Women’s satisfaction with shared decision-making process of caesarian sections and associated factors among post cs delivery women attending st Joseph hospital in Kilimanjaro, Tanzania.

Abstract

ABSTRACT Background: Caesarean section (CS) rates are rising globally, including in Tanzania, where shared decision-making (SDM) is crucial for patient-cantered care. However, the satisfaction of women with the SDM process during CS and the influencing factors are underexplored in Tanzania. St. Joseph Hospital in Kilimanjaro, serving a diverse population, provides an ideal setting to investigate these issues. Factors such as education, socio-economic status, communication quality, cultural beliefs, and family involvement significantly impact satisfaction. This study aims to evaluate post-CS delivery women’s satisfaction with the SDM process at St. Joseph Hospital and identify associated factors. This study aimed to determine the post CS delivery women’s satisfaction with SDM process and associated factors among women attending St. Joseph Hospital, Kilimanjaro, Tanzania. Methodology: A cross-sectional study was conducted at St. Joseph Hospital targeting women aged 18 and above who had undergone a caesarean section. A total of 319 Participants were selected using simple random sampling, and data were collected through Interviewer administered Questionnaire. The primary outcome measured was patient satisfaction with shared decision-making during caesarean delivery. Data analysis was performed using SPSS version 25. A multivariable logistic regression analysis was performed to determine significant predictors of satisfaction at a p-value <0.05. Results: The mean participant age was 30±16.3 years. The majority resided in town 191(59.9%), were married 250(78.4%), had secondary or higher education 220(69.0%), and were employed 258(80.9%). Most participants were multiparous 230(72.1%), initiated ANC in the 2nd and 3rd trimester 264(82.8%), and underwent emergency CS 185(58.0%). The informed consent was most commonly provided by general practitioners (GPs) 103(54.2%). The proportion of participants who were satisfied with shared decision regarding CS was 222(69.6%). Patients with a history of cesarean section (CS) were less satisfied (61.6%) compared to those without (78.1%), and elective CS patients reported higher satisfaction (77.4%) than emergency CS patients (64.0%). Satisfaction was highest among patients who received consent from specialists (94.7%), and those with adequate knowledge (73.0%) and good provider-to-patient communication (71.7%) were more satisfied. In vi multivariable logistic regression, individuals with no history of cesarean section (CS) had an adjusted odd ratio (aOR) of 2.797 (95% CI [1.511, 5.178], p = 0.001). Those who underwent elective CS had an aOR of 2.367 (95% CI [1.293, 4.332], p = 0.005). Informed consent provided by a specialist was associated with a notably higher aOR of 9.468 (95% CI [2.617, 34.258], p = 0.001). Adequate knowledge among patients was linked to an aOR of 4.135 (95% CI [1.512, 11.312], p = 0.006), while good communication showed an aOR of 4.461 (95% CI [1.474, 13.503], p = 0.008). Conclusion: This study highlights the importance of patient involvement in the decision making process for CS, emphasizing that it leads to higher satisfaction, particularly for those new to CS or undergoing elective procedures. The research suggests that active patient participation and thorough information provision may help address the rising CS rates by empowering patients and improving their satisfaction with the healthcare services provided.