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de Azevedo AP, de Rezende Filho JF, Hofer CB, Rego F. The Childbirth Experiences of Pregnant Women Living with HIV Virus: Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:743. [PMID: 38929322 PMCID: PMC11202184 DOI: 10.3390/children11060743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 05/30/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Understand and explore the childbirth experiences of pregnant women living with HIV (PWLWHIV). With the advent of several measures to decrease the intrapartum HIV infection and a strong emphasis on the humanization of childbirth, there is a growing focus on providing positive childbirth experiences for pregnant women. Indeed, a positive childbirth experience is even more important in the group of pregnant women living with HIV (PWLWHIV) as it plays a pivotal role in enhancing the mother's adherence to her postpartum treatment and the newborn's engagement in Infectious Disease services. METHODOLOGY A scoping review was conducted. Searches were performed on databases, such as MEDLINE, PUBMED, WEB OF SCIENCE and Cochrane Library, using the following keywords: childbirth, birth, parturition, HIV, humaniz*, perceived safety, experience, maternal satisfaction, healthcare professional and midwi*. Articles meeting pre-established criteria were selected within the timeframe of 2013 to 2023 for inclusion in the review. RESULTS Out of a total of 2,340,391 articles, 4 were chosen based on our defined criteria. Three primary themes emerged from the selected articles: the assessment of childbirth experience quality, vulnerability and autonomy. CONCLUSIONS The four studies identified had a small sample size and were not adequately conducted with a specific focus on studying the childbirth experience of pregnant women living with HIV (PWLWHIV). This scoping review revealed a gap in the existing literature, indicating a need for further research and clarification in the identified area.
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Affiliation(s)
- Andréa Paula de Azevedo
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Institute of Childcare and Pediatrics Martagão Gesteira, Federal University of Rio de Janeiro, Rua Bruno Lobo, 50, Rio de Janeiro 21941-912, Brazil
| | - Jorge Fonte de Rezende Filho
- National Medicine Academy, Rio de Janeiro 20021-130, Brazil
- Maternity School, Federal University of Rio de Janeiro, Rio de Janeiro 22240-001, Brazil
| | - Cristina Barroso Hofer
- Department Infectious Diseases, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21044-020, Brazil
| | - Francisca Rego
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
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Širvinskienė G, Forray AI, König-Bachmann M, Blaga OM, Grincevičienė Š, Luegmair K, Pranskevičiūtė-Amoson R, Zenzmaier C. Experiences of childbirth care in Lithuania and Romania: Insights from the European Babies Born Better survey. Birth 2024; 51:121-133. [PMID: 37798932 DOI: 10.1111/birt.12771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 06/14/2023] [Accepted: 08/11/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Data on experience and satisfaction of users are essential for improvement of health care, especially in the field of childbirth. The aim of this study was to compare childbirth care experiences in Lithuania and Romania. METHODS Data derived from the EU Babies Born Better online survey were analyzed. Parturients from Lithuania (N = 373) and Romania (N = 359) who had given birth within the last 5 years were included. Participants were asked to (1) describe the best things in childbirth care and (2) suggest changes in the care received at their birthplace. Qualitative data were analyzed using a previously developed deductive coding framework. RESULTS In agreement with previous findings from Austria, positive experiences mainly addressed care experienced at an individual level (in particular healthcare practitioners' competence and personality traits) and suggested changes mainly addressed services at birthplace (issues related to infrastructure, information and counseling, and empowerment). Responses not initially included in the coding framework addressed aspects such as informal payment (in both countries), desire for home birth (particularly in Lithuania), or mistreatment of parturients (particularly in Romania). CONCLUSIONS We conclude that similar trends in childbirth care exist in Lithuania and Romania with regard to parturients' personal experiences and psychosocial needs and that addressing the needs of parturients is important for improving service provision.
