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Gutiérrez NO, Cobo J, Calsina SP, Esteve YC, Oliva JC, Tricas JG. The Effects of Accompaniment on Maternal Anxiety During Elective Cesarean Delivery: A Quasi-experimental Study. Matern Child Health J 2023:10.1007/s10995-023-03677-6. [PMID: 37227622 DOI: 10.1007/s10995-023-03677-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND In Spain, allowing women to be accompanied by their partners during cesarean deliveries is a poorly consolidated practice. Going through this experience alone, not only deprives women from the opportunity of sharing the birth with their partners, but also, forces them to face, on their own, one of the most stressful experiences during pregnancy. OBJECTIVE To analyze whether significant differences exist in levels of anxiety of women who receive an elective cesarean delivery, according to whether they are allowed to be accompanied by their partners. DESIGN Quasi-experimental, longitudinal, prospective study, comparing a group of 31 women receiving elective cesarean deliveries, without the presence of their partners, with a group of 33 women with elective cesarean deliveries who were accompanied by their partners. Anxiety levels were assessed using the STAI-State/Trait scale. Participants were given a questionnaire to assess their level of satisfaction with the care received. RESULTS Anxiety measured via total scores on the STAI-S scale was significantly lower (p < 0.004) among the women who were accompanied by their partners during the elective cesarean delivery (median = 25), compared to the group who were not (median = 50). The differences were also significant (p < 0.003) considering the impact of accompaniment upon the group with high scores in the STAI-S (> 31) and continue to be significant when using the cut-off point of very high scores on the STAI-S (> 45). CONCLUSIONS Presence of partners during elective cesareans is a key factor for decreasing the anxiety caused by the surgery and for improving the overall experience of cesarean deliveries.
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Affiliation(s)
- Noemí Obregón Gutiérrez
- Obstetric and Gynecology Department, Parc Taulí University Hospital, Consorci Corporació Sanitària Parc Taulí, Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Departament of Public Health, Mental Health and Child and Maternal Nursing, University of Barcelona, Barcelona, Spain
| | - Jesus Cobo
- Mental Health Department, Consorci Corporació Sanitària Parc Taulí - I3PT - CIBERSAM, Parc Taulí, 1, 08208, Sabadell, Spain.
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Belaterra, Spain.
| | - Salut Puig Calsina
- Obstetric and Gynecology Department, Parc Taulí University Hospital, Consorci Corporació Sanitària Parc Taulí, Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
| | - Yolanda Canet Esteve
- Obstetric and Gynecology Department, Parc Taulí University Hospital, Consorci Corporació Sanitària Parc Taulí, Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
| | | | - Josefina Goberna Tricas
- Departament of Public Health, Mental Health and Child and Maternal Nursing, University of Barcelona, Barcelona, Spain
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Marín Gabriel MA, Domingo Goneche L, Cuadrado Pérez I, Reyne Vergeli M, Forti Buratti A, Royuela Vicente A, Olabarrieta Arnal I, Sánchez L, Alonso Díaz C, Criado E, Carrizosa Molina T, Caserío Carbonero S, Casas Satre C, Fernández-Cañadas Morillo A. Baby Friendly Hospital Initiative Breastfeeding Outcomes in Mothers with COVID-19 Infection During the First Weeks of the Pandemic in Spain. J Hum Lact 2021; 37:639-648. [PMID: 34374323 DOI: 10.1177/08903344211039182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adherence to the Ten Steps of the Baby-Friendly Hospital Initiative has been shown to have a protective role for the initiation and maintenance of breastfeeding. RESEARCH AIMS (1) To determine the breastfeeding rate during the first 6 months of life in children of mothers diagnosed with COVID-19 infection at the time of birth; and (2) to assess the possible influence of being born in a center with Baby-Friendly Hospital Initiative accreditation. METHODS This was a two-group comparative longitudinal observational study of infants born to mothers with COVID-19 at the time of birth, between March 13-May 31, 2020 (the first wave of the pandemic) in Spain. Fourteen Spanish hospitals participated, five (35.7%) were Baby-Friendly Hospital Initiative accredited. Type of feeding was assessed prospectively at discharge, 1, 3, and 6 months of age. A total of 248 newborns were included in the study. RESULTS A total of 117 (47.3%) newborns were born in Baby-Friendly Hospital Initiative (BFHI) accredited centers. These centers applied skin-to-skin contact with greater probability (OR = 1.9; 95% CI [1.18, 3.29]) and separated the newborns from their mothers less frequently (OR = 0.46; 95% CI [0.26, 0.81]) than non-accredited centers. No differences were observed in relation to the presence of a companion at the time of birth. At discharge, 49.1% (n = 57) of newborns born in BFHI-accredited centers received exclusive breastfeeding versus 35.3% (n = 46) in non-accredited centers (p = .03). No differences were observed in breastfeeding rates throughout follow-up. CONCLUSIONS The exclusive breastfeeding rate at discharge in children of mothers with COVID-19 infection at birth was higher in Baby-Friendly Hospital Initiative accredited centers, which most frequently applied skin-to-skin contact at birth as well as rooming-in.
