Standardize Of Preoperative Visit Contents In Women Who Underwent Cesarean Section And Application Study

Objective:1.To Standardize the contents of preoperative visits for women who underwent elective cesarean delivery and develop a visit process based on the SBAR communication model.2.To investigate the effects of the SBAR communication model+sta-ndardized preoperative visit content on preoperative anxiety,postoperative recovery quality,sleep quality,heart rate,mean arterial pressure(MAP),The initiation time of postoperative ambulation and passing of flatus,time to removal of a urinary catheter.Methods:1.The first draft of the contents of the preoperative visit for women who underwent elective cesarean delivery was developed through semi-structured interviews combined with study group discussions.The sta-ndardized content of the preoperative visit was established through two rounds of expert consultation using the Delphi method.2.88 cases of pregnant women who performed an elective cesarean section and met the inclusion and exclusion criteria were admitted to the obstetrics department of a grade-A tertiary care hospital in Nanchong from September 2021 to October 2021 were selected,which were numbered according to the obstetrics wards’ number and randomly divided into a test group and a control group by lottery:the women admitted to the test ward were the test group,while the women admitted to the control ward were the control group(n=44 for each group).In the control group,the SBAR communication model and the regular preoperative visit content were performed;in the experimental group,the SBAR communication model and the standardized preoperative visit content were performed,and the preoperative visit was conducted by well-trained visitors in the afternoon of the first day before surgery,and the duration of the visit was 20-30 min.Before the visit:maternal preoperative anxiety scores and Sleep Quality Scores were measured using the State Anxiety Scale and the Deep Sleep Quality Scale,and maternal preoperative heart rate and blood pressure were collected using a bedside monitor(MAP=diastolic pressure+1/3 pulse pressure(PP)).Before anesthesia(after admission to the operating room):the pregnant woman herself completed the State Anxiety Scale.First postoperative day,9:00-11:00 am:performed a collection of the Deep Sleep Quality Scale questionnaire.In the first 48 hours after surgery:Recovery Quality Score questionnaire was collected;on the day of discharge:the interviewer went to the woman’s bedside to collect the The initiation time of postoperative ambulation and passing of flatus,and to derive the time of urinary catheter removal from the hospital information system.A t-test for the independent sample was used to compare the effects of preoperative visits with different visit contents on maternal preoperative anxiety,postoperative recovery,heart rate,MAP,time of first out of bed activity,time of urinary catheter removal,and The initiation time passing of flatus between the two groups.A nonparametric test was used to compare the differences in maternal Sleep Quality Scores between the two groups.Result:1.Results of semi-structured interviews:After analysis of the interview data,seven themes related to the information needs for elective cesarean delivery patients during preoperative visits were extracted:information on preoperative preparation;information on the operating room environment;information on surgical procedures;information on anesthesia;information on postoperative pain and recovery;psychological support;and information on surgical perception and discomfort.2.Results of expert consultation:After two rounds of expert consultation,a standardized content of preoperative visits for elective cesarean deliveries was finally developed,including 3 level 1 entry,17 level 2 entries,and 66 level 3 entries.3.The results of the application of the standardized content of preoperative visits for women who underwent elective cesarean section:88 women participated in the study,44 in the test group and 44 in the control group,with no statistically significant differences in general information(P>0.05);before anesthesia(after admission to the operating room)in both groups:anxiety score,heart rate,and MAP were smaller in the test group than in the control group,with statistically significant differences(P<0.05);after surgery in both groups:there was no statistically significant difference between the two groups in the sleep quality score,recovery quality score,time of first out of bed activity,The initiation time passing of flatus and time of urinary catheter removal(P>0.05).Conclusions:The standardized preoperative visit content for elective cesarean delivery should be consistent with the physiological and psychological characteristics of the cesarean delivery population,being scientific and practical.The standardized preoperative visit contents for elective cesarean delivery can alleviate the preoperative anxiety and maintain the stability of physiological indicators of pregnant women who had a cesarean delivery,which is still important for cesarean delivery cases although it cannot improve the postoperative recovery of women.It is suitable to be promoted in the preoperative visit for elective cesarean delivery.