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Jafari E, Asghari-Jafarabadi M, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S. Psychometric properties of the experiences of maternity care scale among Iranian women. BMC Health Serv Res 2024; 24:619. [PMID: 38734592 PMCID: PMC11088168 DOI: 10.1186/s12913-024-11065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Assessing women's perceptions of the care they receive is crucial for evaluating the quality of maternity care. Women's perceptions are influenced by the care received during pregnancy, labour and birth, and the postpartum period, each of which with unique conditions, expectations, and requirements. In England, three Experience of Maternity Care (EMC) scales - Pregnancy, Labour and Birth, and Postnatal - have been developed to assess women's experiences from pregnancy through the postpartum period. This study aimed to validate these scales within the Iranian context. METHODS A methodological cross-sectional study was conducted from December 2022 to August 2023 at selected health centers in Tabriz, Iran. A panel of 16 experts assessed the qualitative and quantitative content validity of the scales and 10 women assessed the face validity. A total of 540 eligible women, 1-6 months postpartum, participated in the study, with data from 216 women being used for exploratory factor analysis (EFA) and 324 women for confirmatory factor analysis (CFA) and other analyses. The Childbirth Experience Questionnaire-2 was employed to assess the convergent validity of the Labour and Birth Scale, whereas women's age was used to assess the divergent validity of the scales. Test-retest reliability and internal consistency were also examined. RESULTS All items obtained an impact score above 1.5, with Content Validity Ratio and Content Validity Index exceeding 0.8. EFA demonstrated an excellent fit with the data (all Kaiser-Meyer-Olkin measures > 0.80, and all Bartlett's p < 0.001). The Pregnancy Scale exhibited a five-factor structure, the Labour and Birth Scale a two-factor structure, and the Postnatal Scale a three-factor structure, explaining 66%, 57%, and 62% of the cumulative variance, respectively, for each scale. CFA indicated an acceptable fit with RMSEA ≤ 0.08, CFI ≥ 0.92, and NNFI ≥ 0.90. A significant correlation was observed between the Labour and Birth scale and the Childbirth Experience Questionnaire-2 (r = 0.82, P < 0.001). No significant correlation was found between the scales and women's age. All three scales demonstrated good internal consistency (all Cronbach's alpha values > 0.9) and test-retest reliability (all interclass correlation coefficient values > 0.8). CONCLUSIONS The Persian versions of all three EMC scales exhibit robust psychometric properties for evaluating maternity care experiences among urban Iranian women. These scales can be utilized to assess the quality of current care, investigate the impact of different care models in various studies, and contribute to maternal health promotion programs and policies.
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Affiliation(s)
- Elham Jafari
- Student Research Comittee, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, 3144, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia.
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Ave, P.O. Box: 51745- 347, Tabriz, 513897977, Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Ave, P.O. Box: 51745- 347, Tabriz, 513897977, Iran.
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Abdolalipour S, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Abbasalizadeh F, Jahanfar S, Mirghafourvand M. Implementation and evaluation of the WHO maternity care model: a convergent parallel mixed-methods study protocol. Front Glob Womens Health 2024; 5:1309886. [PMID: 38746053 PMCID: PMC11091316 DOI: 10.3389/fgwh.2024.1309886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
Background According to the World Health Organization (WHO), intrapartum care is considered a platform for providing respectful, personalized, and women-centered services to women. This study aims to investigate the intrapartum care model proposed by WHO. Methods This convergent parallel mixed-methods study will be carried out in qualitative and quantitative phases. In the quantitative phase (a quasi-experimental study), 108 pregnant women admitted to the maternity ward will be randomized to intervention (receiving intrapartum care based on the WHO model) and control group (receiving routine hospital care) before the beginning of the active stage of labor (cervix dilatation equal to 5 cm) and Wijma's delivery fear scale (DFS) will be completed for them and again at 7-8 cm dilatation. The participants of both groups will be followed up for 6 weeks after labor and then they will be invited to a relatively quiet place to complete the Childbirth Experience Questionnaire (CEQ 2.0), the Edinburgh Postpartum Depression Scale (EPDS), the Post-Traumatic Stress Disorder (PTSD) Symptom Scale (PSS-I), the Pregnancy and Childbirth Questionnaire (PCQ), exclusive breastfeeding and a checklist on willingness to give birth to another child. The qualitative phase will employ content analysis to explain mothers' views about the effects of this model especially subjective components of this model on their labor process after 4-6 weeks. The two phase's results will be discussed in combination. Discussion The implementation of such care models is expected to prevent mental disorders caused by negative experiences of childbirth, and also, prevent uncontrolled increases in cesarean sections. Clinical Trial Registration https://fa.irct.ir/user/trial/68313/view, identifier (IRCT20120718010324N69).
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Affiliation(s)
| | - Shamsi Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fatemeh Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts School of Medicine, Boston, MA, United States
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Abdolalipour S, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Abbasalizadeh F, Jahanfar S, Raphi F, Mirghafourvand M. Effect of implementation of the WHO intrapartum care model on maternal and neonatal outcomes: a randomized control trial. BMC Pregnancy Childbirth 2024; 24:283. [PMID: 38632530 PMCID: PMC11022439 DOI: 10.1186/s12884-024-06449-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND In 2018, the World Health Organization published a set of recommendations for further emphasis on the quality of intrapartum care to improve the childbirth experience. This study aimed to determine the effects of the WHO intrapartum care model on the childbirth experience, fear of childbirth, the quality of intrapartum care (primary outcomes), as well as post-traumatic stress disorder symptoms, postpartum depression, the duration of childbirth stages, the frequency of vaginal childbirth, Apgar score less than 7, desire for subsequent childbearing, and exclusive breastfeeding in the 4 to 6 weeks postpartum period (secondary outcomes). METHODS This study was a randomized controlled trial involving 108 pregnant women admitted to the maternity units of Al-Zahra and Taleghani hospitals in Tabriz-Iran. Participants were allocated to either the intervention group, which received care according to the ' 'intrapartum care model, or the control group, which received the' 'hospital's routine care, using the blocked randomization method. A Partograph chart was drawn for each participant during pregnancy. A delivery fear scale was completed by all participants both before the beginning of the active phase (pre-intervention) and during 7 to 8 cm dilation (post-intervention). Participants in both groups were followed up for 4 to 6 weeks after childbirth and were asked to complete questionnaires on childbirth experience, postpartum depression, and post-traumatic stress disorder symptoms, as well as the pregnancy and childbirth questionnaire and checklists on the desire to have children again and exclusive breastfeeding. The data were analyzed using independent T and Mann-Whitney U tests and analysis of covariance ANCOVA with adjustments for the parity variable and the baseline scores or childbirth fear. RESULTS The average score for the childbirth experience total was notably higher in the intervention group (Adjusted Mean Difference (AMD) (95% Confidence Interval (CI)): 7.0 (0.6 to 0.8), p < 0.001). Similarly, the intrapartum care quality score exhibited a significant increase in the intervention group (AMD (95% CI): 7.0 (4.0 to 10), p < 0.001). Furthermore, the post-intervention fear of childbirth score demonstrated a substantial decrease in the intervention group (AMD (95% CI): -16.0 (-22.0 to -10.0), p < 0.001). No statistically significant differences were observed between the two groups in terms of mean scores for depression, PTSD symptoms, duration of childbirth stages, frequency of vaginal childbirth, Apgar score less than 7, and exclusive breastfeeding in the 4 to 6 weeks postpartum (p > 0.05). CONCLUSION The intrapartum care model endorsed by the World Health Organization (WHO) has demonstrated effectiveness in enhancing childbirth experiences and increasing maternal satisfaction with the quality of obstetric care. Additionally, it contributes to the reduction of fear associated with labor and childbirth. Future research endeavors should explore strategies to prioritize and integrate respectful, high-quality care during labor and childbirth alongside clinical measures.
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Affiliation(s)
- Somayeh Abdolalipour
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Shamsi Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fatemeh Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayesteh Jahanfar
- Tufts School of Medicine, Department of Public Health and Community Medicine, Boston, USA
| | - Fatemeh Raphi
- Master of Midwifery, Clinical Research Development Unit, Taleghani Hospital, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, IR, Iran.