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Affiliation(s)
- Giedrė Širvinskienė
- Department of Health Psychology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Health Research Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alina Ioana Forray
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
- Department of Community Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Oana Maria Blaga
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Švitrigailė Grincevičienė
- Department of Biothermodynamics and Drug Design, Institute of Biotechnology, Life Sciences Centre, Vilnius University, Vilnius, Lithuania
| | - Karolina Luegmair
- Midwifery Department, Health University of Applied Sciences Tyrol, Innsbruck, Austria
- KSH Munich, University of Applied Sciences, Munich, Germany
| | | | - Christoph Zenzmaier
- Midwifery Department, Health University of Applied Sciences Tyrol, Innsbruck, Austria
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Adinew YM, Kelly J, Smith M, Marshall A. Women's perspectives on disrespect and abuse during facility-based childbirth in Ethiopia: a qualitative study. BMC Pregnancy Childbirth 2023; 23:444. [PMID: 37316792 DOI: 10.1186/s12884-023-05762-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Disrespect and abuse violates women's basic human rights and autonomy and can traumatize women who are already in a vulnerable position during childbirth and deter them from utilizing skilled care for future childbirth. This study explored women's perspectives on the acceptability of disrespect and abuse during facility-based childbirth in Ethiopia. METHODS A qualitative descriptive design using five focus group discussions and fifteen in-depth, semi-structured, interviews was conducted with women between October 2019 to January 2020 in north Showa zone of Oromia region, central Ethiopia. Using purposive sampling, women who had given birth at public health facilities of North Showa zone during the twelve months preceding data collection were recruited, regardless of birth outcome. Inductive thematic analysis using Open Code software was used to explore the perspectives of participants. RESULTS While women reject disrespectful and abusive acts during childbirth generally, they may consider some disrespectful acts as acceptable and or necessary under certain circumstances. Four emerging themes were identified. (1) Disrespect and abuse is not acceptable, (2) Disrespectful and abusive actions are acceptable only if intended to save lives, (3) Disrespectful and abusive actions are an accepted part of everyday practice to prevent complications and adverse outcomes, (4) Disrespectful and abusive actions are necessary to discipline disobedient women. CONCLUSION Women's perceptions of disrespectful and abusive acts of care providers is deeply rooted within the context of violence in Ethiopia and the societal hierarchies that have systematically disempowered women. Given the pervasiveness of disrespect and abusive actions during childbirth, policymakers, clinical managers and care providers must take these essential contextual and societal norms into account and devise comprehensive clinical interventions that addresses the root causes.
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Affiliation(s)
- Yohannes Mehretie Adinew
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia.
- College of Health sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia.
| | - Janet Kelly
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia
| | - Morgan Smith
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia
| | - Amy Marshall
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Ramadan M, Muthee TB, Okara L, Feil C, Villar Uribe M. Existing gaps and missed opportunities in delivering quality nutrition services in primary healthcare: a descriptive analysis of patient experience and provider competence in 11 low-income and middle-income countries. BMJ Open 2023; 13:e064819. [PMID: 36854587 PMCID: PMC9980366 DOI: 10.1136/bmjopen-2022-064819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES To assess the competence of primary healthcare (PHC) providers in delivering maternal and child nutrition services at the PHC level and patients' experience in receiving the recommended components of care. DESIGN Observational cross-sectional analysis. SETTING Healthcare facilities in low/middle-income countries (LMICs) with available service provision assessment surveys (Afghanistan (2018), Democratic Republic of Congo (2018), Haiti (2017), Kenya (2010), Malawi (2013-2014), Namibia (2009), Nepal (2015), Rwanda (2007), Senegal (2018), Tanzania (2015) and Uganda (2007). PARTICIPANTS 18 644 antenatal visits and 23 262 sick child visits in 8458 facilities across 130 subnational areas in 11 LMICs from 2007 to 2019. OUTCOMES (1) Provider competence assessed as the direct observations of actions performed during antenatal care (ANC) and sick child visits; and (2) patients' experience defined as the self-reported awareness of the nutrition services received during ANC and sick child visits and provider effectiveness in delivering these services. RESULTS Except for DRC, all countries scored below 50% on patients' experience and provider competence. More than 70% of clients were advised on taking iron supplements during pregnancy; however, less than 32% of patients were advised on iron side effects in all the studied countries. Across all countries, providers commonly took anthropometric measurements of expectant mothers and children; however, such assessments were rarely followed up with advice or counselling about growth patterns. In addition, less than 20% of observed providers advised on early/immediate breast feeding in all countries with available data. CONCLUSION The 11 assessed countries demonstrated the delivery of limited nutrition services; nonetheless, the apparent deficiency in the extent and depth of questions asked for the majority of tracer activities revealed significant opportunities for improving the quality of nutrition service delivery at the PHC level.
