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Sultan P, Jensen SE, Taylor J, et al. Proposed domains for assessing postpartum recovery: a concept elicitation study. BJOG. 2021;doi: 10.1111/1471-0528.16937.
Sultan, P., Jensen, S. E., Taylor, J., El-Sayed, Y., Carmichael, S., Cella, D., Angst, M. S., Gaudilliere, B., Lyell, D. J., & Carvalho, B. (2021). Proposed domains for assessing postpartum recovery: a concept elicitation study. BJOG : an international journal of obstetrics and gynaecology, . https://doi.org/10.1111/1471-0528.16937
Sultan, P, et al. "Proposed domains for assessing postpartum recovery: a concept elicitation study." BJOG : an international journal of obstetrics and gynaecology vol. (2021). doi: https://doi.org/10.1111/1471-0528.16937
Sultan P, Jensen SE, Taylor J, El-Sayed Y, Carmichael S, Cella D, Angst MS, Gaudilliere B, Lyell DJ, Carvalho B. Proposed domains for assessing postpartum recovery: a concept elicitation study. BJOG. 2021 Sep 18; doi: 10.1111/1471-0528.16937. Epub 2021 Sep 18. PMID: 34536324.
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BJOG. 2021 Sep 18; doi: 10.1111/1471-0528.16937. Epub 2021 Sep 18.

Proposed domains for assessing postpartum recovery: a concept elicitation study.

BJOG : an international journal of obstetrics and gynaecology

P Sultan, S E Jensen, J Taylor, Y El-Sayed, S Carmichael, D Cella, M S Angst, B Gaudilliere, D J Lyell, B Carvalho

Affiliations

  1. Department of Anesthesia and Perioperative Pain, Stanford University School of Medicine, Stanford, CA, USA.
  2. Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  3. Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
  4. Pediatrics, Obstetrics and Gynecology and Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA.

PMID: 34536324 DOI: 10.1111/1471-0528.16937

Abstract

OBJECTIVE: To propose postpartum recovery domains.

DESIGN: Concept elicitation study.

SETTING: Semi-structured interviews.

POPULATION: Ten writing committee members and 50 stakeholder interviews (23 postpartum women, nine general obstetricians, five maternal and fetal medicine specialists, eight nurses and five obstetric anaesthetists).

METHODS: Alternating interviews and focus group meetings until concept saturation was achieved (no new themes discussed in three consecutive interviews). Interviews were digitally recorded and transcribed, and an iterative coding process was used to identify domains.

MAIN OUTCOME MEASURES: The primary outcome was to identify recovery domains. We also report key symptoms and concerns. Discussion frequency and importance scores (0-100; 0 = not important; 100 = vitally important to recovery) were used to rank domains. Discussion frequency was used to rank factors helping and hindering recovery, and to determine the greatest challenges experienced postpartum.

RESULTS: Thirty-four interviews and two focus group meetings were performed. The 13 postpartum recovery domains identified, (ranked highest to lowest) were: psychosocial distress, surgical/medical factors, infant feeding and breast health, psychosocial support, pain, physical function, sleep, motherhood experience, infant health, fatigue, appearance, sexual function and cognition. The most frequently discussed factors facilitating postpartum recovery were: family support, lactation/breastfeeding support and partner support. The most frequently discussed factor hindering recovery was inadequate social support. The most frequent challenges reported were: breastfeeding (week 1), breastfeeding (week 3) and sleep (week 6).

CONCLUSIONS: We propose 13 domains that comprehensively describe recovery in women delivering in a single centre within the USA. This provides a novel framework to study the postpartum recovery process.

TWEETABLE ABSTRACT: We propose 13 postpartum recovery domains that provide a framework to study the recovery process following childbirth.

© 2021 John Wiley & Sons Ltd.

Keywords: Caesarean section; childbirth; dimenesions; domains; postpartum; recovery; vaginal delivery

