesthesia care during cesarean delivery in a largely African-American population and to compare them to those obtained in a prior study conducted in a demographically distinct population. Women presenting for scheduled cesarean delivery or induction of labor completed a preoperative survey requesting demographic information and the opportunity to rank ten common potential anesthetic outcomes in relation to each other from most to least desirable. Pain during and after cesarean delivery was ranked as least desirable outcomes and fear of paralysis was respondents’ principal concern with neuraxial anesthesia. Patient preference rankings and concerns were remarkably similar to those previously demonstrated despite a number of demographic differences between the two populations, suggesting generalizability of these preferences to a broader obstetric population
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