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Abdolalipour S, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Abbasalizadeh F, Jahanfar S, Asghari Jafarabadi M, Abdollahi K, Mirghafourvadsnd M. Translation and measurement properties of pregnancy and childbirth questionnaire in Iranian postpartum women. BMC Health Serv Res 2024; 24:365. [PMID: 38519977 PMCID: PMC10958905 DOI: 10.1186/s12913-024-10689-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/06/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Perceived care quality and patient satisfaction have been important care quality indicators in recent decades, and healthcare professionals have been influential on women's childbirth experience. This study investigated the measurement properties of the Persian version of the Pregnancy and Childbirth Questionnaire (PCQ), designed to measure mothers' satisfaction with the quality of healthcare services provided during pregnancy and childbirth. METHODS This is a cross-sectional methodological study. Instrument translation, face validity, content validity, structural validity, and reliability evaluation were performed to determine the measurement properties of the PCQ's Persian version. A backward-forward approach was employed for the translation process. Impact scores were selected based on the items' importance to measure face validity. Content validity index (CVI) and content validity ratio (CVR) were calculated to measure content validity, and exploratory and confirmatory factor analyses were used to measure structural validity. The cluster random sampling method was used, resulting in a sample of 250 eligible women referred to the health centers of Tabriz, Iran, who were 4 to 6 weeks after giving birth. Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC) using a test-retest approach were used to determine the questionnaire's reliability. RESULTS The impact scores of all items were above 1.5, which indicates a suitable face validity. The content validity was also favorable (CVR = 0.95, CVI = 0.90). Exploratory factor analysis on 25 items led to the removal of item 2 due to a factor loading of less than 0.3 and the extraction of three factors explaining 65.07% of the variances. The results of the sample adequacy size were significant (< 0.001, and Kaiser-Meyer-Olkin = 0.886). The model's validity was confirmed based on the confirmatory factor analysis fit indicators (i.e., RMSEA = 0.08, SRMR = 0.09, TLI = 0.91, CFI = 0.93, x2/df = 4.65). The tool's reliability was also confirmed (Cronbach's alpha = 0.88, and ICC (95% CI) = 0.93 (0.88 to 0.95)). CONCLUSION The validity and reliability of the PCQ's Persian version were suitable to measure the extent to which Iranian women are satisfied with the quality of prenatal and intrapartum care.
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Affiliation(s)
- Somayeh Abdolalipour
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Shamsi Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fatemeh Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts School of Medicine, Boston, USA
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, 3144, Melbourne, VIC, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 3800, Melbourne, VIC, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kosar Abdollahi
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvadsnd
- Social determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, IR, Iran.
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Bull C, Carrandi A, Slavin V, Teede H, Callander EJ. Development, woman-centricity and psychometric properties of maternity patient-reported experience measures: a systematic review. Am J Obstet Gynecol MFM 2023; 5:101102. [PMID: 37517609 DOI: 10.1016/j.ajogmf.2023.101102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Valid and reliable maternity patient-reported experience measures are critical to understanding women's experiences of care. They can support clinical practice, health service and system performance measurement, and research. The aim of this review is to identify and critically appraise the risk of bias, woman-centricity (content validity), and psychometric properties of maternity patient-reported experience measures published in the scientific literature. DATA SOURCES MEDLINE, CINAHL Plus, PsycINFO, and Embase were systematically searched for relevant records between January 1, 2010 and July 10, 2021. STUDY ELIGIBILITY CRITERIA We searched for articles describing the instrument development of maternity patient-reported experience measures and measurement properties associated with instrument validity and reliability testing. Articles that described patient-reported experience measures developed outside of the maternity context and articles that did not contribute to the instruments' development, content validation, and/or psychometric evaluation were excluded. METHODS Included articles underwent risk of bias, content validity, and psychometric properties assessments in line with the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) guidance. Patient-reported experience measure results were summarized according to language subgroups. An overall recommendation for use was determined for each patient-reported experience measure language subgroup. RESULTS A total of 54 studies reported on the development and psychometric evaluation of 25 maternity patient-reported experience measures, grouped into 45 language subgroups. The quality of evidence underpinning the instruments' development was generally poor. Only 2 (4.4%) patient-reported experience measures reported sufficient content validity, and only 1 (2.2%) received a level "A" recommendation, required for real-world use. CONCLUSION Maternity patient-reported experience measures demonstrated poor-quality evidence for their measurement properties and insufficient detail about content validity. Future maternity patient-reported experience measure development needs to prioritize women's involvement in deciding what is relevant, comprehensive, and comprehensible to measure. Improving the content validity of maternity patient-reported experience measures will improve overall validity and reliability and facilitate real-world practice improvements. Standardized patient-reported experience measure implementation also needs to be prioritized to support advancements in clinical practice for women.
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Affiliation(s)
- Claudia Bull
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander).
| | - Alayna Carrandi
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander)
| | - Valerie Slavin
- Women-Newborn-Children's Services, Gold Coast Health, Southport, Australia (Dr Slavin)
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander)
| | - Emily J Callander
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander)
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Klootwijk A, Bakx P, Franx A, Bijma H, Ernst-Smelt H, Lamain-de Ruiter M, Posthumus A, van Rijn B. Patient-reported outcome and experience measures for quality improvement in pregnancy and childbirth care: a retrospective cohort study. BMJ Open Qual 2023; 12:bmjoq-2022-001922. [PMID: 36889814 PMCID: PMC10008327 DOI: 10.1136/bmjoq-2022-001922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 01/11/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) can highlight issues that remain unnoticed when using standard clinical quality indicators. However, estimations of the potential power of measuring PROMs and PREMs to identify unrecognised areas suitable for quality improvement are often limited by a lack of reliable real-world data. Here, we report on how the indicator set for PROMs and PREMs that was recently developed by the International Consortium for Health Outcome Measures can change perspectives on quality assessment in women receiving care for pregnancy and childbirth. METHODS PROMs and PREMs were captured 6 months after childbirth via an online survey in a single academic maternity unit in the Netherlands between 2018 and 2019. Indicators of abnormality were scored using predefined cut-off values established by a national consensus group. We used regression analysis to identify associations between PROMs, PREMs and healthcare use, and further stratified data to explore the distribution of indicators among relevant patient subgroups. RESULTS Of 2775 questionnaires, 645 were completed and linked to medical health records. Despite only 5% of women reporting overall dissatisfaction with care, suboptimal scores were often found; in birth experience for 32% of the population, and 42% who experienced painful sexual intercourse. Subgroup analysis further revealed associations with relevant indicators of quality of care; inadequate pain relief among women with preterm birth (OR 8.8), pain with sexual intercourse among women undergoing vaginal assisted delivery (OR 2.2) and women living in a deprived area had problematic birth experiences (coefficient -3.2). CONCLUSION Use of PROMs and PREMs in pregnancy and childbirth care provides new insights on quality of care, resulting in potentially actionable targets for improvement not normally identified with standard clinical quality indicators. Implementation strategies and follow-up are needed to act on these findings.
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Affiliation(s)
- Anouk Klootwijk
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Pieter Bakx
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hilmar Bijma
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hiske Ernst-Smelt
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marije Lamain-de Ruiter
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anke Posthumus
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bas van Rijn
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Vogels-Broeke M, Cellissen E, Daemers D, Budé L, de Vries R, Nieuwenhuijze M. Women's decision-making autonomy in Dutch maternity care. Birth 2022; 50:384-395. [PMID: 35977033 DOI: 10.1111/birt.12674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/15/2022] [Accepted: 07/30/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND A positive childbirth experience is an important outcome of maternity care. A significant component of a positive birth experience is the ability to exercise autonomy in decision-making. In this study, we explore women's reports of their autonomy during conversations about their care with maternity care practitioners during pregnancy and childbirth. METHOD Data were obtained from a cross-sectional survey of women living in The Netherlands that asked about their experiences during pregnancy and childbirth, including their role in conversations concerning decisions about their care. RESULTS A total of 3494 women were included in this study. Most women scored high on autonomy in decision-making conversations. During the latter stage of pregnancy (32+ weeks) and in childbirth, women reported significantly lower levels of autonomy in their care conversations with obstetricians as compared with midwives. Linear regression analyses showed that women's perception of personal treatment increased women's reported autonomy in their conversations with both midwives and obstetricians. Almost half (49.1%) of the women who had at least one intervention during birth reported pressure to accept or submit to that intervention. This was indicated by 48.3% of women with induced labor, 47.3% who had an instrumental vaginal birth, 45.2% whose labor was augmented, and 41.9% of women who had a cesarean birth. CONCLUSIONS In general, women's sense of autonomy in decision-making conversations during prenatal care and birth is high, but there is room for improvement, and this appeared most notably in conversations with obstetricians. Women's sense of autonomy can be enhanced with personal treatment, including shared decision-making and the avoidance of pressuring women to accept interventions.
