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Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety
Background It is unknown whether the implementation of an information video on spinal anesthesia for caesarean section, narrated in a patient's first language, reduces anxiety, increases satisfaction, and improves doctor-patient communication if there is a language barrier. In South Africa most doct...
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| Format: | Thesis |
| Language: | English |
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Department of Anaesthesia and Perioperative Medicine
2022
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| _version_ | 1867613299232735232 |
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| access_status_str | Open Access |
| author | Purcell-Jones, Jessica M A |
| author2 | Duys, Rowan |
| author_browse | Duys, Rowan Purcell-Jones, Jessica M A |
| author_facet | Duys, Rowan Purcell-Jones, Jessica M A |
| author_sort | Purcell-Jones, Jessica M A |
| collection | Thesis |
| description | Background It is unknown whether the implementation of an information video on spinal anesthesia for caesarean section, narrated in a patient's first language, reduces anxiety, increases satisfaction, and improves doctor-patient communication if there is a language barrier. In South Africa most doctors speak English, and patients Xhosa, with educational and cultural disparities existing in many doctor-patient interactions. Methods One hundred and seventy-five Xhosa patients scheduled for elective cesarean section were enrolled in the study. The first 92 patients received “usual care” verbal explanations of the spinal anesthesia procedure (control group); the next 83 patients watched a spinal anesthesia information video (intervention group), narrated in Xhosa. Videos were displayed using smartphones. Maternal anxiety was assessed before and after spinal explanation, using a Numerical Visual Analog Anxiety Scale (NVAAS). A difference in post-explanation NVAAS score of 1.5 points between intervention and control groups was regarded as clinically significant. Patient satisfaction was assessed using the Maternal Satisfaction Scale for Cesarean Section (MSSCS). Results The mean (SD) age (31.5 (5.2) and 32.1 (5.4) years) and pre-explanation NVAAS score (4.2 (3.2) and 4.0 (3.0)) of the intervention and control groups respectively, showed no difference at baseline. The mean (SD) post-explanation decrease in NVAAS score was greater in the intervention- than in the control group (1.6 (3.5) versus .7 (2.3), P = .046, unadjusted mean difference .9 points (95% CI .02 to 1.8)). A linear regression model for the post-explanation NVAAS score showed that the intervention effect was significantly associated with the pre-explanation score (P = .002), adjusted for age and English fluency. Patients with pre-explanation NVAAS scores ³ 5 showed a statistically significant intervention effect. There was no significant difference in patient satisfaction between the intervention and control groups. The smartphone was an accessible and convenient display medium for the video. Ninety nine percent of patients exposed to the intervention would recommend watching the video prior to the procedure. Conclusion In this pilot study, lower NVAAS scores were observed in anxious patients, when a Xhosa information video was used to ameliorate challenges posed by a doctor-patient language barrier. It is easily implemented and demonstrates a novel use of mobile health technology. The study provides baseline data to inform sample size calculations for future studies. A high level of patient recommendation for the video suggests that this is an agreeable practice. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/36044 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:55.830Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Anaesthesia and Perioperative Medicine |
| publisherStr | Department of Anaesthesia and Perioperative Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/36044 Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety Purcell-Jones, Jessica M A Duys, Rowan Dyer, Robert Anaesthesia Perioperative Medicine Background It is unknown whether the implementation of an information video on spinal anesthesia for caesarean section, narrated in a patient's first language, reduces anxiety, increases satisfaction, and improves doctor-patient communication if there is a language barrier. In South Africa most doctors speak English, and patients Xhosa, with educational and cultural disparities existing in many doctor-patient interactions. Methods One hundred and seventy-five Xhosa patients scheduled for elective cesarean section were enrolled in the study. The first 92 patients received “usual care” verbal explanations of the spinal anesthesia procedure (control group); the next 83 patients watched a spinal anesthesia information video (intervention group), narrated in Xhosa. Videos were displayed using smartphones. Maternal anxiety was assessed before and after spinal explanation, using a Numerical Visual Analog Anxiety Scale (NVAAS). A difference in post-explanation NVAAS score of 1.5 points between intervention and control groups was regarded as clinically significant. Patient satisfaction was assessed using the Maternal Satisfaction Scale for Cesarean Section (MSSCS). Results The mean (SD) age (31.5 (5.2) and 32.1 (5.4) years) and pre-explanation NVAAS score (4.2 (3.2) and 4.0 (3.0)) of the intervention and control groups respectively, showed no difference at baseline. The mean (SD) post-explanation decrease in NVAAS score was greater in the intervention- than in the control group (1.6 (3.5) versus .7 (2.3), P = .046, unadjusted mean difference .9 points (95% CI .02 to 1.8)). A linear regression model for the post-explanation NVAAS score showed that the intervention effect was significantly associated with the pre-explanation score (P = .002), adjusted for age and English fluency. Patients with pre-explanation NVAAS scores ³ 5 showed a statistically significant intervention effect. There was no significant difference in patient satisfaction between the intervention and control groups. The smartphone was an accessible and convenient display medium for the video. Ninety nine percent of patients exposed to the intervention would recommend watching the video prior to the procedure. Conclusion In this pilot study, lower NVAAS scores were observed in anxious patients, when a Xhosa information video was used to ameliorate challenges posed by a doctor-patient language barrier. It is easily implemented and demonstrates a novel use of mobile health technology. The study provides baseline data to inform sample size calculations for future studies. A high level of patient recommendation for the video suggests that this is an agreeable practice. 2022-03-10T14:12:25Z 2022-03-10T14:12:25Z 2021 2022-03-10T14:11:37Z Master Thesis Masters MMed http://hdl.handle.net/11427/36044 eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences |
| spellingShingle | Anaesthesia Perioperative Medicine Purcell-Jones, Jessica M A Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety |
| thesis_degree_str | Master's |
| title | Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety |
| title_full | Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety |
| title_fullStr | Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety |
| title_full_unstemmed | Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety |
| title_short | Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety |
| title_sort | overcoming language barriers using an information video on spinal anesthesia for cesarean section implementation and impact on maternal anxiety |
| topic | Anaesthesia Perioperative Medicine |
| url | http://hdl.handle.net/11427/36044 |
| work_keys_str_mv | AT purcelljonesjessicama overcominglanguagebarriersusinganinformationvideoonspinalanesthesiaforcesareansectionimplementationandimpactonmaternalanxiety |