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Affiliation(s)
- Marwa Ramadan
- Health, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA
| | - Tonny B Muthee
- Health, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA
| | - Latifat Okara
- Health, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA
| | - Cameron Feil
- Health, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA
| | - Manuela Villar Uribe
- Health, Nutrition and Population, The World Bank Group, Washington, District of Columbia, USA
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Esan DT, Sokan-Adeaga AA, Rasaq NO. Assessment of satisfaction with delivery care among mothers in selected health care facilities in Ekiti state. J Public Health Res 2022; 11:22799036221127572. [PMID: 36226307 PMCID: PMC9549099 DOI: 10.1177/22799036221127572] [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: 05/26/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
The study assessed the maternal satisfaction with delivery care in selected health care facilities in Ekiti state. The study employed a descriptive cross-sectional study design and a simple random sampling technique was utilized to select respondents based on calculated sample size and a total of 267 respondents participated in the study. A semi-structured pretested questionnaire was used for the data collection. Data was analyzed and summarized using descriptive statistics and inferential statistics (Chi-square) with significance set at p < 0.05. The mean respondents' age was 28.2 ± 1.4 years with majority falling within the age group of 21-30 years. Majority of the respondents revealed to be satisfied with the following: proximity of the health facilities 194 (72.7%); cost of service 174 (65.2%); drug availability 184 (69.7%); cleanliness of the hospital ambience 219 (82.0%); and professional conduct of the care givers 186 (70.2%). However, the respondents expressed dissatisfaction in terms of the following: referral link 107 (40.1%); waiting time 122 (45.7%); communication gap 56 (21.0%); and maintenance of privacy 51 (19.1%). Overall, majority (94.8%) of the respondents were satisfied with the delivery services rendered at the facilities while 14 (5.2%) expressed dissatisfaction. Furthermore, a significant association exists between respondents' level of education and maternal satisfaction on delivery care (p < 0.05). Although the general maternal gratification/satisfaction on intrapartum and postpartum care in this study was overwhelmingly high, the few domains of discontentment identified need to be addressed by all the stakeholders in the health sector to enhance the usage of health care services amongst women, thus promoting the attainment of Sustainable Development Goal (SDG) 3.
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Affiliation(s)
- Deborah Tolulope Esan
- Department of Nursing Science, Afe
Babalola University, Ado-Ekiti, Ekiti, Nigeria,Deborah Tolulope Esan, Department of
Nursing Science, College of Medicine and Health Sciences, Afe Babalola
University, P.M.B. 5454, Ado-Ekiti, Ekiti 360102, Nigeria.
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Sehngelia L, Pavlova M, Groot W. Women’s satisfaction with maternal care services in Georgia. HEALTH POLICY OPEN 2021. [DOI: 10.1016/j.hpopen.2020.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Pereda-Goikoetxea B, Huitzi-Egilegor JX, Zubeldia-Etxeberria J, Uranga-Iturrioz MJ, Elorza-Puyadena MI. Hospital Childbirth: Perspectives of Women and Professionals for a Positive Experience-A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910238. [PMID: 34639543 PMCID: PMC8507606 DOI: 10.3390/ijerph181910238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022]
Abstract
The perception and interpretation of childbirth are changing as values change. This requires women and professionals to adapt to new circumstances. The objective of this study was to analyze the perspectives of women and professionals on hospital birth and to identify improvement areas in order to achieve a positive perinatal experience. A qualitative prospective study with a phenomenological approach was conducted using semi-structured interviews with women, two and eight months after childbirth, participant observation, and professional focus groups. The analysis of the transcribed texts involved a thematic inductive approach. Four improvement areas emerged from the analysis: (a) strengthening communication and the therapeutic relationship; (b) unifying criteria between hospitals and primary care centers to provide coordinated and coherent information; (c) involvement of the partner in the whole process of pregnancy-childbirth-puerperium; (d) improvement of the spaces used in prenatal care and births. The need for a continuity of care from the beginning of pregnancy to the postpartum period is emphasized, which requires an improvement in information, participation, and the promotion of shared decision-making. To this end, coordinated interdisciplinary work, involvement of the partner and the improvement of the spaces used in prenatal care and births are essential.