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Affiliation(s)
- Maaike Vogels-Broeke
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Evelien Cellissen
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Darie Daemers
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Luc Budé
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Raymond de Vries
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Deherder E, Delbaere I, Macedo A, Nieuwenhuijze MJ, Van Laere S, Beeckman K. Women's view on shared decision making and autonomy in childbirth: cohort study of Belgian women. BMC Pregnancy Childbirth 2022; 22:551. [PMID: 35804308 PMCID: PMC9264300 DOI: 10.1186/s12884-022-04890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Health care providers have an important role to share evidence based information and empower patients to make informed choices. Previous studies indicate that shared decision making in pregnancy and childbirth may have an important impact on a woman’s birth experience. In Flemish social media, a large number of women expressed their concern about their birth experience, where they felt loss of control and limited possibilities to make their own choices. The aim of this study is to explore autonomy and shared decision making in the Flemish population. Methods This is a cross-sectional, non-interventional study to explore the birth experience of Flemish women. A self-assembled questionnaire was used to collect data, including the Pregnancy and Childbirth Questionnaire (PCQ), the Labor Agentry Scale (LAS), the Mothers Autonomy Decision Making Scale (MADM), the 9-item Shared Decision Making Questionnaire (SDM–Q9) and four questions on preparation for childbirth. Women who gave birth two to 12 months ago were recruited by means of social media in the Flemish area (Northern part of Belgium). Linear mixed-effect modelling with backwards variable selection was applied to examine relations with autonomy in decision making. Results In total, 1029 mothers participated in this study of which 617 filled out the survey completely. In general, mothers experienced moderate autonomy in decision-making, both with an obstetrician and with a midwife with an average on the MADM score of respectively 18.5 (± 7.2) and 29.4 (±10.4) out of 42. The linear mixed-effects model showed a relationship between autonomy in decision-making (MADM) for the type of healthcare provider (p < 0.001), the level of self-control during labour and birth (LAS) (p = 0.003), the level of perceived quality of care (PCQ) (p < 0.001), having epidural analgesia during childbirth (p = 0.026) and feeling to have received sufficient information about the normal course of childbirth (p < 0.001). Conclusions Childbearing women in Flanders experience moderate levels of autonomy in decision- making with their health care providers, where lower autonomy was observed for obstetricians compared to midwives. Future research should focus more on why differences occur between obstetrics and midwives in terms of autonomy and shared decision-making as perceived by the mother.
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Affiliation(s)
- Elke Deherder
- VIVES University of Applied Sciences, Doorniksesteenweg 145, 8500, Kortrijk, Belgium.
| | - Ilse Delbaere
- VIVES University of Applied Sciences, Doorniksesteenweg 145, 8500, Kortrijk, Belgium
| | - Adriana Macedo
- Student master management and policy of health care, department of Public Health and Nursing and Midwifery Unit, Vrije Universiteit Brussel, UZ Brussel, Brussels, Belgium
| | - Marianne J Nieuwenhuijze
- Research Centre for Midwifery Science Maastricht, Zuyd University / CAPHRI, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, the Netherlands
| | - Sven Van Laere
- Vrije Universiteit Brussel, Interfaculty Center Data processing & Statistics, Laarbeeklaan, 103, Brussels, Belgium
| | - Katrien Beeckman
- Vrije Universiteit Brussel, Universitair ziekenhuis Brussel (UZ Brussel), Faculty of Medicine and Pharmacy, Public Health, Nursing and Midwifery Research Unit, Laarbeeklaan 101, 1090, Brussels, Belgium.,Verpleeg- en vroedkunde, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking (MIDREP), Universiteit Antwerpen, Antwerpen, Belgium
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Lemmens SMP, van Montfort P, Meertens LJE, Spaanderman MEA, Smits LJM, de Vries RG, Scheepers HCJ. Perinatal factors related to pregnancy and childbirth satisfaction: a prospective cohort study. J Psychosom Obstet Gynaecol 2021; 42:181-189. [PMID: 31913725 DOI: 10.1080/0167482x.2019.1708894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Satisfaction of pregnancy and childbirth is an important quality measure of maternity care. Satisfaction questionnaires generally result in high scores. However, it has been argued that dissatisfaction relies on a different construct. In response to a worldwide call for obstetric care that is more woman-centered, we identified and described the contributors to suboptimal satisfaction with pregnancy and childbirth. METHODS A prospective subcohort of 739 women from a larger cohort (Expect Study I, n = 2614) received a pregnancy and childbirth satisfaction questionnaire. Scores were transformed to a binary outcome whereby a score <100 points corresponded with less satisfied women. We performed a multiple logistic regression analysis to define independent perinatal factors related to suboptimal satisfaction. RESULTS Decreased perceived personal well-being, antenatal anxiety, and obstetrician-led care during labor were all independently associated with suboptimal pregnancy and childbirth satisfaction. No difference in satisfaction was found between antenatal care led by a midwife or an obstetrician, but midwife-led antenatal care reduced the odds of suboptimal satisfaction compared to women who were transferred to an obstetrician in the antenatal period. Antenatal anxiety was experienced by 25% of all women and is associated with decreased satisfaction scores. DISCUSSION Screening and treatment of women suffering from anxiety might improve pregnancy and childbirth satisfaction, but further research is necessary. Women's birthing experience may improve by reducing unnecessary secondary obstetric care.
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Affiliation(s)
- Stéphanie M P Lemmens
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Pim van Montfort
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Linda J E Meertens
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Luc J M Smits
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Raymond G de Vries
- Research Center for Midwifery Science Maastricht, Zuyd University, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Hubertina C J Scheepers
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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10
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de Wolff MG, Midtgaard J, Johansen M, Rom AL, Rosthøj S, Tabor A, Hegaard HK. Effects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157875. [PMID: 34360168 PMCID: PMC8345548 DOI: 10.3390/ijerph18157875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/30/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022]
Abstract
The proportion of childbearing women with pre-existing chronic medical conditions (CMC) is rising. In a randomized controlled trial, we aimed to evaluate the effects of a midwife-coordinated maternity care intervention (ChroPreg) in pregnant women with CMC. The intervention consisted of three main components: (1) Midwife-coordinated and individualized care, (2) Additional ante-and postpartum consultations, and (3) Specialized known midwives. The primary outcome was the total length of hospital stay (LOS). Secondary outcomes were patient-reported outcomes measuring psychological well-being and satisfaction with maternity care, health utilization, and maternal and infant outcomes. A total of 362 women were randomized to the ChroPreg intervention (n = 131) or Standard Care (n = 131). No differences in LOS were found between groups (median 3.0 days, ChroPreg group 0.1% lower LOS, 95% CI −7.8 to 7%, p = 0.97). Women in the ChroPreg group reported being more satisfied with maternity care measured by the Pregnancy and Childbirth Questionnaire (PCQ) compared with the Standard Care group (mean PCQ 104.5 vs. 98.2, mean difference 6.3, 95% CI 3.0–10.0, p < 0.0001). In conclusion, the ChroPreg intervention did not reduce LOS. However, women in the ChroPreg group were more satisfied with maternity care.
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Affiliation(s)
- Mie G. de Wolff
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.J.); (A.L.R.); (H.K.H.)
- The Research Unit for Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark;
- Correspondence: ; Tel.: +45-23306414
| | - Julie Midtgaard
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark;
- Mental Health Centre Glostrup, University of Copenhagen, 2600 Glostrup, Denmark
| | - Marianne Johansen
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.J.); (A.L.R.); (H.K.H.)
- Unit for Pregnancy and Heart Disease, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Ane L. Rom
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.J.); (A.L.R.); (H.K.H.)
- The Research Unit for Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark
| | - Susanne Rosthøj
- Section of Biostatistics, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark;
| | - Ann Tabor
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Hanne K. Hegaard
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.J.); (A.L.R.); (H.K.H.)
- The Research Unit for Women’s and Children’s Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark;
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11
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Peters M, Kolip P, Schäfers R. A questionnaire to measure the quality of midwifery care in the postpartum period from women's point of view: development and psychometric testing of MMAYpostpartum. BMC Pregnancy Childbirth 2021; 21:412. [PMID: 34078295 PMCID: PMC8171045 DOI: 10.1186/s12884-021-03857-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/05/2021] [Indexed: 12/05/2022] Open
Abstract
Background Home postpartum care is a major part of midwifery care in Germany. The user perspective plays an increasingly important role in the evaluation of health services, but there is a lack of valid and theoretically based measuring instruments, especially in midwifery care. The aim of this study was to develop and validate an instrument for measuring quality of midwifery care in the postpartum period from the perspective of women. Methods The following steps were taken to achieve this: (1) definition of the goals of midwifery work; (2) literature-based item development; (3) item selection based on a pre-test (n = 16); (4) item reduction and investigation of factor structure by means of explorative factor analysis (EFA; n = 133);(5) second EFA (n = 741) and confirmatory factor analysis (CFA; n = 744) based on a split representative sample survey; (6) hypothesis-based testing of correlations to sociodemographic characteristics of women and to characteristics of care. Results Measurement of Midwifery quality postpartum (MMAYpostpartum) consists of three scales with a total of 17 items which were found to have acceptable internal consistency: Personal Control (Cronbach’s alpha = .80), Trusting Relationship (Cronbach’s alpha = .87) and Orientation and Security (Cronbach’s alpha = .78). CFA verified and confirmed three factors: CFI = .928, TLI = .914, RMSEA = 0.073. Conclusion MMAYpostpartum is a predominantly valid, reliable short tool for evaluating the quality of midwifery care postpartum. It can be used to evaluate midwifery care, to compare different care models and in intervention research. It thus supports the orientation of midwives’ work towards the needs of women and their families.