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Affiliation(s)
| | - Miguel A Marín Gabriel
- Deparment of Neonatology, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain. Pediatric Deparment Associate Professor, Autónoma University, Madrid, Spain
| | - Laura Domingo Goneche
- Deparment of Neonatology, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
| | | | - Mar Reyne Vergeli
- Deparment of Neonatology, Sant Joan de Deu University Hospital, Barcelona, Catalunya, Spain
| | - Azul Forti Buratti
- Deparment of Psychiatry, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain
| | - Ana Royuela Vicente
- Biostatistics Unit, Puerta de Hierro Biomedical Research Institute, CIBERESP, Madrid, Spain
| | | | - Laura Sánchez
- Deparment of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Clara Alonso Díaz
- Deparment of Neonatology, 12 de Octubre University Hospital, Madrid, Spain
| | - Enrique Criado
- Deparment of Neonatology, Clínico San Carlos University Hospital, Madrid, Spain
| | | | - Sonia Caserío Carbonero
- Deparment of Neonatology, Río Hortega University Hospital, Valladolid, Castilla y León, Spain
| | - Cristina Casas Satre
- Deparment of Neonatology, Josep Trueta University Hospital, Girona, Catalunya, Spain
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Morell E, Peralta FM, Higgins N, Suchar A, Fitzgerald P, McCarthy RJ. Effect of companion presence on maternal satisfaction during neuraxial catheter placement for labor analgesia: a randomized clinical trial. Int J Obstet Anesth 2018; 38:66-74. [PMID: 30477998 DOI: 10.1016/j.ijoa.2018.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/23/2018] [Accepted: 10/26/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia. METHODS Healthy nulliparous parturients planning to receive neuraxial labor analgesia after admission to labor, and who had a companion with them at the time of interview, were randomized to having a companion present or not present in the labor and delivery room during neuraxial catheter placement. Participants completed questionnaires to assess maternal anxiety, pain catastrophizing and health literacy. Satisfaction was scored on 5-point Likert scale (1- highly dissatisfied, 2- dissatisfied, 3- neutral, 4- satisfied, 5- highly satisfied). RESULTS A total of 143 participants completed the study. The Wilcoxon-Mann-Whitney odds ratio for a random pair of satisfaction scores for a woman with her companion present compared with companion not present was 1.93 (95% CI 1.30 to 2.81, P=0.001). Anxiety scores were decreased following the procedure (P=0.39) in both groups. Eighty-nine percent of women randomized to companion not present would have preferred to have a companion present (P <0.001) compared with only one with their companion present who would have preferred her companion to be not present (P=0.99). CONCLUSION Maternal satisfaction can be improved with the presence of a companion in the labor and delivery room at the time of neuraxial catheter placement for labor analgesia.
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Affiliation(s)
- E Morell
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States of America
| | - F M Peralta
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States of America
| | - N Higgins
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States of America
| | - A Suchar
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States of America
| | - P Fitzgerald
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States of America
| | - R J McCarthy
- Department of Anesthesiology, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612, United States of America.
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Kumaraswami S, Pothula S, Inchiosa MA, Kubal KP, Burns MA. Anesthesiologists' Preferences regarding Visitor Presence during Placement of Neuraxial Labor Analgesia. Anesthesiol Res Pract 2018; 2018:3481975. [PMID: 29887886 PMCID: PMC5985117 DOI: 10.1155/2018/3481975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/14/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Neuraxial labor analgesia has become an integral part of modern obstetric anesthetic practice. Presence of a familiar person during its placement may be beneficial to the patient. A survey was sent to anesthesiologists practicing obstetric anesthesia in the USA to determine their views. METHODS The survey queried the following: existence of a written policy; would they allow a visitor; visitor's view, sitting or standing; reasons to allow or not allow a visitor; and influence by other staff on the decision. The responses were analyzed using multiple chi-square analyses. RESULTS Most practitioners supported allowing a visitor during placement. Reduction of patient anxiety and fulfillment of patient request were the major reasons for allowing a visitor. Sitting position and no view of the workspace were preferred. Visitor interference and safety were cited as the major reasons for precluding a visitor. Nonanesthesia providers rarely influenced the decision. Epidural analgesia was the preferred technique. Essentially no bias was found in the responses; there was statistical uniformity regardless of procedures done per week, years in practice, professional certification, geographic region (rural, urban, or suburban), or academic, private, or government responders. CONCLUSION The practice of visitor presence during the placement of neuraxial labor analgesia is gaining acceptance.
