Satisfaction with perinatal care in Vysočina region in the period between October 2013 and September 2014
Authors:
L. Takács 1; J. Mlíková Seidlerová 2; F. Smolík 3; S. Hoskovcová 1; P. Antonín 4; J. Vařáková 5; A. Valová 6; T. Svoboda 7; J. Dočkalová 8
Authors‘ workplace:
Katedra psychologie FF UK, Praha, vedoucí katedry doc. PhDr. I. Gillernová, CSc.
1; II. interní klinika, LF UK, Plzeň, přednosta prof. MUDr. J. Filipovský, CSc.
2; Psychologický ústav AV ČR, Praha
3; Gynekologicko-porodnické oddělení Nemocnice Havlíčkův Brod
4; Gynekologicko-porodnické oddělení Nemocnice Nové Město na Moravě
5; gynekologicko-porodnické oddělení Nemocnice Jihlava
6; Gynekologicko-porodnické oddělení Nemocnice Pelhřimov
7; Gynekologicko-porodnické oddělení Nemocnice Třebíč
8
Published in:
Ceska Gynekol 2015; 80(6): 426-435
Overview
Objective:
To assess women's satisfaction with perinatal care provided in maternity hospitals in Vysočina region, to identify the areas with high satisfaction scores as well as those requiring improvement, and to describe the factors influencing women's satisfaction, i. e. dissatisfaction with the care provided during labor and birth and the early postpartal period.
Design:
Original study.
Setting:
Department of Psychology, Faculty of Philo-sophy, Charles University, Prague.
Methods:
The satisfaction survey was conducted in all maternity hospitals in Vysočina region (Jihlava, Havlíčkův Brod, Třebíč, Pelhřimov, Nové město na Moravě) during the period between October 2013 and September 2014. All women who had given birth in those hospitals during the period were approached and asked to participate in this survey. The women evaluated the perinatal care not before 58 days after birth, so that the evaluation of perinatal care did not take place directly during their stay at maternity hospital. In total, 1366 women took part in the study. The original Czech questionnaire KLI-P was used for the data collection. The KLI-P measures psychosocial climate of maternity hospitals on the following six scales: helpfulness and empathy of caregivers; control and involvement in decision-making; communication of information and availability of caregivers; dismissive attitude and lack of interest; physical comfort and services. The satisfaction rates with component dimensions of intrapartal and postpartal care at the maternity hospitals in Vysočina region were compared to the satisfaction rates for the Czech Republic as a whole as obtained in our previous study. We used the Kruskal–Wallis test for this comparison. The ordinal logistical regression (cumulative logit model) was used to identify predictors of women's satisfaction with intrapartum and postpartum care in Vysočina region.
Results:
The women who delivered at maternity hospitals in Vysočina region were significantly more satisfied with all dimensions of care received both at delivery (DU) and after-birth unit (ABU) as compared to the average parturient's satisfaction in the Czech Republic as specified in our previous study. The best rated scale at DU in Vysočina region was Physical comfort and services (93% vs. 85% for the whole country; P < 0,0001), while the worst evaluation score received the scale Control and involvement in decision-making (75% vs. 58% for the whole country; P < 0,0001). At ABU, the best rated scale was Control and involvement in decision-making (95% vs. 89% for the whole country; P < 0,0001), while the lowest evaluation score was found for the scale Physical comfort and services (85% vs. 76% for the whole Republic; P < 0,0001). The women perceived generally the caregivers as helpful and kind but they often missed sufficient emotional support. They considered the information received easy to understand, but they would welcome more information in general. Among the most important determinants of parturient‘s satisfaction with care at DU were kind and helpful attitude of midwives (P < 0,0001), confidence in physicians (P < 0,0001), sufficient provision of information (P = 0,0016), pleasant appearance of the delivery room (P = 0,0010), kind and helpful attitude of physicians (P = 0,018). Among the most important determinants of satisfaction with care at ABU were sufficient provision of information (P = 0,0007), equipment of the room (P = 0,0014), informations regarding the care for the newborn (P = 0,0013), emotional support (P = 0,0039) and confidence in staff employed in newborn care (P = 0,025).
Conclusion:
Satisfaction with care received at maternity hospitals in Vysočina region was rated very high. However, despite its high quality, the perinatal care in Vysočina region suffers from several shortcomings. Regarding the significance of the individual determinants of parturient's satisfaction, improving the quality of care requires first of all better provision of information both during the labor and postpartal period. It would be beneficial to provide the health care professionals with the opportunities of attending a training in breastfeeding support and communication and of taking part in clinical supervision.
Keywords:
maternal-child nursing, perinatal care, psychosocial factors, patient satisfaction, maternity hospital, Czech Republic
Sources
1. Brown, S., Lumley, J. Satisfaction with care in labor and birth: a survey of 790 Australian women. Birth, 1994, 21, p. 4–13.