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Affiliation(s)
- Mirjam Peters
- Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany. .,Department of Applied Sciences, The Hochschule für Gesundheit, University of Applied Sciences (hsg), Bochum, Germany.
| | - Petra Kolip
- Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Rainhild Schäfers
- Department of Applied Sciences, The Hochschule für Gesundheit, University of Applied Sciences (hsg), Bochum, Germany
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12
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Lempersz C, van der Hout-van der Jagt MB, Manders N, Backx N, van Laar JOEH, Oei SG. User evaluation of real-time CTG home monitoring: A pilot study. Eur J Obstet Gynecol Reprod Biol 2021; 258:473-474. [PMID: 33531188 DOI: 10.1016/j.ejogrb.2021.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Carlijn Lempersz
- Máxima Medical Centre, Department of Obstetrics and Gynaecology, Veldhoven, the Netherlands.
| | - M Beatrijs van der Hout-van der Jagt
- Máxima Medical Centre, Department of Obstetrics and Gynaecology, Veldhoven, the Netherlands; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands
| | | | | | - Judith O E H van Laar
- Máxima Medical Centre, Department of Obstetrics and Gynaecology, Veldhoven, the Netherlands
| | - S Guid Oei
- Máxima Medical Centre, Department of Obstetrics and Gynaecology, Veldhoven, the Netherlands; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands
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13
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Witteveen AB, Henrichs J, Walker AL, Bohlmeijer ET, Burger H, Fontein-Kuipers Y, Schellevis FG, Stramrood CAI, Olff M, Verhoeven CJ, de Jonge A. Effectiveness of a guided ACT-based self-help resilience training for depressive symptoms during pregnancy: Study protocol of a randomized controlled trial embedded in a prospective cohort. BMC Pregnancy Childbirth 2020; 20:705. [PMID: 33213400 PMCID: PMC7676420 DOI: 10.1186/s12884-020-03395-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/04/2020] [Indexed: 01/30/2023] Open
Abstract
Background During pregnancy, about 10 to 20% of women experience depressive symptoms. Subclinical depression increases the risk of peripartum depression, maternal neuro-endocrine dysregulations, and adverse birth and infant outcomes. Current treatments often comprise face-to-face psychological or pharmacological treatments that may be too intensive for women with subclinical depression leading to drop-out and moderate effectiveness. Therefore, easily accessible, resilience enhancing and less stigmatizing interventions are needed to prevent the development of clinical depression. This paper describes the protocol of a prospective cohort study with an embedded randomized controlled trial (RCT) that aims to improve mental resilience in a sample of pregnant women through a self-help program based on the principles of Acceptance and Commitment Therapy (ACT). Maternal and offspring correlates of the trajectories of peripartum depressive symptoms will also be studied. Methods Pregnant women (≥ 18 years) receiving care in Dutch midwifery practices will participate in a prospective cohort study (n ~ 3500). Between 12 and 18 weeks of pregnancy, all women will be screened for depression with the Edinburgh Postnatal Depression Scale (EPDS). Women with an EPDS score ≥ 11 will be evaluated with a structured clinical interview. Participants with subclinical depression (n = 290) will be randomized to a 9-week guided self-help ACT-training or to care as usual (CAU). Primary outcomes (depressive symptoms and resilience) and secondary outcomes (e.g. anxiety and PTSD, bonding, infant development) will be collected via online questionnaires at four prospective assessments around 20 weeks and 30 weeks gestation and at 6 weeks and 4 months postpartum. Maternal hair cortisol concentrations will be assessed in a subsample of women with a range of depressive symptoms (n = 300). The intervention’s feasibility will be assessed through qualitative interviews in a subsample of participants (n = 20). Discussion This is the first study to assess the effectiveness of an easy to administer intervention strategy to prevent adverse mental health effects through enhancing resilience in pregnant women with antepartum depressive symptomatology. This longitudinal study will provide insights into trajectories of peripartum depressive symptoms in relation to resilience, maternal cortisol, psychological outcomes, and infant developmental milestones. Trial registration Netherlands Trial Register (NTR), NL7499. Registered 5 February 2019.
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Affiliation(s)
- Anke B Witteveen
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Jens Henrichs
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Annika L Walker
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology , University of Twente , Drienerlolaan 5, 7522 NB, Enschede, Netherlands
| | - Huibert Burger
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Hanzeplein 1, Groningen, 9713GZ, Netherlands
| | - Yvonne Fontein-Kuipers
- Institute for Healthcare - School of Midwifery , Rotterdam University of Applied Sciences , Rochussenstraat 198, 3015 EK, Rotterdam, Netherlands
| | - Francois G Schellevis
- Department of General Practice , Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Public Health Research Institute , Van der Boechorststraat 7, 1081 BT, Amsterdam, Netherlands.,NIVEL Netherlands Institute for Health Services Research , Otterstraat 118, 3513 CR, Utrecht, Netherlands
| | - Claire A I Stramrood
- Department of Obstetrics and Gynaecology, OLVG, Oosterpark 9, 1091 AC, Amsterdam, Netherlands
| | - Miranda Olff
- Department of Psychiatry UMC, location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.,ARQ National Psychotrauma Centre , Nienoord 5, 1112 XE, Diemen, Netherlands
| | - Corine J Verhoeven
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Department of Obstetrics and Gynecology Maxima Medical Centre , Veldhoven, Netherlands.,Division of Midwifery School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Ank de Jonge
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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14
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Marques GM, Nascimento DZ, Trevisol DJ, Iser BP. Instruments measuring pregnant women’s expectations of labor and childbirth: A systematic review. Eur J Obstet Gynecol Reprod Biol 2020; 246:90-98. [DOI: 10.1016/j.ejogrb.2020.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/07/2020] [Accepted: 01/11/2020] [Indexed: 01/04/2023]
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15
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Noben L, Goossens SMTA, Truijens SEM, van Berckel MMG, Perquin CW, Slooter GD, van Rooijen SJ. A Virtual Reality Video to Improve Information Provision and Reduce Anxiety Before Cesarean Delivery: Randomized Controlled Trial. JMIR Ment Health 2019; 6:e15872. [PMID: 31850850 PMCID: PMC6939281 DOI: 10.2196/15872] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Anxiety levels before cesarean delivery (CD) can lead to a negative birth experience, which may influence several aspects of the woman's life in the long term. Improving preoperative information may lower preoperative anxiety and lead to a more positive birth experience. OBJECTIVE This study aimed to determine whether a virtual reality (VR) video in addition to standard preoperative information decreases anxiety levels before a planned CD. METHODS Women scheduled to undergo term elective CD were recruited from the outpatient clinic. They were randomized and stratified based on history of emergency CD (yes or no). All participants received standard preoperative information (folder leaflets and counseling by the obstetrician); the VR group additionally watched the VR video showing all aspects of CD such as the ward admission, operating theater, spinal analgesia, and moment of birth. The primary outcome measure was a change in score on the Visual Analogue Scale for Anxiety (ΔVAS-A) measured at admission for CD, compared with the baseline VAS-A score. RESULTS A total of 97 women were included for analysis. The baseline characteristics were similar in both groups, except for a significantly higher level of education in the control group. There was no significant decrease in the VAS-A score of the women in the VR group (n=49) compared with those in the control group (n=48; ΔVAS-A=1.0; P=.08; 95% CI -0.1 to 2.0). Subgroup analysis for the group of women with a history of emergency CD showed a trend toward decreased preoperative anxiety, despite the small sample size of this subgroup (n=17; P=.06). Of the 26 participants who provided completed questionnaires, 22 (85%) in the VR group reported feeling more prepared after seeing the VR video; of the 24 participants' partners who completed the questionnaires, 19 (79%) agreed with the participants. No discomfort or motion sickness was reported. CONCLUSIONS A VR video may help patients and their partners feel better prepared when planning a CD. This study showed that VR does not lead to a decrease in preoperative anxiety. However, subgroups such as women with a history of emergency CD may benefit from VR videos. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number (ISRCTN) 74794447; http://www.isrctn.com/ISRCTN74794447 (retrospectively registered).