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Onchonga D, Keraka M, MoghaddamHosseini V, Várnagy Á. Does institutional maternity services contribute to the fear of childbirth? A focus group interview study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 30:100669. [PMID: 34583286 DOI: 10.1016/j.srhc.2021.100669] [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: 08/03/2021] [Revised: 09/05/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The quality of institutional maternity services offered significantly determine the health outcomes of pregnant women and their infants. OBJECTIVES The study aimed at understanding perceptions and experiences of new mothers diagnosed with the fear of childbirth in Kenya; regarding the institutional maternity services offered and if they contribute to the fear of childbirth (FOC). METHODS This was a qualitative descriptive study. A total of 29 women who had given birth recently in a maternity institution, and had been screened with the fear of childbirth at 32 weeks' gestation period participated in focus group interviews. The Framework for Assessing the Quality of Care of institutional maternity services (FAQC) developed by the University of Southampton was adopted in this study. Thematic analyses were used. RESULTS It was reported that institutional maternity services contributed directly and indirectly to FOC. The direct contribution included the performance of unintended caesarian sections, severe and prolonged labour pains and negative attitude of healthcare providers. The indirect contribution was in form of challenges in the provision of care and the experience of care in the maternity institutions. In the provision of care; human and physical resources, inadequate referral systems, and inadequate management of emergencies were reported. In the experience of care; lack of cognition, respect, dignity, equity and inadequacies in emotional support were reported. CONCLUSION The study identified systemic challenges related to both the provision and the experience of care. Therefore, there is need to astutely analyze all critical steps identified in the FAQC, as this will greatly improve the uptake of institutional maternity services.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary; School of Public Health, Kenyatta University, Kenya.
| | | | - Vahideh MoghaddamHosseini
- Department of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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Price TS, Andries C, Palokas M, Christian R. Factors contributing to a positive childbirth experience for women in a hospital setting: an umbrella review protocol. JBI Evid Synth 2021; 20:854-859. [PMID: 34494615 DOI: 10.11124/jbies-21-00132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this umbrella review is to identify and evaluate the factors that contribute to a positive childbirth experience in laboring women in the hospital setting. INTRODUCTION Childbirth is a milestone for women. Overall, the experience can positively or negatively affect self-esteem, bonding, future childbirth decisions, and overall health and well-being. Understanding of the mother's perception and expectation of the childbirth event is needed to promote positive experiences and outcomes. INCLUSION CRITERIA This review will consider qualitative systematic reviews that include pregnant women, women in active labor, or women who have recently given birth. This review will consider systematic reviews conducted in a hospital setting in any geographical location reporting on women's positive childbirth experiences, and the factors that led to positive experiences. METHODS The search strategy will aim to locate qualitative systematic reviews. Databases to be searched include MEDLINE (PubMed), CINAHL (EBSCO), Embase (Elsevier), Scopus (Elsevier), JBI Database of Evidence Based Practice (Ovid), and Cochrane Database of Systematic Reviews (Cochranelibrary.com). Sources of unpublished reviews and gray literature to be searched include ProQuest Dissertations and Theses Sciences and Engineering Collection (ProQuest) and OpenGrey (www.opengrey.eu/). Search limitations include reviews after the year 2001 and in the English language. Data will be extracted from systematic reviews by two independent reviewers and findings from the included reviews, as they relate to the umbrella review question, will be presented in a tabular format with supplemental narrative to ensure interpretability. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42021251796).
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Affiliation(s)
- Tara S Price
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
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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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Lopes F, Nakamura MU, Nomura RMY. Women's satisfaction with childbirth in a public hospital in Brazil. Birth 2021; 48:251-256. [PMID: 33543497 DOI: 10.1111/birt.12534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate women's satisfaction with vaginal birth in a public hospital in São Paulo, Brazil. METHODS A total of 372 low-risk postpartum women were interviewed. Maternal satisfaction was measured by the Mackey Childbirth Satisfaction Rating Scale (MCSRS), validated to Brazilian Portuguese. The scale is divided into six subscales: self-evaluation, partner, baby, nursing, physicians, and overall satisfaction. Childbirth care data were related to maternal mobility, shower bath, birth ball exercises, manual massage, and the health care providers assisting delivery. RESULTS The MCSRS total score was significantly higher in women living with their partners than those not living with a partner (median 145.5 vs 133.0; P = 0.019), in women with a companion during childbirth than those with no labor support (146.0 vs 136.5; P = 0.047), and in women who early breastfed within the first hour compared with those who did not (146.0 vs 137.0; P = 0.001). Multiple regression identified 'living with partner' (coefficient 6.205; P = 0.043) and 'breastfeeding within the first hour' (coefficient 7.856; P = 0.005) as independent variables that determine the total score of MCSRS. CONCLUSIONS Our findings indicate that living with one's partner and early initiation of breastfeeding are key factors enhancing satisfaction with vaginal birth in women who received care at a public Brazilian hospital.
