Miremberg Hadas, Yirmiya Karen, Vinter Dana, Lauterbach Roy, Yefet Enav, Nassra Rima, Paz Yael Ganor, Hagege Rina, Weiner Eran
Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel (Drs Miremberg, Ganor Paz, and Weiner); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Miremberg and Weiner).
Department of Psychology, Bar-Ilan University, Ramat Gan, Israel (Dr Yirmiya); Interdisciplinary Center, Herzliya, Israel (Dr Yirmiya).
Am J Obstet Gynecol MFM. 2022 May;4(3):100604. doi: 10.1016/j.ajogmf.2022.100604. Epub 2022 Feb 28.
Cesarean delivery is one of the most common procedures performed in obstetrics, and although cesarean delivery is a blissful occasion, it is commonly associated with fear and anxiety for the new mother.
We aimed to study the impact of watching a detailed, informative video on maternal anxiety levels, childbirth experience, and patient satisfaction in patients undergoing a primary cesarean delivery.
We performed a multicenter randomized control trial. Women scheduled to undergo a primary nonemergent cesarean delivery were recruited. All participants in the intervention group watched an informative video on recruitment. This 4-minute video described in detail the expected cesarean delivery process: preparations before entering the operation room, regional anesthesia administration, sterile covering, the surgical procedure itself, and recovery (including mobilization and lactation). Situation-specific anxiety was measured at recruitment, before exposure to the video (S1), at the day of the operation (S2), and at postpartum day 1 (S3) using the State-Trait Anxiety Inventory score. In addition, participants answered a 10-item Childbirth Experience Questionnaire. A sample size of 63 per group was planned to achieve 80% power to detect a difference of 5 points in the primary outcome (State-Trait Anxiety Inventory score on the day of the operation).
Overall, 154 participants from 4 medical centers were randomized, and 132 participants were analyzed after completing all questionnaires, 64 participants in the video group and 68 participants in the control group. The groups did not differ in demographics and delivery characteristics and had similar baseline anxiety levels (S1). On operation day (S2, the primary outcome), significantly lower anxiety levels were reported in the video group than in the control group (State-Trait Anxiety Inventory scores, 41.3±9.5 vs 49.3±10.3; P<.001). Moreover, anxiety levels in postpartum day 1 (S3) remained significantly lower in the video group (P<.001). No difference between the groups in childbirth experience score or patient satisfaction was demonstrated.
A detailed informative video shown to patients before primary cesarean delivery decreased maternal anxiety levels before and after the procedure.
剖宫产是产科最常见的手术之一，尽管剖宫产是一件令人幸福的事，但新妈妈通常会感到恐惧和焦虑。
我们旨在研究观看详细、信息丰富的视频对首次剖宫产患者的产妇焦虑水平、分娩体验和患者满意度的影响。
我们进行了一项多中心随机对照试验。招募计划进行首次非急诊剖宫产的女性。干预组的所有参与者在招募时观看了一段信息丰富的视频。这段4分钟的视频详细描述了预期的剖宫产过程：进入手术室前的准备、区域麻醉的实施、无菌覆盖、手术过程本身以及恢复情况（包括活动和哺乳）。使用状态-特质焦虑量表在招募时、接触视频前（S1）、手术当天（S2）和产后第1天（S3）测量特定情境焦虑。此外，参与者回答了一份10项的分娩体验问卷。计划每组样本量为63，以达到80%的检验效能来检测主要结局（手术当天的状态-特质焦虑量表得分）相差5分的差异。
总体而言，来自4个医疗中心的154名参与者被随机分组，132名参与者在完成所有问卷后进行分析，视频组64名参与者，对照组68名参与者。两组在人口统计学和分娩特征方面无差异，基线焦虑水平相似（S1）。在手术当天（S2，主要结局），视频组报告的焦虑水平显著低于对照组（状态-特质焦虑量表得分，41.3±9.5对49.3±10.3；P<.001）。此外，视频组产后第1天（S3）的焦虑水平仍显著较低（P<.001）。两组在分娩体验得分或患者满意度方面未显示出差异。
在首次剖宫产术前向患者展示详细的信息丰富的视频可降低手术前后的产妇焦虑水平。
