YouTube and pain management after cesarean birth: what are patients watching? (Preprint)

Abstract

YouTube is an increasingly common source of health information; however, the reliability and quality of information is inadequately understood. Several studies have evaluated YouTube as a resource during pregnancy and found the available information to be of poor quality. Given the increasing attention to postpartum health and the importance of promoting safe opioid use after birth, YouTube may be a source of information for birthing individuals. However, little is known about the available information on YouTube regarding postpartum pain.

To systematically evaluate the quality of YouTube videos as an educational resource regarding postpartum cesarean pain management.

A systematic search of YouTube videos was conducted on 6/25/2021 using 36 postpartum cesarean pain management-related keywords, which were identified by clinical experts. The search replicated a default YouTube search via a public account. The first 60 results from each keyword search were reviewed and unique videos were analyzed. An overall content score was developed based on prior literature and expert opinion to evaluate video relevance and comprehensiveness. The DISCERN Instrument, a validated metric to assess consumer health information, was used to evaluate the reliability of video information. Videos with an overall content score ≥ 5 and DISCERN score ≥ 39 were classified as a high-quality health education resource. Descriptive analysis and intergroup comparisons by video source and quality were conducted.

Of 73 unique videos, video sources included medical videos (N=36; 49.3%), followed by personal vlog (N=32; 43.8%), advertisement (N=3; 4.1%), and media (N=2, 2.7%). The average overall content score was 3.6 (SD±2.0) of 9 and average DISCERN score was 39.2 (SD±8.1) of 75, indicating low comprehensiveness and fair information reliability, respectively. High-quality videos (N=22; 30.1%) most frequently addressed overall content regarding pain duration (100%), pain types (91%), return to activity instructions (86%), and non-pharmacologic methods for pain control (86%). There were differences in overall content score (P=.02) by video source but not DISCERN score (P=.45). Personal Vlog videos had the highest overall content score at 4.0 (SD+/-2.1) followed by medical videos at 3.3 (SD+/-2.0). Longer video duration and greater number of comments and likes were significantly correlated with overall content score, whereas the number of video comments was inversely correlated with the DISCERN score.

Individuals seeking information from YouTube regarding postpartum cesarean pain management are likely to encounter videos that lack adequate comprehensiveness and reliability. Clinicians should counsel patients to use caution when using YouTube as a health information resource.