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Affiliation(s)
- Fernanda Lopes
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, São Paulo, Brazil
| | - Mary Uchiyama Nakamura
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, São Paulo, Brazil
| | - Roseli Mieko Yamamoto Nomura
- Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, São Paulo, Brazil
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Najjarzadeh M, Mohammad-Alizadeh-Charandabi S, Abbas-Alizadeh S, Asghari Jafarabadi M, Mirghafourvand M, Tagipour-Amidi N, Sawyer A, Ayers S. Validity and reliability of the Iranian preterm birth experiences and satisfaction scale: A methodological and cross-sectional study. Health Promot Perspect 2021; 11:97-108. [PMID: 33758761 PMCID: PMC7967130 DOI: 10.34172/hpp.2021.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/27/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Women’s experience and satisfaction with childbirth care are increasingly being addressed by health care providers, managers, and policymakers. Due to need for a validated special scale for assessing satisfaction of women with preterm birth, we aimed to translate and adapt the first specific tool, Preterm Birth Experiences and Satisfaction Scale (P-BESS), into Persian language and evaluate its psychometric properties. Methods: A methodological and cross-sectional study was conducted in two tertiary levels of maternal hospitals in Tabriz. The Iranian version of the scale was developed from the original English version using forward-backward translation. After confirmation of its face and content validity, the scale was completed by 201 women who had given birth prematurely. Results: Exploratory factor analysis revealed three factors (staff professionalism and empathy, confidence in Staff, information and explanations) with eigenvalues greater than 1, explaining a total variance of 55.4%. Confirmatory factory analysis showed that the 17-item, three factor model fitted the data well: the root mean square error of approximation 0.060. There were moderate correlations between the total and sub-scales of Iranian P-BESS and overall satisfaction (r = 0.45 to 0.66), as well as need for improvement (r = -0.46 to -0.61), which confirm convergent validity. Internal consistency and test–retest reliability of the scale and its sub-scales were satisfactory (α = 0.852 to 0.922, intraclass correlation coefficient; 0.83 to 0.92). Conclusion: The Iranian version of P-BESS is a valid and reliable scale which can be used by policy makers, managers, health care providers and researchers.
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Affiliation(s)
- Maryam Najjarzadeh
- Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shamsi Abbas-Alizadeh
- Women's Reproductive Health Research Center, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahid Tagipour-Amidi
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, UK
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Perriman N, Davis DL, Muggleton S. Developing an instrument to measure satisfaction with continuity of midwifery care drawing on the Delphi technique. Women Birth 2021; 35:e84-e90. [PMID: 33468441 DOI: 10.1016/j.wombi.2021.01.008] [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: 06/28/2020] [Revised: 11/16/2020] [Accepted: 01/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Maternal satisfaction with maternity care is an important indicator of quality maternity services. Continuity of midwifery models of care are increasing in Australia and while several instruments have been developed to measure satisfaction with maternity care most of these have not been validated and there are none that are appropriate to continuity of midwifery maternity care models. AIM To develop a questionnaire to measure women's satisfaction with maternity services provided in a continuity of midwifery care service model. METHODS A modified Delphi technique was used. A heterogenous panel of eight experts provided feedback over four rounds. The starting point for the questionnaire was informed by two systematic literature reviews focusing on available instruments for measuring maternal satisfaction with maternity care and what women value continuity of midwifery models of care. FINDINGS The Continuity of Midwifery Care Satisfaction Survey (COMcareSS) was developed after four rounds of feedback with the expert panel. The survey comprises nine domains and fifty-nine questions. The domains include demographics, maternity care outcomes, facilities, the midwife/woman relationship, building capacity-empowerment, decision making and involvement, personalised care, advice care and support and general. CONCLUSIONS Consumer satisfaction is an important indicator of quality care. This is the first instrument to be developed that is appropriate to continuity of midwifery models of care. The important next step is to pilot test the instrument to establish its validity and reliability.
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Affiliation(s)
- Noelyn Perriman
- University of Canberra, University Drive, Bruce, ACT 2617 Australia; Calvary Public Hospital Bruce, Haydon Drive, Bruce, ACT 2617 Australia.