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Affiliation(s)
- Lore Noben
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands.,Eindhoven MedTech Innovation Center, Eindhoven, Netherlands
| | - Simone Maria Theresia Anna Goossens
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands.,Eindhoven MedTech Innovation Center, Eindhoven, Netherlands
| | - Sophie Eva Marieke Truijens
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, Netherlands.,Eindhoven MedTech Innovation Center, Eindhoven, Netherlands
| | | | | | | | - Stefanus Johannes van Rooijen
- Department of Surgery, Máxima Medical Center, Veldhoven, Netherlands.,Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
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16
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de Wolff MG, Johansen M, Ersbøll AS, Rosthøj S, Brunsgaard A, Midtgaard J, Tabor A, Hegaard HK. Efficacy of a midwife-coordinated, individualized, and specialized maternity care intervention (ChroPreg) in addition to standard care in pregnant women with chronic disease: protocol for a parallel randomized controlled trial. Trials 2019; 20:291. [PMID: 31138296 PMCID: PMC6537398 DOI: 10.1186/s13063-019-3405-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/06/2019] [Indexed: 12/26/2022] Open
Abstract
Background and objectives The number of women of childbearing age with chronic diseases is rising. Evidence has shown that obstetric complications and poor psychological well-being are more prevalent among this group, in addition to these women reporting experiences of less than satisfactory care. More research is needed to investigate how to best meet the special needs of this group during pregnancy and postpartum. Previous research has shown that care coordination, continuity of care, woman-centered care, and specialized maternity care interventions delivered to women with high-risk pregnancies can improve patient-reported outcomes and pregnancy outcomes and be cost-effective. However, no previous trials have examined the efficacy and cost-effectiveness of such interventions among pregnant women with chronic diseases. This paper describes the protocol of a randomized controlled trial (RCT) of a midwife-coordinated, individualized and specialized maternity care intervention (ChroPreg) as an add-on to standard care for pregnant women with chronic diseases. Methods/design This two-arm parallel group RCT will be conducted from October 2018 through June 2020 at the Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark. Pregnant women with chronic diseases are invited to participate; women will be randomized and allocated 1:1 to the ChroPreg intervention plus standard care or standard care alone. The ChroPreg intervention consists of three main components: (1) coordinated and individualized care, (2) additional ante- and postpartum consultations, and (3) specialized midwives. The primary outcome is length of hospital stay during pregnancy and in the postpartum period, and secondary outcomes are psychological well-being (five-item World Health Organization Well-Being Index, Edinburgh Postnatal Depression Scale, Cambridge Worry Scale), health-related quality of life (12-Item Short Form Health Survey), patient satisfaction (Pregnancy and Childbirth Questionnaire), number of antenatal contacts, and pregnancy and delivery outcomes. Data are collected via patient-administered questionnaires and medical records. Discussion This trial is anticipated to contribute to the field of knowledge on which planning of improved antenatal, intra-, and postpartum care for women with chronic disease is founded. Trial registration ClinicalTrials.gov, NCT03511508. Registered April 27, 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3405-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mie Gaarskjaer de Wolff
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,Faculty of Health and Medical Science, Copenhagen University, Blegdamsvej 3, 2200, Copenhagen, Denmark.
| | - Marianne Johansen
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Center for Pregnancy and Heart Disease, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark
| | - Anne S Ersbøll
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Gynecology and Obstetrics, North Zealand Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark
| | - Susanne Rosthøj
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Entrance B, 2nd floor, Postbox 2099, DK-1014, Copenhagen, Denmark
| | - Anne Brunsgaard
- Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Julie Midtgaard
- The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, section 9701, Ryesgade 27, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Ann Tabor
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.,Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen N, Denmark
| | - Hanne Kristine Hegaard
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
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17
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Tocchioni V, Seghieri C, De Santis G, Nuti S. Socio-demographic determinants of women's satisfaction with prenatal and delivery care services in Italy. Int J Qual Health Care 2018; 30:594-601. [PMID: 29672762 PMCID: PMC6185688 DOI: 10.1093/intqhc/mzy078] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 03/07/2018] [Accepted: 03/29/2018] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the extent to which socio-demographic variables affect women's satisfaction regarding antenatal and perinatal care. DESIGN To take into account the role of the context in shaping women's satisfaction, we used multilevel models, with women at the lower level, and the health districts of residence, or the hospitals in which the delivery took place, at the higher level. SETTING Tuscany (Italy). PARTICIPANTS The study is based on a representative survey focused on the satisfaction and experience of 4598 new mothers who gave birth in one of the 25 hospitals in Tuscany (Italy) in 2012. MAIN OUTCOME MEASURES Women's overall satisfaction in the prenatal period and their overall satisfaction during hospitalization for delivery. RESULTS Regarding pregnancy, women's satisfaction increased with age, and was generally higher among foreign women coming from non-Western countries and among highly educated women. Regarding delivery, age proved insignificant, whereas citizenship and education maintained the same association with satisfaction. Contrary to our expectations, the number of previous pregnancies turned out to be insignificant. CONCLUSIONS Our findings suggest that the quality of maternity services was perceived differently in different socio-demographic groups: women's expectations affected satisfaction, but in different ways, in various socio-demographic groups, both during pregnancy and at delivery. Keeping these socio-demographic factors into account in the analysis of satisfaction may help organisations to identify areas where pregnancy and delivery services can be better targeted and where increasing awareness among professionals in their everyday practice is most needed.
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Affiliation(s)
- Valentina Tocchioni
- Department of Statistics, Informatics, Applications ‘G. Parenti’, University of Florence, Viale Morgagni 59, Florence, Italy
| | - Chiara Seghieri
- Management and Health Laboratory, Institute of Management, Scuola Superiore Sant’Anna, Piazza Martiri della Libertà 33, Pise, Italy
| | - Gustavo De Santis
- Department of Statistics, Informatics, Applications ‘G. Parenti’, University of Florence, Viale Morgagni 59, Florence, Italy
| | - Sabina Nuti
- Management and Health Laboratory, Institute of Management, Scuola Superiore Sant’Anna, Piazza Martiri della Libertà 33, Pise, Italy
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18
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van Montfort P, Willemse JP, Dirksen CD, van Dooren IM, Meertens LJ, Spaanderman ME, Zelis M, Zwaan IM, Scheepers HC, Smits LJ. Implementation and Effects of Risk-Dependent Obstetric Care in the Netherlands (Expect Study II): Protocol for an Impact Study. JMIR Res Protoc 2018; 7:e10066. [PMID: 29728345 PMCID: PMC5960040 DOI: 10.2196/10066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/28/2018] [Accepted: 04/04/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Recently, validated risk models predicting adverse obstetric outcomes combined with risk-dependent care paths have been made available for early antenatal care in the southeastern part of the Netherlands. This study will evaluate implementation progress and impact of the new approach in obstetric care. OBJECTIVE The objective of this paper is to describe the design of a study evaluating the impact of implementing risk-dependent care. Validated first-trimester prediction models are embedded in daily clinical practice and combined with risk-dependent obstetric care paths. METHODS A multicenter prospective cohort study consisting of women who receive risk-dependent care is being performed from April 2017 to April 2018 (Expect Study II). Obstetric risk profiles will be calculated using a Web-based tool, the Expect prediction tool. The primary outcomes are the adherence of health care professionals and compliance of women. Secondary outcomes are patient satisfaction and cost-effectiveness. Outcome measures will be established using Web-based questionnaires. The secondary outcomes of the risk-dependent care cohort (Expect II) will be compared with the outcomes of a similar prospective cohort (Expect I). Women of this similar cohort received former care-as-usual and were prospectively included between July 1, 2013 and December 31, 2015 (Expect I). RESULTS Currently, women are being recruited for the Expect Study II, and a total of 300 women are enrolled. CONCLUSIONS This study will provide information about the implementation and impact of a new approach in obstetric care using prediction models and risk-dependent obstetric care paths. TRIAL REGISTRATION Netherlands Trial Register NTR4143; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4143 (Archived by WebCite at http://www.webcitation.org/6t8ijtpd9).
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Affiliation(s)
- Pim van Montfort
- Care and Public Health Research Institute, Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Jessica Ppm Willemse
- Care and Public Health Research Institute, Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Carmen D Dirksen
- Care and Public Health Research Institute, Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Ivo Ma van Dooren
- Department of Obstetrics and Gynecology, Sint Jans Gasthuis Weert, Weert, Netherlands
| | - Linda Je Meertens
- Care and Public Health Research Institute, Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Marc Ea Spaanderman
- School for Oncology and Developmental Biology, Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Maartje Zelis
- Department of Obstetrics and Gynecology, Zuyderland Medical Centre, Heerlen, Netherlands
| | - Iris M Zwaan
- Department of Obstetrics and Gynecology, Laurentius Hospital, Roermond, Netherlands
| | - Hubertina Cj Scheepers
- School for Oncology and Developmental Biology, Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Luc Jm Smits
- Care and Public Health Research Institute, Department of Epidemiology, Maastricht University, Maastricht, Netherlands
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Jeong GH, Kim HK, Kim YH, Kim SH, Lee SH, Kim KW. [Development of an Instrument to Assess the Quality of Childbirth Care from the Mother's Perspective]. J Korean Acad Nurs 2018. [PMID: 29535283 DOI: 10.4040/jkan.2018.48.1.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery. METHODS The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients. RESULTS The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, p<.001). The internal consistency reliability was acceptable (Cronbach's alpha =.96). CONCLUSION This instrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery.
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Affiliation(s)
- Geum Hee Jeong
- Division of Nursing, Hallym University, Chuncheon, Korea
| | - Hyun Kyoung Kim
- Department of Nursing, Korea Christian University, Seoul, Korea.
| | - Young Hee Kim
- Department of Nursing, Dongguk University, Gyeongju, Korea
| | - Sun Hee Kim
- College of Nursing, Daegu Catholic University, Daegu, Korea
| | - Sun Hee Lee
- Department of Nursing Science, Gimcheon University, Gimcheon, Korea
| | - Kyung Won Kim
- Department of Nursing, Daegu Haany University, Daegu, Korea
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van Stenus CMV, Boere-Boonekamp MM, Kerkhof EFGM, Need A. Client experiences with perinatal healthcare for high-risk and low-risk women. Women Birth 2018; 31:e380-e388. [PMID: 29395696 DOI: 10.1016/j.wombi.2018.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/27/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
PROBLEM It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. BACKGROUND In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of complications can cause elevated levels of emotional distress. AIM The purpose of this study is to describe client experiences with perinatal healthcare and to determine which, if any, background characteristics, pregnancy circumstances, childbirth or follow-up care characteristics are explaining variables of differences in client experiences between high-risk and low-risk women. METHODS Client experiences were measured with a validated questionnaire completed by 1388 women within 12 weeks after childbirth. FINDINGS Women rated their experiences with perinatal healthcare with a mean score of 3.78 on a scale of 1-4; 5.5% of the women rated their experiences as "notably bad". Client experiences with perinatal healthcare show small variations, with a lower mean score for women who were at high risk (3.75) compared to low-risk women (3.84). This difference is partially due to more unplanned medical interventions and pain relief during childbirth in the high-risk group. Also, single mothers and non-Dutch women were more susceptible to less positive experiences. CONCLUSION Given the potential negative impact of adverse client experiences, this study highlights the need for healthcare professionals to be aware of what women are susceptible for having had negative experiences. It is advised that healthcare provision be altered to tailor to the needs of these women.
