The Effect of a Simple Perioperative Video on Maternal Anxiety and Satisfaction Before Regional Anesthesia in a Caribbean Setting: A Randomized Controlled Trial

Effectiveness of preoperative multimedia educational sessions on the levels of anxiety and satisfaction among women undergoing cesarean: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to explore the effectiveness of preoperative multimedia educational sessions on the levels of anxiety and satisfaction among women undergoing cesarean section (CS). The Scopus, PubMed, and Cochrane databases were searched without language limitations for eligible randomized controlled trials (RCTs) published from their inception up to October 15, 2023. A random-effect meta-analysis was conducted, and the quality of this meta-analysis was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Seven RCTs (n = 1006 women) met the inclusion criteria. Preoperative multimedia sessions were found to significantly reduce anxiety levels (n = 6 RCTs, weighted mean difference: -3.10; 95 percent confidence intervals (CI): -4.48, -1.73; I2 = 44.24 percent, moderate certainty of evidence) compared to the control group. However, there was no significant difference between the two groups regarding women's satisfaction after surgery (n = 5 RCTs, risk ratio: 1.37; 95 percent CI: 0.76, 2.50; I2 = 98.26 percent, moderate certainty of evidence). Leave-one-out sensitivity analysis showed robustness of the outcomes. The findings of this meta-analysis suggest that providing multimedia educational programs before surgery could potentially have a beneficial effect on the levels of anxiety experienced by women undergoing CS. However, it is imperative to validate these results through larger samples and multi-centered RCTs.

Informational video on preoperative anxiety and postoperative satisfaction prior to elective cesarean delivery: a systematic review and meta-analysis

BACKGROUND

Preoperative anxiety affects 60 to 80% of patients who are candidates for surgery. Reducing preoperative anxiety can improve surgical outcomes, shorten hospital stays, and minimize disruptions in lifestyle. Having information affects people ability to identify important points and improve their understanding, and lack of information causes fear and anxiety, which negatively affects decision-making. Studies have shown that the intervention of education before cesarean section has a beneficial effect on women anxiety level. Providing information before surgery can reduce patients' anxiety. This study was conducted to determine the effect of information video before elective cesarean delivery on preoperative anxiety and post-operative satisfaction.

METHODS

The search for relevant studies was systematically conducted in PubMed, Scopus, Web of Science, Cochrane Library, SID (Persian database), and Google Scholar (search engine) until July 4, 2023, in both English and Persian languages. The revised tool for assessing the risk of bias in randomized trials (RoB 2.0) and ROBIN-I were used to evaluate the risk of bias, and heterogeneity was assessed using I². In cases of high heterogeneity, a random effects model was used instead of a fixed effects model. Subgroup analysis was performed based on the duration of the video, and the type of intervention for the primary outcome. Sensitivity analysis was conducted based on the type of study. A random-effects meta-regression analysis was conducted to identify potential sources of high heterogeneity for preoperative anxiety. The certainty of the evidence was assessed using GRADE.

RESULTS

A total number of 557 articles were found in databases. Three hundred sixty-eight studies were screened based on their titles, abstracts, and full texts. Of these, 16 studies were assessed for eligibility, and 7 were excluded. Ultimately, nine papers were included. Meta-analysis results showed that the information video before elective cesarean delivery compared to control group may have little or no effect on preoperative anxiety, but the evidence is uncertain (SMD - 0.22, 95% CI -0.51 to 0.06, 9 trials, 1020 participants, I2 = 80%; very low-certainty evidence). Also, it probably increases the post-operative satisfaction (SMD 0.26, 95% CI 0.10 to 0.42, 5 trials, 618 participants, I2 = 0%; Moderate-certainty evidence). The random effect meta-regression analyses indicated a significant correlation between the mean age of the intervention group (β = 0.137, P < 0.001) and the mean age of the control group (β = 0.150, P = 0.0246) with effect size.

CONCLUSION

This study found that watching an informational video prior to elective cesarean delivery resulted in a decrease in preoperative anxiety. However, it is important to note that the reduction was not statistically significant, and there was a high level of inconsistency among the results. Nonetheless, the intervention did lead to an improvement in women's post-operative satisfaction. To determine the optimal time duration and content type of informational videos, further studies with more appropriate methodology are necessary.