MedPath

Attachment Predicts Post Cesarean Pain

Conditions
Attachment Disorder
Cesarean Section Complications
Post Operative Recovery
Registration Number
NCT04863651
Lead Sponsor
Western University, Canada
Brief Summary

The Adult Attachment Style (AAS) is a questionnaire designed to measure how an adult generally feels in their close personal relationships. The questionnaire has two main axes of measurements - avoidance and anxiety, that gives rise to four different categories of attachment styles. Women's attachment styles have been shown to be correlated to pain during labour, but not after. No study has analyzed whether attachment styles are correlated to the pain after cesarean section. This study will assess correlation between the AAS score, and pain after elective cesarean section. Additionally, this study aims to clarify the correlation between attachment scale and overall quality of recovery after cesarean section as defined by a recently validated tool, the ObsQoR10.

Detailed Description

Overall recovery after cesarean section is difficult to measure and must consider several factors that may influence recovery. The ObsQoR10 is a recently validated tool that provides an overall picture of post cesarean recovery using pain, functional milestones, and emotional needs1. One of the factors that may influence recovery post operatively is a person's Adult Attachment Style (AAS).

AAS refers to how a person "generally feels in close relationships in their lives" and is prevalent in literature in the context of chronic pain. AAS has been shown to be correlated to patients' psychological stress2, self reported pain intensity and even the prevalence of chronic pain conditions like fibromyalgia3. In a cohort of patients with chronic pain, securely attached individuals were less likely to report disability due to pain, depressive symptoms and perceived negative spouse responses in comparison to securely attached individuals4. Another cohort showed that patients were characterized as fearful avoidant were more likely to catastrophize their pain and exhibit activity avoiding behaviours5.

Literature on AAS in the context of pain experienced by parturients is not as well characterized. Costas-Martins et al showed that insecurely attached women experience more pain during labour6. Costas-Martins et al include in their cohort a number of cesarean patients but do not consider them separately. To date there has not been a study investigating whether the AAS of parturients undergoing cesarean section is correlated to their perceived pain.2

While pain is an important clinical outcome, overall recovery as measured by the ObsQoR10 may present a more complete clinical picture of the predictive power of a person's AAS. Our study aims to characterize whether parturients' AAS is correlated with their overall recovery post cesarean section as well as pain.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
65
Inclusion Criteria

i. English Speaking ii. Elective Cesarean Sections iii. ASA 3 or lower iv. Singleton Pregnancy v. Between 37-40 weeks gestation

Exclusion Criteria

i. Patient Refusal ii. History of chronic pain condition, currently on medication iii. Diagnosed General Anxiety Disorder iv. Diagnosed substance use disorder

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Pain Score24 hours

Pain score from 0-10, measured at 24 hours post-operative

Secondary Outcome Measures
NameTimeMethod
ObsQoR10 Score24 hours

Total score on the ObsQoR10 tool, a quality of recovery tool post cesarean section. Collected at 24 hours post-operative.

First Occurrence of Nausea24 hours

The first time the patient reports feeling nauseous within the first 24 hours post-operative.

First Occurrence of Pruritis24 hours

The first time the patient reports feeling vomiting within the first 24 hours post-operative.

First Occurence of Sedation24 hours

The first time the patient reports feeling sedated within the first 24 hours post-operative.

Total Opioid Consumption first 24h24 hours

Total consumption of opioids by the patient in the first 24 hours post-operative, including the time at which additional opioid analgesia was first requested by the patient.

First Occurrence of Vomiting24 hours

The first time the patient reports feeling vomiting within the first 24 hours post-operative.

Trial Locations

Locations (1)

Victoria Hospital

🇨🇦

London, Ontario, Canada

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