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Affiliation(s)
- Cherelle M V van Stenus
- Institute for Innovation and Governance Studies, Departments of Public Administration and Health Technology & Services Research, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | - Magda M Boere-Boonekamp
- Institute for Innovation and Governance Studies, Department of Health Technology & Services Research, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | | | - Ariana Need
- Institute for Innovation and Governance Studies, Department of Public Administration, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
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Perdok H, Verhoeven CJ, van Dillen J, Schuitmaker TJ, Hoogendoorn K, Colli J, Schellevis FG, de Jonge A. Continuity of care is an important and distinct aspect of childbirth experience: findings of a survey evaluating experienced continuity of care, experienced quality of care and women's perception of labor. BMC Pregnancy Childbirth 2018; 18:13. [PMID: 29310627 PMCID: PMC5759271 DOI: 10.1186/s12884-017-1615-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 12/07/2017] [Indexed: 11/10/2022] Open
Abstract
Background To compare experienced continuity of care among women who received midwife-led versus obstetrician-led care. Secondly, to compare experienced continuity of care with a. experienced quality of care during labor and b. perception of labor. Methods We conducted a questionnaire survey in a region in the Netherlands in 2014 among 790 women after they gave birth. To measure experienced continuity of care, the Nijmegen Continuity Questionnaire was used. Quality of care during labor was measured with the Pregnancy and Childbirth Questionnaire, and to measure perception of labor we used the Childbirth Perception Scale. Results Three hundred twenty five women consented to participate (41%). Of these, 187 women completed the relevant questions in the online questionnaire. 136 (73%) women were in midwife-led care at the onset of labor, 15 (8%) were in obstetrician-led care throughout pregnancy and 36 (19%) were referred to obstetrician-led care during pregnancy. Experienced personal and team continuity of care during pregnancy were higher for women in midwife-led care compared to those in obstetrician-led care at the onset of labor. Experienced continuity of care was moderately correlated with experienced quality of care although not significantly so in all subgroups. A weak negative correlation was found between experienced personal continuity of care by the midwife and perception of labor. Conclusion This study suggests that experienced continuity of care depends on the care context and is significantly higher for women who are in midwife-led compared to obstetrician-led care during labor. It will be a challenge to maintain the high level of experienced continuity of care in an integrated maternity care system. Experienced continuity of care seems to be a distinctive concept that should not be confused with experienced quality of care or perception of labor and should be considered as a complementary aspect of quality of care. Electronic supplementary material The online version of this article (10.1186/s12884-017-1615-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hilde Perdok
- Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands and at Catharina Hospital, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Corine J Verhoeven
- Department of Midwifery Science, AVAG and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands and at Maxima Medical Center, Veldhoven, The Netherlands
| | - Jeroen van Dillen
- Department of Obstetrics and Gynaecology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Tjerk Jan Schuitmaker
- Faculty of Earth & Life Sciences, Athena Institute, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Jolanda Colli
- Midwifery practice Oestgeest, The Netherlands and Co-operation of Midwives Leiden area (Cooperatie LEO), Leiden, The Netherlands
| | - François G Schellevis
- Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands and Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Ank de Jonge
- Department of Midwifery Science, Midwifery Academy Amsterdam/Groningen (AVAG) and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands and at Catharina Hospital, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
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Meertens LJE, Scheepers HC, De Vries RG, Dirksen CD, Korstjens I, Mulder AL, Nieuwenhuijze MJ, Nijhuis JG, Spaanderman ME, Smits LJ. External Validation Study of First Trimester Obstetric Prediction Models (Expect Study I): Research Protocol and Population Characteristics. JMIR Res Protoc 2017; 6:e203. [PMID: 29074472 PMCID: PMC5680517 DOI: 10.2196/resprot.7837] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A number of first-trimester prediction models addressing important obstetric outcomes have been published. However, most models have not been externally validated. External validation is essential before implementing a prediction model in clinical practice. OBJECTIVE The objective of this paper is to describe the design of a study to externally validate existing first trimester obstetric prediction models, based upon maternal characteristics and standard measurements (eg, blood pressure), for the risk of pre-eclampsia (PE), gestational diabetes mellitus (GDM), spontaneous preterm birth (PTB), small-for-gestational-age (SGA) infants, and large-for-gestational-age (LGA) infants among Dutch pregnant women (Expect Study I). The results of a pilot study on the feasibility and acceptability of the recruitment process and the comprehensibility of the Pregnancy Questionnaire 1 are also reported. METHODS A multicenter prospective cohort study was performed in The Netherlands between July 1, 2013 and December 31, 2015. First trimester obstetric prediction models were systematically selected from the literature. Predictor variables were measured by the Web-based Pregnancy Questionnaire 1 and pregnancy outcomes were established using the Postpartum Questionnaire 1 and medical records. Information about maternal health-related quality of life, costs, and satisfaction with Dutch obstetric care was collected from a subsample of women. A pilot study was carried out before the official start of inclusion. External validity of the models will be evaluated by assessing discrimination and calibration. RESULTS Based on the pilot study, minor improvements were made to the recruitment process and online Pregnancy Questionnaire 1. The validation cohort consists of 2614 women. Data analysis of the external validation study is in progress. CONCLUSIONS This study will offer insight into the generalizability of existing, non-invasive first trimester prediction models for various obstetric outcomes in a Dutch obstetric population. An impact study for the evaluation of the best obstetric prediction models in the Dutch setting with respect to their effect on clinical outcomes, costs, and quality of life-Expect Study II-is being planned. TRIAL REGISTRATION Netherlands Trial Registry (NTR): NTR4143; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4143 (Archived by WebCite at http://www.webcitation.org/6t8ijtpd9).
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Affiliation(s)
| | - Hubertina Cj Scheepers
- School for Oncology and Developmental Biology (GROW), Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Raymond G De Vries
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.,Research Centre for Midwifery Science, Faculty of Health, Zuyd University, Maastricht, Netherlands
| | - Carmen D Dirksen
- Care and Public Health Research Institute (CAPHRI), Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Irene Korstjens
- Research Centre for Midwifery Science, Faculty of Health, Zuyd University, Maastricht, Netherlands
| | - Antonius Lm Mulder
- School for Oncology and Developmental Biology (GROW), Department of Pediatrics, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Marianne J Nieuwenhuijze
- Research Centre for Midwifery Science, Faculty of Health, Zuyd University, Maastricht, Netherlands
| | - Jan G Nijhuis
- School for Oncology and Developmental Biology (GROW), Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Marc Ea Spaanderman
- School for Oncology and Developmental Biology (GROW), Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Luc Jm Smits
- Care and Public Health Research Institute (CAPHRI), Department of Epidemiology, Maastricht University, Maastricht, Netherlands
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Development of a questionnaire for assessing the childbirth experience (QACE). BMC Pregnancy Childbirth 2017; 17:279. [PMID: 28854894 PMCID: PMC5577741 DOI: 10.1186/s12884-017-1462-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 08/21/2017] [Indexed: 11/13/2022] Open
Abstract
Background Due to its potential impact on women’s psychological health, assessing perceptions of their childbirth experience is important. The aim of this study was to develop a multidimensional self-reporting questionnaire to evaluate the childbirth experience. Methods Factors influencing the childbirth experience were identified from a literature review and the results of a previous qualitative study. A total of 25 items were combined from existing instruments or were created de novo. A draft version was pilot tested for face validity with 30 women and submitted for evaluation of its construct validity to 477 primiparous women at one-month post-partum. The recruitment took place in two obstetric clinics from Swiss and French university hospitals. To evaluate the content validity, we compared item responses to general childbirth experience assessments on a numeric, 0 to 10 rating scale. We dichotomized two group assessment scores: “0 to 7” and “8 to 10”. We performed an exploratory factor analysis to identify underlying dimensions. Results In total, 291 women completed the questionnaire (response rate = 61%). The responses to 22 items were statistically significant between the 0 to 7 and 8 to 10 groups for the general childbirth experience assessments. An exploratory factor analysis yielded four sub-scales, which were labelled “relationship with staff” (4 items), “emotional status” (3 items), “first moments with the new born,” (3 items) and “feelings at one month postpartum” (3 items). All 4 scales had satisfactory internal consistency levels (alpha coefficients from 0.70 to 0.85). The full 25-item version can be used to analyse each item by itself, and the short 4-dimension version can be scored to summarize the general assessment of the childbirth experience. Conclusions The Questionnaire for Assessing the Childbirth Experience (QACE) could be useful as a screening instrument to identify women with negative childbirth experiences. It can be used as both a research instrument in its short version and a questionnaire for use in clinical practice in its full version. Electronic supplementary material The online version of this article (10.1186/s12884-017-1462-x) contains supplementary material, which is available to authorized users.