| | - Deborah Lee Davis
- University of Canberra, University Drive, Bruce, ACT 2617 Australia; ACT Health, Yamba Drive, Garran, ACT 2605 Australia
| | - Sally Muggleton
- University of Canberra, University Drive, Bruce, ACT 2617 Australia
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Floris L, de Labrusse C. Cross-cultural validation and psychometrics' evaluation of women's experience of maternity care scale in French: the ESEM. BMC Med Res Methodol 2020; 20:188. [PMID: 32652954 PMCID: PMC7353730 DOI: 10.1186/s12874-020-01052-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 06/16/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Evaluating women's satisfaction should reflect the entire maternity care experience (antenatal, intrapartum and postnatal). The Women's Experience Maternity Care Scale (WEMCS) questionnaire enables this assessment. The purpose of this study was to translate in French, adapt and explore the psychometric properties of the WEMCS and to determine the best cut-off on the optimal satisfaction for the three scales. METHODS Backward, forward translation and cross-cultural adaptation were processed to validate the French version of WEMCS: Échelle de Satisfaction de l'Experience des soins en Maternité (ESEM). Psychometric tests assessed the questionnaire, which includes three scales, such as construct validity, internal consistency, Cronbach's alpha coefficients and ceiling and floor effects. A receiver operating characteristic (ROC) curve was used to determine the best cut-off values for optimal satisfaction. Reproducibility was verified by test-retest reliability. RESULTS Primiparas with uncomplicated pregnancies were recruited antenatally at the University Hospital of Geneva. Of the 229 patients who agreed to participate, 202 women (88.2%) returned the test and retest questionnaires. Principal component analysis for the antenatal, intrapartum and postnatal scales suggested the unidimensional character of the three scales; Cronbach's alpha coefficients were high for the three scales with values of > 0.85. Construct validity based on the five-point Likert scale values showed a Spearman's rho correlation of r = 0.56 for the antenatal scale (p < 0.001) and r = 0.62 for the intrapartum scale (p < 0.001), as well as a strong correlation with the postnatal scale, with r = 0.78 (p < 0.001). Optimum cut-off scores for the ROC curve of the antenatal, intrapartum and postnatal scores were equal to or higher than 48, 50 and 70, respectively. The three scales showed good sensitivity and good specificity. The stability of the ESEM questionnaire was confirmed by intra-class correlation coefficients of > 0.80. However, the three scales revealed ceiling effects. CONCLUSION The psychometric proprieties of the ESEM demonstrate it's ability to evaluate the quality of perinatal health care. The ESEM should be tested in the context of different models of women's care and with women with different degrees of pregnancy complications to explore the validity of this scale.
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Affiliation(s)
- L. Floris
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland
- University of Geneva, 1211 Geneva, Switzerland
| | - C. de Labrusse
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland
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Alfaro Blazquez R, Ferrer Ferrandiz E, Gea Caballero V, Corchon S, Juarez-Vela R. Women's satisfaction with maternity care during preterm birth. Birth 2019; 46:670-677. [PMID: 31531890 DOI: 10.1111/birt.12453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/10/2019] [Accepted: 08/19/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Women's satisfaction with maternity care is strongly influenced by their sociodemographic characteristics, values, and attitudes. The arrival of a preterm baby is often a traumatic time, with unique factors involved. The Spanish Preterm Birth Experience and Satisfaction Scale (P-BESS) is a robust instrument capable of assessing women's satisfaction during preterm birth. The purpose of this study was to assess women's satisfaction with maternity care during labor and birth with preterm babies in a Spanish-speaking population. METHODS This is a cross-sectional study. Participants were 182 women who gave birth within 37 weeks' gestation. Factors associated with satisfaction were studied through univariate and bivariate analyses and through multiple linear regression using the backward elimination method. RESULTS Women reported high satisfaction with maternity care overall (average score of 84 out of 95). Women with a university education were generally less satisfied. Women were more satisfied if they were pregnant for the first time. Women who reported a previous premature birth or neonatal death were more satisfied, and women who had prior miscarriages were less satisfied compared with women without these experiences. CONCLUSIONS The analysis confirmed that the majority of women surveyed were very satisfied with their childbirth experience. The Spanish P-BESS can be a useful way of prioritizing intervention measures, focusing on those aspects lowest scored by women, such as "information and explanations" and "confidence in staff," to improve maternity services for families experiencing preterm birth.
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Affiliation(s)
- Ruben Alfaro Blazquez
- Department of Obstetrics, University and Polytechnic Hospital "La Fe", Valencia, Spain.,School of Nursing and Podiatry, University of Valencia, Valencia, Spain
| | - Esperanza Ferrer Ferrandiz
- Nursing School "La Fe", University of Valencia, Valencia, Spain.,Nursing Research Group in Art and Science of Care (GREIACC), Valencia, Spain
| | - Vicente Gea Caballero
- Nursing School "La Fe", University of Valencia, Valencia, Spain.,Nursing Research Group in Art and Science of Care (GREIACC), Valencia, Spain
| | - Silvia Corchon
- School of Nursing and Podiatry, University of Valencia, Valencia, Spain
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Duley L, Dorling J, Ayers S, Oliver S, Yoxall CW, Weeks A, Megone C, Oddie S, Gyte G, Chivers Z, Thornton J, Field D, Sawyer A, McGuire W. Improving quality of care and outcome at very preterm birth: the Preterm Birth research programme, including the Cord pilot RCT. PROGRAMME GRANTS FOR APPLIED RESEARCH 2019. [DOI: 10.3310/pgfar07080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background
Being born very premature (i.e. before 32 weeks’ gestation) has an impact on survival and quality of life. Improving care at birth may improve outcomes and parents’ experiences.
