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5790095

Understanding Patient Experience of elective Caesarean Section -- an exploratory mixed method study utilising Patient Shadowing

Part of Topic

Original Research

Understanding patient experience with elective Caesarean Section – an exploratory mixed method study utilising patient shadowing

E. Hughes, S. Brady, T. Tan, P. Popivanov

 

Introduction:

Patient experience (PE) during elective LSCS is a core part of patient centred care (PCC). Although there is no agreed definition of PCC, it encompasses the theory and practice of caring for patients and their families in ways that are meaningful and valuable to them. Although there has been an increasing drive for better understanding of PE, and more meaningful patient involvement in service design and improvement, efforts have sometimes failed to acknowledge the depth of these experiences. Furthermore, recent research is in agreement and demonstrates that patient-centredness is poorly studied by conventional research methods. Patient shadowing (PS) method of qualitative research that  has been recently proposed as a research method for PCC.  Purpose of this exploratory study: to utilise PS and gain better understanding of PE on the day of El LSCS in a tertiary maternal hospital.

 

Methods:

 

•An ethnographic method of qualitative research, where investigators observe and/or interact with the study participants in their real-life environment through an event
•Shadowing Event defined as arrival at hospital car park until 30 minutes after arrival on postnatal ward
•2nd year medical students (pre-clinical years) recruited as Shadowers
•40 patients approached, 34 patients consented to being shadowed, 30 patients shadowed (2 opted out on day, 2 delivered prior to event)
•Inclusion criteria; El LSCS, English speaking, Consented
•Eligible patients identified at the Anaesthetic Pre-Assessment Clinic
•Detailed explanation and PIL. Written consent obtained morning of surgery
•Consolidated criteria for reporting qualitative research (COREQ) checklist used to guide study reporting.
•Shadowers followed participants and recorded real-time observations, comments, questions.  Also recorded touchpoints, timings spent at each touchpoint and Caregivers encountered.
•Generated 30 logbooks detailing patient experiences recorded in patients’ own words.
•Subjected to Thematic Analysis (Braun and Clarke’s Steps) coded by hand
•6 Themes and 9 Subthemes emerged based on recurring sentiments or events coded for within transcripts 
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