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Nilvér H, Begley C, Berg M. Measuring women's childbirth experiences: a systematic review for identification and analysis of validated instruments. BMC Pregnancy Childbirth 2017; 17:203. [PMID: 28662645 PMCID: PMC5492707 DOI: 10.1186/s12884-017-1356-y] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/26/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Women's childbirth experience can have immediate as well as long-term positive or negative effects on their life, well-being and health. When evaluating and drawing conclusions from research results, women's experiences of childbirth should be one aspect to consider. Researchers and clinicians need help in finding and selecting the most suitable instrument for their purpose. The aim of this study was therefore to systematically identify and present validated instruments measuring women's childbirth experience. METHODS A systematic review was conducted in January 2016 with a comprehensive search in the bibliographic databases PubMed, CINAHL, Scopus, The Cochrane Library and PsycINFO. Included instruments measured women's childbirth experiences. Papers were assessed independently by two reviewers for inclusion, and quality assessment of included instruments was made by two reviewers independently and in pairs using Terwee et al's criteria for evaluation of psychometric properties. RESULTS In total 5189 citations were screened, of which 5106 were excluded by title and abstract. Eighty-three full-text papers were reviewed, and 37 papers were excluded, resulting in 46 included papers representing 36 instruments. These instruments demonstrated a wide range in purpose and content as well as in the quality of psychometric properties. CONCLUSIONS This systematic review provides an overview of existing instruments measuring women's childbirth experiences and can support researchers to identify appropriate instruments to be used, and maybe adapted, in their specific contexts and research purpose.
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Affiliation(s)
- Helena Nilvér
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Cecily Begley
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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Henrichs J, Verfaille V, Viester L, Westerneng M, Molewijk B, Franx A, van der Horst H, Bosmans JE, de Jonge A, Jellema P. Effectiveness and cost-effectiveness of routine third trimester ultrasound screening for intrauterine growth restriction: study protocol of a nationwide stepped wedge cluster-randomized trial in The Netherlands (The IRIS Study). BMC Pregnancy Childbirth 2016; 16:310. [PMID: 27737654 PMCID: PMC5064939 DOI: 10.1186/s12884-016-1104-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 10/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management. Methods For this trial, 15,000 women with a singleton pregnancy receiving care in 60 participating primary care midwifery practices will be included at 22 weeks of gestation. In the intervention (n = 7,500) and control group (n = 7,500) fetal growth will be monitored by serial fundal height assessments. All practices will start offering the control condition (ultrasonography based on medical indication). Every three months, 20 practices will be randomized to the intervention condition, i.e. apart from ultrasonography if indicated, two routine ultrasound examinations will be performed (at 28–30 weeks and 34–36 weeks). If IUGR is suspected, both groups will receive subsequent clinical management as described in the IRIS study protocol that will be developed before the start of the trial. The primary dichotomous clinical composite outcome is ‘severe adverse perinatal outcome’ up to 7 days after birth, including: perinatal death; Apgar score <4 at 5 minutes after birth; impaired consciousness; need for assisted ventilation for more than 24 h; asphyxia; septicemia; meningitis; bronchopulmonary dysplasia; intraventricular hemorrhage; cystic periventricular leukomalacia; neonatal seizures or necrotizing enterocolitis. For the economic evaluation, costs will be measured from a societal perspective. Quality of life will be measured using the EQ-5D-5 L to enable calculation of QALYs. Cost-effectiveness and cost-utility analyses will be performed. In a qualitative sub-study (using diary notes from 32 women for 9 months, at least 10 individual interviews and 2 focus group studies) we will explore ethical considerations of additional ultrasonography and how to deal with them. Discussion The results of this trial will assist healthcare providers and policymakers in making an evidence-based decision about whether or not introducing routine third trimester ultrasonography. Trial registration NTR4367, 21 March 2014.
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Affiliation(s)
- Jens Henrichs
- Department of Midwifery Science, AVAG and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, A-511, 1081 BT, Amsterdam, The Netherlands. .,Department of Pediatrics, Emma Children's Hospital, Amsterdam Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Viki Verfaille
- Department of Midwifery Science, AVAG and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, A-511, 1081 BT, Amsterdam, The Netherlands
| | - Laura Viester
- Department of Midwifery Science, AVAG and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, A-511, 1081 BT, Amsterdam, The Netherlands
| | - Myrte Westerneng
- Department of Midwifery Science, AVAG and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, A-511, 1081 BT, Amsterdam, The Netherlands
| | - Bert Molewijk
- Department of Medical Humanities, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Arie Franx
- Department of Gynecology, Utrecht University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Henriette van der Horst
- Department of General Practice, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Ank de Jonge
- Department of Midwifery Science, AVAG and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, A-511, 1081 BT, Amsterdam, The Netherlands
| | - Petra Jellema
- Department of Pediatrics, Emma Children's Hospital, Amsterdam Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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A systematic review of the relationship factor between women and health professionals within the multivariant analysis of maternal satisfaction. Midwifery 2016; 41:68-78. [PMID: 27551856 DOI: 10.1016/j.midw.2016.08.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 07/17/2016] [Accepted: 08/05/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION personalised support provided to women by health professionals is one of the prime factors attaining women's satisfaction during pregnancy and childbirth. However the multifactorial nature of 'satisfaction' makes difficult to assess it. Statistical multivariate analysis may be an effective technique to obtain in depth quantitative evidence of the importance of this factor and its interaction with the other factors involved. This technique allows us to estimate the importance of overall satisfaction in its context and suggest actions for healthcare services. METHODS systematic review of studies that quantitatively measure the personal relationship between women and healthcare professionals (gynecologists, obstetricians, nurse, midwifes, etc.) regarding maternity care satisfaction. The literature search focused on studies carried out between 1970 and 2014 that used multivariate analyses and included the woman-caregiver relationship as a factor of their analysis. RESULTS twenty-four studies which applied various multivariate analysis tools to different periods of maternity care (antenatal, perinatal, post partum) were selected. The studies included discrete scale scores and questionnaires from women with low-risk pregnancies. The "personal relationship" factor appeared under various names: care received, personalised treatment, professional support, amongst others. The most common multivariate techniques used to assess the percentage of variance explained and the odds ratio of each factor were principal component analysis and logistic regression. DISCUSSION the data, variables and factor analysis suggest that continuous, personalised care provided by the usual midwife and delivered within a family or a specialised setting, generates the highest level of satisfaction. In addition, these factors foster the woman's psychological and physiological recovery, often surpassing clinical action (e.g. medicalization and hospital organization) and/or physiological determinants (e.g. pain, pathologies, etc.).
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Abstract
Purpose
– Achieving maternity-care outcomes that align with women’s needs, preferences and expectations is important but theoretically driven measures of women’s satisfaction with their entire maternity-care experience do not appear to exist. The purpose of this paper is to outline the development of an instrument to assess women’s perception of their entire maternity-care experience.
Design/methodology/approach
– A questionnaire was developed on the basis of previous research and informed by a framework of standard service quality categories covering the spectrum of typical consumer concerns. A pilot survey with a sample of 195 women who had recent experience of birth was undertaken to establish valid and reliable scales pertaining to different stages of maternity care. Exploratory factor analysis was used to interpret scales and convergent validity was assessed using a modified version of the Client Satisfaction Questionnaire.
Findings
– Nine theoretically informed, reliable and valid stand-alone scales measuring the achievement of different dimensions of women’s expectancies of public maternity care were developed. The study scales are intended for use in identifying some potential areas of focus for quality improvement in the delivery of maternity care.
Research limitations/implications
– Reliable and valid tools for monitoring the extent to which services respond to women’s expectations of their entire maternity care form part of the broader toolkit required to adequately manage health-care quality. This study offers guidance on the make-up of such tools.
Originality/value
– The scales produced from this research offer a means to assess maternity care across the full continuum of care and are brief and easy to use.