Objectives
To improve the quality of care and outcomes following very preterm birth.
Design
We used mixed methods, including a James Lind Alliance prioritisation, a systematic review, a framework synthesis, a comparative review, qualitative studies, development of a questionnaire tool and a medical device (a neonatal resuscitation trolley), a survey of practice, a randomised trial and a protocol for a prospective meta-analysis using individual participant data.
Setting
For the prioritisation, this included people affected by preterm birth and health-care practitioners in the UK relevant to preterm birth. The qualitative work on preterm birth and the development of the questionnaire involved parents of infants born at three maternity hospitals in southern England. The medical device was developed at Liverpool Women’s Hospital. The survey of practice involved UK neonatal units. The randomised trial was conducted at eight UK tertiary maternity hospitals.
Participants
For prioritisation, 26 organisations and 386 individuals; for the interviews and questionnaire tool, 32 mothers and seven fathers who had a baby born before 32 weeks’ gestation for interviews evaluating the trolley, 30 people who had experienced it being used at the birth of their baby (19 mothers, 10 partners and 1 grandmother) and 20 clinicians who were present when it was being used; for the trial, 261 women expected to have a live birth before 32 weeks’ gestation, and their 276 babies.
Interventions
Providing neonatal care at very preterm birth beside the mother, and with the umbilical cord intact; timing of cord clamping at very preterm birth.
Main outcome measures
Research priorities for preterm birth; feasibility and acceptability of the trolley; feasibility of a randomised trial, death and intraventricular haemorrhage.
Review methods
Systematic review of Cochrane reviews (umbrella review); framework synthesis of ethics aspects of consent, with conceptual framework to inform selection criteria for empirical and analytical studies. The comparative review included studies using a questionnaire to assess satisfaction with care during childbirth, and provided psychometric information.
Results
Our prioritisation identified 104 research topics for preterm birth, with the top 30 ranked. An ethnographic analysis of decision-making during this process suggested ways that it might be improved. Qualitative interviews with parents about their experiences of very preterm birth identified two differences with term births: the importance of the staff appearing calm and of staff taking control. Following a comparative review, this led to the development of a questionnaire to assess parents’ views of care during very preterm birth. A systematic overview summarised evidence for delivery room neonatal care and revealed significant evidence gaps. The framework synthesis explored ethics issues in consent for trials involving sick or preterm infants, concluding that no existing process is ideal and identifying three important gaps. This led to the development of a two-stage consent pathway (oral assent followed by written consent), subsequently evaluated in our randomised trial. Our survey of practice for care at the time of birth showed variation in approaches to cord clamping, and that no hospitals were providing neonatal care with the cord intact. We showed that neonatal care could be provided beside the mother using either the mobile neonatal resuscitation trolley we developed or existing equipment. Qualitative interviews suggested that neonatal care beside the mother is valued by parents and acceptable to clinicians. Our pilot randomised trial compared cord clamping after 2 minutes and initial neonatal care, if needed, with the cord intact, with clamping within 20 seconds and initial neonatal care after clamping. This study demonstrated feasibility of a large UK randomised trial. Of 135 infants allocated to cord clamping ≥ 2 minutes, 7 (5.2%) died and, of 135 allocated to cord clamping ≤ 20 seconds, 15 (11.1%) died (risk difference –5.9%, 95% confidence interval –12.4% to 0.6%). Of live births, 43 out of 134 (32%) allocated to cord clamping ≥ 2 minutes had intraventricular haemorrhage compared with 47 out of 132 (36%) allocated to cord clamping ≤ 20 seconds (risk difference –3.5%, 95% CI –14.9% to 7.8%).
Limitations
Small sample for the qualitative interviews about preterm birth, single-centre evaluation of neonatal care beside the mother, and a pilot trial.
Conclusions
Our programme of research has improved understanding of parent experiences of very preterm birth, and informed clinical guidelines and the research agenda. Our two-stage consent pathway is recommended for intrapartum clinical research trials. Our pilot trial will contribute to the individual participant data meta-analysis, results of which will guide design of future trials.
