Evaluation of the knowledge of patients undergoing elective cesarean section about applicable anesthesia methods

SUMMARY Evaluation of the knowledge of patients undergoing elective cesarean section about applicable anesthesia methods Objective: The choice of anesthesia method for cesarean sections in pregnant women is a critical decision that directly affects both maternal and fetal outcomes. Physiological and anatomical changes that occur during pregnancy complicate anesthesia administration; therefore, assessing pregnant women's knowledge, past experiences, and anesthesia preferences is of clinical importance. This study aims to examine the factors influencing anesthesia preferences, sources of information, previous anesthesia experiences, and the impact of these experiences on current preferences. Materials and Methods: This prospective, descriptive, and cross-sectional survey was conducted with 107 pregnant women over the age of 18, with ASA 1-III, Turkish proficiency, and mental illness who were scheduled for elective cesarean sections in the operating room of the Anesthesiology and Reanimation Clinic of Manisa Celal Bayar University Hafsa Sultan Hospital. At the beginning of the study, voluntary informed consent was obtained from the pregnant women after obtaining approval from the local ethics committee of our hospital. A 22-question questionnaire was used as the data collection tool. The survey questions were developed by the researcher and the consultant based on relevant literature reviews. The first four questions in the survey included the patients' demographic information, while questions 5-7 addressed their surgical history, questions 8-16 addressed their knowledge, attitudes, and behaviors regarding anesthesia methods, and questions 17-19 addressed their opinions after meeting with the anesthesiologist. Questions 20-22 addressed the timing and delivery method of the information provided through the survey. Patients who refused to participate in the study, those without a mental illness, those scheduled for emergency surgery, and those who did not speak Turkish were excluded. The researcher administered the survey to participating patients via face-to-face interviews while routine monitoring (ECG, noninvasive blood pressure, pulse oximetry) was performed in the operating room. The questionnaire was read to the patients by the anesthesiologist, and their responses were recorded. SPSS 27 statistical software package (Statistical Package for the Social Sciences – IBM®) was used to analyze the data obtained from the study, and p<0.05 was considered statistically significant. Results: The mean age of the pregnant women in the study was 30.68±5.26 years, with an age range of 20 to 43 years. It was determined that 30 (28.04%) of the pregnant women in the study had primary school education, 37 (34.58%) had secondary school education, and 40 (37.38%) had higher education. 70 (65.42%) of the pregnant women were housewives. 27 (25.23%) of the pregnant women in the study had a healthcare worker in their family. 66 (61.68%) of the pregnant women had undergone at least one previous surgery. 33 (30.84) of the pregnant women in the study had previously undergone C/S surgery. The most frequently preferred anesthesia method by the pregnant women in the study was spinal anesthesia. A significant relationship was found between the education level of the pregnant women and their anesthesia preference (p<0.05). It was determined that primary school graduates mostly preferred verbal information, while higher education graduates had a more positive attitude towards information supported by video and visual materials. Furthermore, no significant relationship was found between satisfaction with previous anesthesia experiences and current preference (p>0.05). The majority of pregnant women (86.92%) preferred verbal information, while only 13.08% preferred visual and video information. Discussing anesthesia methods with an obstetrician significantly influenced pregnant women's anesthesia preferences (p<0.05). Doctors were the most frequently preferred information source, and the doctor's information was found to be highly consistent with other sources (p<0.05). Conclusion: Pregnant women's knowledge level about anesthesia, information sources, and educational background significantly influence the preferred anesthesia method for cesarean section. In particular, as the level of education increases, the tendency towards multimodal (visual and video-supported) information increases. The majority of pregnant women's preference for verbal information highlights the reassuring effect of face-to-face communication. The results of the study highlight the importance of more comprehensive anesthesia information programs tailored to pregnant women's educational levels.