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Tancred T, Schellenberg J, Marchant T. Using mixed methods to evaluate perceived quality of care in southern Tanzania. Int J Qual Health Care 2016; 28:233-9. [PMID: 26823050 PMCID: PMC4833203 DOI: 10.1093/intqhc/mzw002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/09/2022] Open
Abstract
Objective To compare perceived quality of maternal and newborn care using quantitative and qualitative methods. Design A continuous household survey (April 2011 to November 2013) and in-depth interviews and birth narratives. Setting Tandahimba district, Tanzania. Participants Women aged 13–49 years who had a birth in the previous 2 years were interviewed in a household survey. Recently delivered mothers and their partners participated in in-depth interviews and birth narratives. Intervention None. Main Outcome Measures Perceived quality of care. Results Quantitative: 1138 women were surveyed and 93% were confident in staff availability and 61% felt that required drugs and equipment would be available. Drinking water was easily accessed by only 60% of respondents using hospitals. Measures of interaction with staff were very positive, but only 51% reported being given time to ask questions. Unexpected out-of-pocket payments were higher in hospitals (49%) and health centres (53%) than in dispensaries (31%). Qualitative data echoed the lack of confidence in facility readiness, out-of-pocket payments and difficulty accessing water, but was divergent in responses about interactions with health staff. More than half described staff interactions that were disrespectful, not polite, or not helpful. Conclusion Both methods produced broadly aligned results on perceived readiness, but divergent results on perceptions about client–staff interactions. Benefits and limitations to both quantitative and qualitative approaches were observed. Using mixed methodologies may prove particularly valuable in capturing the user experience of maternal and newborn health services, where they appear to be little used together.
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Affiliation(s)
- Tara Tancred
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Tanya Marchant
- London School of Hygiene and Tropical Medicine, London, UK
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The Effect of Multiprofessional Simulation-Based Obstetric Team Training on Patient-Reported Quality of Care. Simul Healthc 2015. [DOI: 10.1097/sih.0000000000000099] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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van der Kooy J, Valentine NB, Birnie E, Vujkovic M, de Graaf JP, Denktaş S, Steegers EAP, Bonsel GJ. Validity of a questionnaire measuring the world health organization concept of health system responsiveness with respect to perinatal services in the Dutch obstetric care system. BMC Health Serv Res 2014; 14:622. [PMID: 25465053 PMCID: PMC4265356 DOI: 10.1186/s12913-014-0622-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 11/19/2014] [Indexed: 12/16/2022] Open
Abstract
Background The concept of responsiveness, introduced by the World Health Organization (WHO), addresses non-clinical aspects of health service quality that are relevant regardless of provider, country, health system or health condition. Responsiveness refers to “aspects related to the way individuals are treated and the environment in which they are treated” during health system interactions. This paper assesses the psychometric properties of a newly developed responsiveness questionnaire dedicated to evaluating maternal experiences of perinatal care services, called the Responsiveness in Perinatal and Obstetric Health Care Questionnaire (ReproQ), using the eight-domain WHO concept. Methods The ReproQ was developed between October 2009 and February 2010 by adapting the WHO Responsiveness Questionnaire items to the perinatal care context. The psychometric properties of feasibility, construct validity, and discriminative validity were empirically assessed in a sample of Dutch women two weeks post partum. Results A total of 171 women consented to participation. Feasibility: the interviews lasted between 20 and 40 minutes and the overall missing rate was 8%. Construct validity: mean Cronbach’s alphas for the antenatal, birth and postpartum phase were: 0.73 (range 0.57-0.82), 0.84 (range 0.66-0.92), and 0.87 (range 0.62-0.95) respectively. The item-own scale correlations within all phases were considerably higher than most of the item-other scale correlations. Within the antenatal care, birth care and post partum phases, the eight factors explained 69%, 69%, and 76% of variance respectively. Discriminative validity: overall responsiveness mean sum scores were higher for women whose children were not admitted. This confirmed the hypothesis that dissatisfaction with health outcomes is transferred to their judgement on responsiveness of the perinatal services. Conclusions The ReproQ interview-based questionnaire demonstrated satisfactory psychometric properties to describe the quality of perinatal care in the Netherlands, with the potential to discriminate between different levels of quality of care. In view of the relatively small sample, further testing and research is recommended. Electronic supplementary material The online version of this article (doi:10.1186/s12913-014-0622-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jacoba van der Kooy
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Room Hs-408, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Nicole B Valentine
- World Health Organization, Social Determinants of Health - Public Health, Environmental and Social Determinants of Health, Family, Women's and Children's Health, Avenue Appia 20, Geneva, 1211, Switzerland. .,Department of Public Health, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Erwin Birnie
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Room Hs-408, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands. .,Institute of Health Policy and Management, Erasmus University Rotteram, PO Box 1738, Rotterdam, DR 3000, The Netherlands.
| | - Marijana Vujkovic
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Room Hs-408, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Johanna P de Graaf
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Room Hs-408, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Semiha Denktaş
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Room Hs-408, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Room Hs-408, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Gouke J Bonsel
- Department of Obstetrics and Gynaecology, Division of Obstetrics & Prenatal Medicine, Room Hs-408, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands. .,University of Applied Sciences, Midwifery Academy Rotterdam (Verloskunde Academie Rotterdam), Dr. Molewaterplein 40, Rotterdam, GD 3015, The Netherlands. .,Department of Public Health, Erasmus MC, PO Box 2040, Rotterdam, CA 3000, The Netherlands.
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Banga FR, Truijens SEM, Fransen AF, Dieleman JP, van Runnard Heimel PJ, Oei GS. The impact of transmural multiprofessional simulation-based obstetric team training on perinatal outcome and quality of care in the Netherlands. BMC MEDICAL EDUCATION 2014; 14:175. [PMID: 25145317 PMCID: PMC4236579 DOI: 10.1186/1472-6920-14-175] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/14/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Perinatal mortality and morbidity in the Netherlands is relatively high compared to other European countries. Our country has a unique system with an independent primary care providing care to low-risk pregnancies and a secondary/tertiary care responsible for high-risk pregnancies. About 65% of pregnant women in the Netherlands will be referred from primary to secondary care implicating multiple medical handovers. Dutch audits concluded that in the entire obstetric collaborative network process parameters could be improved. Studies have shown that obstetric team training improves perinatal outcome and that simulation-based obstetric team training implementing crew resource management (CRM) improves team performance. In addition, deliberate practice (DP) improves medical skills. The aim of this study is to analyse whether transmural multiprofessional simulation-based obstetric team training improves perinatal outcome. METHODS/DESIGN The study will be implemented in the south-eastern part of the Netherlands with an annual delivery rate of over 9,000. In this area secondary care is provided by four hospitals. Each hospital with referring primary care practices will form a cluster (study group). Within each cluster, teams will be formed of different care providers representing the obstetric collaborative network. CRM and elements of DP will be implemented in the training. To analyse the quality of care as perceived by patients, the Pregnancy and Childbirth Questionnaire (PCQ) will be used. Furthermore, self-reported collaboration between care providers will be assessed. Team performance will be measured by the Clinical Teamwork Scale (CTS). We employ a stepped-wedge trial design with a sequential roll-out of the trainings for the different study groups.Primary outcome will be perinatal mortality and/or admission to a NICU. Secondary outcome will be team performance, quality of care as perceived by patients, and collaboration among care providers. CONCLUSION The effect of transmural multiprofessional simulation-based obstetric team training on perinatal outcome has never been studied. We hypothesise that this training will improve perinatal outcome, team performance, and quality of care as perceived by patients and care providers. TRIAL REGISTRATION The Netherlands National Trial Register, http://www.trialregister.nl/NTR4576, registered June 1, 2014.
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Affiliation(s)
- Franyke R Banga
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands
| | - Sophie E M Truijens
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands
| | - Annemarie F Fransen
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands
| | | | - Pieter J van Runnard Heimel
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands
| | - Guid S Oei
- Department of Obstetrics and Gynaecology, Máxima Medical Centre, De Run 4600, P.O. Box 7777, Veldhoven, 5500 MB, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Changaee F, Simbar M, Irajpour A, Akbari S. Quality assessment of peripartum care. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e9069. [PMID: 25068068 PMCID: PMC4103001 DOI: 10.5812/ircmj.9069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 03/01/2014] [Indexed: 11/25/2022]
Abstract
Background: Maternal health improvement is one of the eight goals of the third millennium development, set in 2000. Pregnancy complications are the most important causes of maternal mortality worldwide. Proper and qualified health care access is one the most important factors for reducing maternal and neonatal mortality rates. Objectives: This study aimed to determine quality of peripartum care in Lorestan province in 2013. Materials and Methods: This was a descriptive cross-sectional study, in which quality of peripartum care was assessed among 200 women (sample size was determined according to other studies), referred to Lorestan province public hospitals. Quality assessment according to the WHO was used for the framework of structure, process and outcome. Data was collected by a researcher-made checklist, developed based on the administered instructions by Iran Health Ministry. The checklists were filled by observation. The calculated quality scores were expressed as percentage. SPSS version 18 was used for data analysis. Results: The mean percentages of compatibility with desirable situation were 54%, 57% and 66% in first, second and third stage of labor, respectively. The lowest scores were related to: Leopold maneuvers in the first stage, hand washing in the second stage and pulse control in the third stage of labor. Conclusions: Quality of peripartum care is moderate in Lorestan province, therefore, continuous evaluation of quality of care by administrators and hospital staff is essential to improve this quality and will ultimately result in maternal and neonatal health improvement.
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Affiliation(s)
- Farahnaz Changaee
- Department of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Masoumeh Simbar
- Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Masoumeh Simbar, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-219355347941, Fax: +98-2188560501, E-mail:
| | - Alireza Irajpour
- Department of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Soheyla Akbari
- Department of Medicine, Lorestan University of Medical Sciences, Khoramabad, IR Iran
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