Perioperative mobile application for mothers undergoing Cesarean delivery: a prospective cohort study on patient engagement

Janny Xue Chen Ke, Ronald B George, Lori Wozney, Allana Munro, Janny Xue Chen Ke, Ronald B George, Lori Wozney, Allana Munro

Abstract

Purpose: Giving birth is the most common reason for hospital admission, with Cesarean delivery being the most frequently performed inpatient surgery. Through a needs assessment and iterative design process involving patients and obstetric anesthesiologists, we previously developed a mobile application, C-Care, for patients undergoing Cesarean delivery. The focus of C-Care is perioperative education and self-monitoring of potential anesthetic complications. This study aimed to obtain feedback on patient engagement with C-Care.

Method: We conducted a prospective cohort study of patients ≥ 18 yr (n = 36) undergoing elective Cesarean delivery. Anonymous usage data were recorded for 30 days. On postoperative days 1-5, participants received daily self-monitoring questionnaires within C-Care. Fourteen days after surgery, participants received an online survey regarding satisfaction and use of C-Care.

Results: Thirty-five out of 36 participants visited the application after orientation, with a median [interquartile range (IQR)] age of 32 [31-36] yr. Each participant visited the application a median of 15 [9-31] times over 30 days and completed a median of 3 [2-4] out of five self-monitoring questionnaires. Each participant viewed a median of 4 [2-7] out of eight education topics, with the most viewed patient education topics being "Controlling Pain" and "The First Few Days". Visits to the application were highest in the first week postpartum. Of the 18 respondents who completed the day 14 survey, 83% (n = 15) participants would recommend C-Care to other women, and the median participant satisfaction score was 7.5 out of 10 (range, 2-10).

Conclusion: Most participants used this mobile application for patient education and self-monitoring after elective Cesarean delivery. Insights into patient engagement with C-Care after Cesarean delivery could help design more effective perioperative mobile telehealth programs.

Trial registration: www.ClinicalTrials.gov (NCT03746678); registered 5 November 2018.

Keywords: Cesarean delivery; mobile health; obstetric anesthesia; patient engagement; postoperative care.

Figures

Fig. 1
Fig. 1
Methodology overview
Fig. 2
Fig. 2
CONSORT diagram of patient recruitment
Fig. 3
Fig. 3
Timing of total (light colour) and unique (dark colour) participant visits. Plots display visit time of day (a) and number of postoperative day (b) for visits to the mobile application, as well as time of day (c) for questionnaire completion
Fig. 4
Fig. 4
Incidence of symptoms reported by participants in the self-monitoring questionnaire: headache (red), pain affecting function (dark orange), weakness/numbness (light orange), nausea/vomiting (yellow), other (green), and none (blue). Each participant may report multiple positive symptoms within the same questionnaire

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Source: PubMed

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