References

  1. Ritchie H. How many people die and how many are born each year? [Internet]. Our world in Data. 2019 [https://ourworldindata.org/births-and-deaths]. Accessed 17 September 2020. - PubMed
  2. Martin J, Hamilton B, Osterman M, Births DA. Final data for 2018. Natl Vital Stat Rep 2019;68:1-7. - PubMed
  3. Ciechanowicz S, Setty T, Robson E, Sathasivam C, Chazapis M, Dick J, et al. Development and evaluation of an obstetric quality-of-recovery score (ObsQoR-11) after elective Caesarean delivery. Br J Anaesth 2018;122:69-78. - PubMed
  4. Ciechanowicz S, Howle R, Heppolette C, Nakhjavani B, Carvalho B, Sultan P. Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery. Int J Obstet Anesth 2019;39:51-9. - PubMed
  5. Sultan P, Kormendy F, Nishimura S, Carvalho B, Guo N, Papageorgiou C. Comparison of spontaneous versus operative vaginal delivery using Obstetric Quality of Recovery-10 (ObsQoR-10): an observational cohort study. J Clin Anesth 2020;63:109781. - PubMed
  6. Sultan P, Kamath N, Carvalho B, Bansal P, El Khateb R, Dougan S, et al. Evaluation of inpatient postpartum recovery using the Obstetric Quality of Recovery-10 (ObsQoR-10) patient-reported outcome measure: a single center observational study. Am J Obstet Gynecol MFM 2020;2:100202. - PubMed
  7. Sharawi N, Klima L, Shah R, Blake L, Carvalho B, Sultan P. Evaluation of patient-reported outcome measures of functional recovery following caesarean section: a systematic review using the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist. Anaesthesia 2019;74:1439-55. - PubMed
  8. Sultan P, Sadana N, Sharawi N, Blake L, El-Boghdadly K, Falvo A, et al. Evaluation of domains of patient-reported outcome measures for recovery after childbirth: a scoping and systematic review. JAMA Netw Open 2020;3:e205540. - PubMed
  9. Sultan P, Sharawi N, Blake L, Ando K, Sultan E, Aghaeepour N, et al. Use of patient-reported outcome measures to assess outpatient postpartum recovery: a systematic review. JAMA Netw Open 2021;4:e2111600. - PubMed
  10. Cella D, Rosenbloom S, Beaumont J, Yount S, Paul D, Hampton D. Development and validation of 11 symptom indexes to evaluate response to chemotherapy for advanced cancer. JNCCN 2011;9:268-78. - PubMed
  11. Victorson D, Anton S, Hamilton A, Yount S, Cella D. A conceptual model of the experience of dyspnea and functional limitations in chronic obstructive pulmonary disease. Value Heal 2009;12:1018-25. - PubMed
  12. Eton D, Shevrin D, Beaumont J, Victorson D, Cella D. Constructing a conceptual framework of patient-reported outcomes for metastatic hormone-refractory prostate cancer. Value Heal 2010;13:613-23. - PubMed
  13. Kaiser K, Shaunfield S, Clayman M, Ruderman E, Cella D. Content validation of the functional assessment of chronic illness therapy (FACIT)-fatigue scale in moderately to highly active rheumatoid arthritis. Rhematol Curr Res 2016;6:1000193. - PubMed
  14. Bowen G. Naturalistic inquiry and the saturation concept: a research note. Qual Res 2008;8:137-52. - PubMed
  15. Lai J-S, Jensen S, Patel Z, Listernick R, Charrow J. Using a qualitative approach to conceptualize concerns of patients with neurofibromatosis type 1 associated plexiform neurofibromas (pNF) across the lifespan. Am J Med Genet Part A 2017;173:79-87. - PubMed
  16. Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods 2006;18:59-82. - PubMed
  17. Myles P. More than just morbidity and mortality - quality of recovery and long-term functional recovery after surgery. Anaesthesia 2020;75:e143-50. - PubMed
  18. Sultan P, Ando K, Sultan E, Hawkins J, Chitneni A, Sharawi N, et al. A systematic review of patient-reported outcome measures used to assess postpartum pain using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Br J Anaesth 2021;127:264-74. - PubMed
  19. Sultan P, Ando K, Sultan E, Hawkins J, Blake L, Barwick F, et al. A systematic review of patient-reported outcome measures used to assess sleep in postpartum women using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Sleep 2021. https://doi.org/10.1093/sleep/zsab128. [Epub ahead of print]. - PubMed
  20. Nikan F, Jafarabadi M, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Montazeri A, Asadi S. Psychometric properties of the Iranian version of a postpartum women's quality of life questionnaire (PQOL): a methodological study. Iran Red Crescent Med J 2016;18:e35460. - PubMed
  21. Sheil E, Bull M, Moxon B, Muehl P, Kroening K, Peterson-Palmberg G, et al. Concerns of childbearing women: a maternal concerns questionnaire as an assessment tool. J Obstet Gynecol Neonatal Nurs 1995;24:149-55. - PubMed
  22. Webster J, Nicholas C, Velacott C, Cridland N, Fawcett L. Validation of the WHOQOL-BREF among women following childbirth. Aust New Zeal J Obstet Gynaecol 2010;50:132-7. - PubMed
  23. Sultan P, Carvalho B. Postpartum recovery: what does it take to\x92get back to a baseline? Curr Opin Obs Gynecol 2021;33:86-93. - PubMed
  24. PROMIS. PROMIS® Instrument Development and Validation Scientific Standards Version 2.0 [Internet]. 2013. pp. 1-72 [http://www.healthmeasures.net/images/PROMIS/PROMISStandards_Vers2.0_Final.pdf]. Accessed 3 March 2020. - PubMed

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