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Cesarean section is currently the most commonly performed surgical procedure worldwide, accounting for more than one-fifth of all deliveries in France. The experience of childbirth, particularly when it involves a cesarean section, is a significant life event with physical, psychological, and relational consequences. Many factors influence women's perceptions of this experience, including whether the procedure was planned or unexpected, the quality of analgesia, communication with healthcare providers, and the degree of involvement in decision-making. Conversely, a negative experience may impair the mother infant bond or delay postpartum recovery. The quality of anesthetic management is a major determinant of maternal satisfaction.
Maternal satisfaction is widely recognized as an important indicator of healthcare quality. Its assessment requires a multidimensional approach. Although several tools exist in French to measure satisfaction during pregnancy or childbirth in general, none are specifically designed to evaluate the experience of cesarean section, with its particular features-especially those related to anesthesia. Scales such as Questionnaire for the Evaluation of the Childbirth Experience (QEVA) or Women's Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ4) do not sufficiently address the specific characteristics of this procedure.
The Maternal Satisfaction Scale for Caesarean Section (MSSCS), originally developed in English, is currently the only validated instrument specifically designed to assess women's satisfaction following a cesarean section. It covers the anesthetic, technical, psychological, and environmental dimensions of the procedure. To date, this scale has neither been translated nor validated in French.
The availability of a validated French version of the MSSCS would improve the assessment of maternal experience in French-speaking settings and help identify concrete areas for improvement in anesthetic and obstetric care related to cesarean section.
This prospective, single-center, non-interventional study focuses on a specific population of women undergoing cesarean section and is conducted in two phases, including a questionnaire validation process.
The first phase involves the translation and cultural adaptation of the Maternal Satisfaction Scale for Caesarean Section (MSSCS) in accordance with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. This phase includes several steps: forward translation by two independent translators (one physician and one non-physician), reconciliation of the translated versions, back-translation, harmonization by an expert committee, pilot testing with 10 patients, and finalization of the scale.
The second phase consists of administering the translated questionnaire to a sample of women who have delivered by cesarean section at the Hôpital Couple Enfant of Grenoble Alpes University Hospital during their maternity stay. Two additional satisfaction assessment tools (QEVA) and a global Visual Analog Scale will also be administered. Eligible patients will be informed both orally and in writing shortly after their cesarean section. If they agree to participate, they will complete the questionnaires on postoperative day 1 whenever possible, or at another time during their hospitalization, without any modification to their standard care. This phase will allow field testing of the final French version of the scale and enable its psychometric validation.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Post-Cesarean Maternal Satisfaction Scale Questionnaire | Other | consists of beta-testing the MSSCS on 10 cesarean patients to assess item clarity and comprehension, followed by analysis, minor revisions, and finalization of the translated scale in accordance with ISPOR guidelines. A final report will document all translation and cultural adaptation decisions. This phase 2 involves administering the finalized French version of the MSSCS, along with QEVA and a global visual analog scale, to eligible women after cesarean section during their maternity stay to evaluate satisfaction. | ||
| Post-Cesarean Maternal Satisfaction Scale Questionnaire | Other | This phase consists of beta-testing the MSSCS on 10 cesarean patients to assess item clarity and comprehension, followed by analysis, minor revisions, and finalization of the translated scale in accordance with ISPOR guidelines. A final report will document all translation and cultural adaptation decisions. Phase 2 involves administering the finalized French version of the MSSCS, along with QEVA and a global visual analog scale, to eligible women after cesarean section during their maternity stay to evaluate satisfaction. |
| Measure | Description | Time Frame |
|---|---|---|
| Translate and validate the "Maternal Satisfaction Scale for Caesarean Section" (MSSCS) questionnaire into French | The translation will be conducted in accordance with the recommendations of ISPOR (International Society for Pharmacoeconomics and Outcomes Research) to ensure content validity. Other validity criteria to be assessed will include acceptability and feasibility, reliability, construct validity, and convergent validity. | from day 1 to day 3 |
| Measure | Description | Time Frame |
|---|---|---|
| Compare MSSCS scores based on factors that may influence the cesarean section experience : to demonstrate to study the determinants (known from the literature or hypothesized by the authors) of post-cesarean satisfaction at the Couple Enfant Hospital |
|
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Inclusion Criteria:
Exclusion Criteria:
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Patient who underwent a cesarean section under regional anesthesia at the Couple Enfant Hospital
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jean Noel EJ EVAIN, Doctor | Contact | 04 76 76 67 29 | +33 | jnevain@chu-grenoble.fr |
| Angélina AP Pollet | Contact | 04 76 76 67 29 | +33 | apollet@chu-grenoble.fr |
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| PubMed Identifier | Type | Citation | Retractions |
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| 29481436 | Background | Schober P, Boer C, Schwarte LA. Correlation Coefficients: Appropriate Use and Interpretation. Anesth Analg. 2018 May;126(5):1763-1768. doi: 10.1213/ANE.0000000000002864. | |
| Background | Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994. | ||
| 28616007 |
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The data will be anonymized and stored at the University Hospital Grenoble
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| from day 1 to day 3 |
| Background |
| Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017 May;11(Suppl 1):S80-S89. doi: 10.4103/sja.SJA_203_17. |
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