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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Parturients' Stated Preferences for Labor Analgesia: A Discrete Choice Experiment
Semra Ozdemir1,2,3, Teresa Chen4, Chin Wen Tan4,5
1Health Services and Systems Research, Duke-NUS Medical School, Singapore.
Objective:
The objective was to investigate the extent to which treatment benefits, risks and costs affected parturients' preferences for labor analgesia.
Methods:
We recruited 248 healthy parturients prior to labor at an antenatal ward and administered a discrete choice experiment survey. Parturients were asked to choose among four hypothetical forms of labor analgesia: epidural analgesia, pethidine, Entonox and no analgesia, which were defined by: pain score, duration of second stage of labor, risks of instrumental delivery, back pain and permanent nerve injury, and out-of-pocket cost. We used mixed logit model to calculate the relative importance of each attribute (out of 100).
Results:
Parturients preferred receiving labor analgesia over not receiving analgesia and those who had positive past experience with epidural preferred epidural over other modalities. Out-of-pocket cost (28%), duration of second stage of labor (26%) and pain score following treatment (18%) were the most important attributes.
Conclusion:
Out-of-pocket cost was a major concern. Parturients prioritized having lower pain and shorter labor experience over risks associated with epidural analgesia. Parturients should be presented with realistic range of risks of side-effects so that they can decide how to balance risks against benefits and costs associated with child labor.
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