2. Bystrova, K., Ivanova, V., Edhborg, M., et al. Early contact versus separation: effects on mother-infant interaction one year later. Birth, 2009, 36, p. 97–109.
3. Goodman, P., Mackey, MC., Tavakoli, AS. Factors related to childbirth satisfaction. J Adv Nurs, 2004, 46, p. 212–219.
4. Gungor, I., Beji, NK. Development and psychometric testing of the scales for measuring maternal satisfaction in normal and caesarean birth. Midwifery, 2012, 28, p. 348–357.
5. Hundley, V., Ryan, M., Graham, W. Assessing women‘s preferences for intrapartum care. Birth, 2001, 28, p. 254–263.
6. Jacoby, A. Women‘s preferences for and satisfaction with current procedures in childbirth – findings from a national study. Midwifery, 1987, 3, p. 117–124.
7. Langmeier, J., Krejčířová, D. Vývojová psychologie. Praha: Grada. 2009.
8. Lavender, T., Walkinshaw, SA., Walton, I. A prospective study of women‘s views of factors contributing to a positive birth experience. Midwifery, 1999, 15, p 40–46.
9. Lerman, S., Shahar, G., Czarkowski, K., et al. Predictors of satisfaction with obstetric care in high-risk pregnancy: the importance of patient-provider relationship. J Clin Psychol Medical Settings, 2007, 14, p. 330–334.
10. Linder-Pelz, S., Struening, EL. The multidimensionality of patient satisfaction with a clinic visit. J Community Health, 1985, 10, p. 42–54.
11. Mitchell, PH., Ferketich, S., Jennings, BM. Quality health outcomes model. American Academy of Nursing Expert Panel on Quality Health Care. Image J Nurs Sch, 1998, 30, p 43–46.
12. Redshaw, M. Women as consumers of maternity care: measuring „satisfaction“ or „dissatisfaction“? Birth, 2008, 35, p. 73–76.
13. Sadler, LC., Davison, T., McCowan, LM. Maternal satisfaction with active management of labor: a randomized controlled trial. Birth, 2001, 28, p. 225–235.
14. Sandin-Bojö, AK., Kvist, LJ. Care in labor: a Swedish survey using the Bologna Score. Birth, 2008, 35, p. 321–328.
15. Sandin-Bojö, AK., Larsson, BW., Hall-Lord, ML. Women‘s perception of intrapartal care in relation to WHO recommendations. J Clin Nurs, 2008, 17, p. 2993–3003.
16. Sawyer, A., Ayers, S., Abbott, J., et al. Measures of satisfaction with care during labour and birth: a comparative review. BMC Pregnancy Childbirth, 2013, 13, p. 108.
17. Shafiei, T., Small, R., McLachlan, H. Women‘s views and experiences of maternity care: a study of immigrant Afghan women in Melbourne, Australia. Midwifery, 2012, 28, p. 198–203.
18. Srivastava, A., Avan, BI., Rajbangshi, P., Bhattacharyya, S. Determinants of women‘s satisfaction with maternal health care: a review of literature from developing countries. BMC Pregnancy Childbirth, 2015, 15, p. 97.
19. Takács, L., Kodyšová, E. Psychosociální faktory ovlivňující spokojenost rodiček s perinatální péčí. Čes Gynek, 2011, 76, s. 199–204.
20. Takács, L., Seidlerová, J. Psychosociální klima porodnice očima rodiček: I. výsledky celorepublikového průzkumu spokojenosti s perinatální péčí v ČR u reprezentativního souboru 1195 rodiček. Čes Gynek, 2013, 78, s. 157–168.
21. Takács, L., Seidlerová, J., Hoskovcová, S., et al. Psychosociální aspekty v současném českém porodnictví. Kvalita perinatální péče očima rodiček. Praha: FF UK, 2012.
22. Takács, L., Seidlerová, J., Šulová, L., et al. Social psychological predictors of satisfaction with intrapartum and postpartum care – what matters to women in Czech maternity hospitals? Open Medicine, 2015, 10, p. 119–127.
23. Takács, L., Sněhotová, J., Hoskovcová, S. Dotazník psychosociálního klimatu porodnice KLI-P. Testcentrum . 2012.
24. Waldenström, U. Why do some women change their opinion about childbirth over time? Birth, 2004, 31, p. 102–107.
25. Waldenström, U., Borg, IM., Olsson, B., et al. The childbirth experience: a study of 295 new mothers. Birth, 1996, 23, p. 144–153.
26. Waldenström, U., Rudman, A., Hildingsson, I. Intrapartum and postpartum care in Sweden: women‘s opinions and risk factors for not being satisfied. Acta Obstet Gynecol Scand, 2006, 85, p. 551–560.
27. World Health Organization. Care in Normal Birth: A practical Guide. WHO, Maternal Health and Safe Motherhood Programme, Division of Family Health, Geneva. 1996.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
2015 Issue 6
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