The Effect of Enhanced Recovery After Cesarean Surgery (ERACS) on Patient Satisfaction and Revisit Intention: The Mediating Role of Postoperative Pain
Keywords:
ERACS, postoperative pain, cesarean section, patient satisfaction, revisit intention
Abstract
Cesarean section (CS) is often associated with postoperative pain that may reduce patient satisfaction. Enhanced Recovery After Cesarean Surgery (ERACS) is a multimodal perioperative protocol designed to accelerate recovery. This study evaluated the effect of ERACS on postoperative pain, patient satisfaction, revisit intention, and the mediating role of postoperative pain. A quasi-experimental posttest-only control group study included 80 women undergoing Cesarean section (CS) at Simpang Lima Gumul Regional Hospital Kediri (40 ERACS and 40 non-ERACS). Data were analyzed using a Linear Mixed Model, Mann–Whitney U test, Spearman's rank correlation, and Hayes' PROCESS Macro Model 4. ERACS significantly reduced pain at rest and movement (p < 0.001), improved patient satisfaction (p = 0.008), but had no significant effect on revisit intention (p = 0.591). Postoperative pain did not mediate the relationship between ERACS and patient satisfaction or revisit intention (95% CI included zero). Pain at rest and movement were negatively correlated with patient satisfaction (r = –0.310, p = 0.005; r = –0.297, p = 0.007), patient satisfaction was positively correlated with revisit intention (r = 0.613, p < 0.001). Neither pain at rest and movement measure were associated with revisit intention (r = −0.049, p = 0.667; and r = 0.002, p = 0.987). ERACS effectively reduced postoperative pain and improved patient satisfaction. However, revisit intention was influenced more by patient satisfaction and service quality than by postoperative pain.
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Kuppan, J. I., Chandran, S., Rajendran, S. S., Narayanasamy, V., Ethiraj, K., Gopalan, C., & Khan, A. J. T. (2025). From incision to empowerment: Enhancing maternal recovery and self-care through structured post-caesarean support. Bioinformation, 21(8), 2744–2746. https://doi.org/10.6026/973206300212744
Kurniawan, A., & Pratiwi, N. P. (2025). Post-Anesthesia Recovery Experience Following Cesarean Section with ERACS Protocol : A Phenomenological Study in Indonesia. Journal of Applied Nursing and Health, 7(2), 352–366.
Kusumadewi, A. G., Lestari, S., Nasution, R., Girsang, E., & Napiah, A. (2025). An Analysis Of Factors Influencing Bpjs Patient Loyalty Based On Customer Satisfaction Theory At Bandung General Hospital Medan. Jurnal Ners, 9, 7131–7138.
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Lestari, M. I., Sari, D., Chandra, S., Purwoko, P., Isngadi, I., & Umar, T. P. (2025). Enhanced recovery after cesarean (ERAC) versus conventional care: An expanded systematic review and meta-analysis of 18,368 subjects. Journal of Anaesthesiology, Clinical Pharmacology, 41(1), 48–61. https://doi.org/10.4103/joacp.joacp_339_23
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Manzoor, F., Wei, L., Hussain, A., Asif, M., & Shah, S. (2019). Patient satisfaction with health care services; an application of physician’s behavior as a moderator. International Journal of Environmental Research and Public Health [revista en Internet] 2019 [acceso 20 de octubre de 2022]; 16(18): 1-16. Int J Environ Res Public Health, 1–16.
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Millizia, A., Rizka, A., & Mellaratna, W. P. (2023). Patient Satisfaction Level of Enhanced Recovery after C-Section at Abby Maternal and Child Hospital Lhokseumawe. Eureka Herba Indonesia, 4(1), 171–175. https://doi.org/https://doi.org/10.37275/ehi.v4i1.60
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Noviyani, A., & Viwattanakulvanid, P. (2024). Exploring patients ’ perspectives on healthcare service quality in outpatient settings at a public hospital in Palembang , Indonesia : A qualitative study. Open Access Macedonian Journal of Medical Sciences., 10(6), 703–711.
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Published
2026-08-30
How to Cite
Windy Ari Wijaya, H. A. Rohendi, & Mira Veranita. (2026). The Effect of Enhanced Recovery After Cesarean Surgery (ERACS) on Patient Satisfaction and Revisit Intention: The Mediating Role of Postoperative Pain. International Journal of Economics, Business and Innovation Research, 5(05), 2745-2777. https://doi.org/10.63922/ijebir.v5i05.6247
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