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Affiliation(s)
- Sangeeta Kumaraswami
- Department of Anesthesiology, New York Medical College at Westchester Medical Center, 100 Woods Road, Macy Pavilion 2391, Valhalla, NY 10595, USA
| | - Suryanarayana Pothula
- Department of Anesthesiology, New York Medical College at Westchester Medical Center, 100 Woods Road, Macy Pavilion 2391, Valhalla, NY 10595, USA
| | - Mario Anthony Inchiosa
- Department of Pharmacology and Anesthesiology, New York Medical College at Westchester Medical Center, 100 Woods Road, Macy Pavilion 2391, Valhalla, NY 10595, USA
| | - Keshar Paul Kubal
- Department of Anesthesiology, New York Medical College at Westchester Medical Center, 100 Woods Road, Macy Pavilion 2391, Valhalla, NY 10595, USA
| | - Micah Alexander Burns
- Department of Anesthesiology, New York Medical College at Westchester Medical Center, 100 Woods Road, Macy Pavilion 2391, Valhalla, NY 10595, USA
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Mohan B, Kumar R, Attri JP, Chatrath V, Bala N. Anesthesiologist's Role in Relieving Patient's Anxiety. Anesth Essays Res 2017; 11:449-452. [PMID: 28663639 PMCID: PMC5490100 DOI: 10.4103/0259-1162.194576] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Anesthesia and surgery have proved to be highly anxiety provoking and with the rise of elective surgery, its aspect of patient's experience has become prominent in time. However, our fault as anesthesiologists is that we have not made people get versed with what we people as anesthesiologist do in the operating room. Hence, keeping in view all this, a study was carried out, in which video information/images regarding anesthesia and surgical procedure was shown to patients on PowerPoint Presentation. Different images showing previous patient's hospital journey were shown to educate patients. METHODS Two hundred patients scheduled to undergo elective surgery were taken and were divided into two groups of 100 each. Patients (study group or Group I) were shown video clippings/images of other previously operated patients and their hospital journey including surgery and anesthesia for which patient came in hospital. The study was carried out on the patient in each group while Group II was treated in normal way and not shown any type of images/videos. Hamilton Anxiety Rating Scale was used as a criterion to measure the level of anxiety in Group I and II at four different intervals that are before pre anesthetic check up (PAC), after showing videos and images in Group I, 1 h before surgery and 8 h after surgery. STATISTICAL ANALYSIS The results of observation of both the groups at different intervals time were statistically compared and analyzed. These characteristics were analyzed using the "Chi-square tests" and "unpaired t-test." RESULTS Video and images information if done preoperatively have been shown to reduce patient's anxiety, although little is known regarding the effects of the method. CONCLUSION Showing videos/images of hospital journey for educating the patients before the operation is beneficial to patients undergoing elective surgery.
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Affiliation(s)
- Brij Mohan
- Department of Anesthesia, Government Medical College, Amritsar, Punjab, India
| | - Rajan Kumar
- Department of Anesthesia, Government Medical College, Amritsar, Punjab, India
| | - Joginder Pal Attri
- Department of Anesthesia, Government Medical College, Amritsar, Punjab, India
| | - Veena Chatrath
- Department of Anesthesia, Government Medical College, Amritsar, Punjab, India
| | - Neeru Bala
- Department of Psychiatry, Government Medical College, Amritsar, Punjab, India
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De Jong A, Benayoun L, Al Taweel B, Wernet A. Spontaneous presence of partners reduces pain memory during epidural catheter placement. Int J Obstet Anesth 2013; 22:259-60. [PMID: 23692705 DOI: 10.1016/j.ijoa.2013.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 03/16/2013] [Accepted: 03/29/2013] [Indexed: 10/26/2022]
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Gallardo P, Rodríguez Fraile JR, Muñoz Corsini L, Ruiz P, Kabiri M, Martin D. [Labor pain worries future fathers more than the mothers]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2013; 60:29-36. [PMID: 23107812 DOI: 10.1016/j.redar.2012.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 07/30/2012] [Accepted: 08/29/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the concerns of the future father about labor pain and another 9 items which could be important to the well-being of the mother during delivery. To investigate any possible differences in opinion between the future father and mother. PATIENTS AND METHODS An anonymous and voluntary questionnaire was offered to the father and the pregnant patient during the last month of pregnancy. They had to answer the questionnaire separately, scoring 10 items in a 0-10 point ordinal scale, according to their concerns and the importance for the good development of the delivery (0= not concerned about/insignificant to 10=concerned about/great importance). The items included were: 1) esthetic aftermath, 2) embarassment, 3) continous information, 4) walking during labor, 5) drinking during labor, 6) companionship, 7) labor pain, 8) keeping composure, 9) kindness, 10) room comfortability. Data on age, education, parity and nationality were recorded. RESULTS A total of 147 questionnaires were completed, 99 by mothers, and 48 by fathers. Pain was the most important concern for the future fathers scoring a mean (SD) of 8.15 (2), while continuous information 7.71 (2.5), kindness 7.9 (2.1), and companionship 8.21 (2.3) were more important than pain for mothers. A statistically significant difference was found between fathers and mothers regarding labor pain (P=.001), walking during labor (P=.003), and drinking during labor (P=.009). CONCLUSIONS The result of our study suggests that increasing the presence of the father during the delivery process, and taking care of the emotional aspects and the quality of the information given could be very important for the perception of satisfaction.
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Affiliation(s)
- P Gallardo
- Hospital Universitario de Guadalajara, Guadalajara, España.
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Orbach-Zinger S, Ginosar Y, Sverdlik J, Treitel C, MacKersey K, Bardin R, Peleg D, Eidelman LA. Partner's presence during initiation of epidural labor analgesia does not decrease maternal stress: a prospective randomized controlled trial. Anesth Analg 2012; 114:654-60. [PMID: 22253271 DOI: 10.1213/ane.0b013e318241f4f3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Epidural analgesia reduces pain and anxiety during childbirth. In this randomized controlled trial, we sought to determine whether partner presence during the initiation of epidural analgesia reduces stress of both the mother and her partner and their perception of maternal pain. METHODS Healthy, nulliparous women who were accompanied by their partners and requested neuraxial analgesia were enrolled into the study. The study took place in the Labor and Delivery Unit of a large tertiary hospital in Israel. Upon request for epidural analgesia, both partners were assessed for baseline anxiety (numerical rating scale, 0 to 10), systolic blood pressure, heart rate, estimated contraction pain of parturient (verbal rating scale for pain, 0 to 10), and salivary amylase. After measurements, couples were randomized into 1 of 2 groups: "partner in" and "partner out." Immediately after epidural catheter insertion, anxiety, arterial blood pressure, heart rate, and salivary amylase were measured again in both partners. Both partners were asked to complete the State Anxiety Inventory questionnaire measuring current anxiety. The parturient was asked to rate the pain of epidural catheter insertion. The primary outcome measurement was parturient and partner anxiety as assessed by the numerical rating scale. RESULTS Eighty-four couples were randomized (partner in 41, partner out 42, protocol violation 1). At baseline there was no difference in self-reported anxiety of parturients between the partner-in and partner-out groups (median interquartile range 7.5 [6.0 to 9.0] versus 7.0 [3.5 to 8.5]; P = 0.26, difference in medians = -1.0; 95% confidence interval [CI] of difference -2.0 to 1.0). After epidural catheter insertion, parturients in the partner-in group had a higher level of anxiety than those in the partner-out group (8.0 [7.0 to 10.0] versus 7.0 [5.0 to 9.0]; P = 0.03, difference in medians -1.0; 95% CI of difference -2.0 to 0.0). Pain scores during epidural catheter placement were higher in partner-in than in partner-out groups (7.0 [4.0 to 8.0] versus 4.0 [3.0 to 6.0]; P = 0.004, difference in medians = -2.0; 95% CI of difference -3.0 to -1.0). CONCLUSION Partner presence during epidural catheter insertion for labor analgesia did not decrease anxiety levels. To the contrary, anxiety and pain of epidural catheter placement were greater if the partner remained in the room.
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Affiliation(s)
- Sharon Orbach-Zinger
- Department of Anesthesiology, Rabin Medical Center-Beilinson Hospital, 39 Jabotinski St., Petach Tikvah, Israe.
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Jlala HA, Bedforth NM, Hardman JG. Anesthesiologists' perception of patients' anxiety under regional anesthesia. Local Reg Anesth 2010; 3:65-71. [PMID: 22915871 PMCID: PMC3417950 DOI: 10.2147/lra.s11271] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this survey is to report anesthesiologists’ perception of patients’ anxiety under regional anesthesia, its frequency, effects and causes, and the strategies employed to reduce it. Electronic questionnaires were sent to all grades of anesthesiologists in Nottingham, UK. The response rate for the survey was 79%. Over half of the anesthesiologists in our region believe that anxiety during regional anesthesia is not common. Surgery and anesthesia, followed by block failure were reported by anesthesiologists as the most common causes of patients’ anxiety. Frequently employed techniques to manage anxiety were communication or sedation. Most respondents felt that regional anesthesia provides good analgesia and patient satisfaction. However, 20% felt that regional anesthesia is painful or unpleasant for patients, perhaps explaining the reluctance by some anesthesiologists to perform regional anesthesia.
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Affiliation(s)
- Hatem A Jlala
- University Department of Anaesthesia, Queens' Medical Centre, Nottingham, UK
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