Future work
Research in preterm birth should take account of the top priorities. Further evaluation of neonatal care beside the mother is merited, and future trial of alternative policies for management of cord clamping should take account of the meta-analysis.
Study registration
This study is registered as PROSPERO CRD42012003038 and CRD42013004405. In addition, Current Controlled Trials ISRCTN21456601.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 7, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Lelia Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Jon Dorling
- Department of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Sandy Oliver
- Social Science Research Unit and EPPI-Centre, Institute of Education, University of London, London, UK
| | | | - Andrew Weeks
- University of Liverpool and Liverpool Women’s Hospital, Members of Liverpool Health Partners, UK
| | - Chris Megone
- Inter Disciplinary Ethics Applied, University of Leeds, Leeds, UK
| | - Sam Oddie
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Gill Gyte
- National Childbirth Trust, London, UK
| | | | - Jim Thornton
- Department of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
| | - David Field
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - William McGuire
- Centre for Reviews and Dissemination, University of York, York, UK
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Redshaw M, Martin CR, Savage-McGlynn E, Harrison S. Women's experiences of maternity care in England: preliminary development of a standard measure. BMC Pregnancy Childbirth 2019; 19:167. [PMID: 31088487 PMCID: PMC6518811 DOI: 10.1186/s12884-019-2284-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 04/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As maternity services evolve and the population of women served also changes, there is a continuing need to effectively document the views of women with recent experience of care. A woman's maternity experience can have a positive or negative effect upon her emotional well-being and health, in the immediate and the long-term, which can also impact the infant and the wider family system. Measuring women's perceptions of maternity services is an important way of monitoring the quality of care provision, as well as providing key indicators to organisations of the services that they are providing. It follows that, without information identifying possible areas in need of improvement, it is not clear what changes should be made to improve the experiences of women during their journey through maternity services from pregnancy to the early weeks at home with a new baby . The objective is to describe the development process and psychometric properties of a measure of women's experience of maternity care covering the three distinctly different phases of maternity - pregnancy, labour and birth, and the early postnatal period. METHODS Data from a national survey of women who had recently given birth (n = 504) were used. Exploratory and confirmatory factor analytic methods were employed. The measure was assessed for underlying latent factor structure, as well as for reliability, internal consistency, and validity (predictive, convergent and discriminant). RESULTS The models developed confirmed the use of three separate, but related scales about experience of maternity care during pregnancy, labour and birth and the postnatal period. Data reduction was effective, resulting in a measure with 36 items (12 per scale). CONCLUSION The need for a psychometrically robust and qualitatively comprehensive measure of women's experience of maternity care has been addressed in the development and validation of this prototype measure. The whole measure can be used at one time point, or the three separate subscales used as individual measures of experience during particular phases of the maternity journey with identified factor structures in their own right.
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Affiliation(s)
- Maggie Redshaw
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
| | - Colin R Martin
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Emily Savage-McGlynn
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Sian Harrison
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
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Catala P, Peñacoba C, Carmona J, Marin D. Do maternal personality variables influence childbirth satisfaction? A longitudinal study in low-risk pregnancies. Women Health 2019; 60:197-211. [DOI: 10.1080/03630242.2019.1613473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Javier Carmona
- Nursing; Psychology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - Dolores Marin
- Nursing; Psychology, Universidad Rey Juan Carlos, Alcorcón, Spain
- Obstetrics Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
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A qualitative study of hospital birth perceptions: The helix of priority needs. Midwifery 2019; 74:91-98. [PMID: 30939335 DOI: 10.1016/j.midw.2019.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/25/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To understand which needs are considered priorities in the hospital birth experience from the perspectives of postpartum women. DESIGN This qualitative prospective study used a phenomenological approach. Data were collected through participant observations and semi-structured interviews recorded at eight weeks and eight months after childbirth. The data were analysed using a thematic approach. PARTICIPANTS The study cohort consisted of 43 participants at eight weeks after childbirth and 33 participants eight months after childbirth. SETTING Donostia University Hospital, San Sebastián, Spain, in 2016-2017. FINDINGS Through the analysis, the following four main themes emerged, each in different categories: (a) Professional care: symbiosis between the woman and the professional: (a.1) professional treatment and its characteristics, (a.2) professional competence, and (a.3) professional information and listening: pillars in the support relationship. (b) Control and hospital safety: (b.1) hospital environment: external control. (c) Presence of the partner: (c.1) support, guidance, and participation. (d) Perception of observed feelings: (d.1) fear of complications or separation from the child, (d.2) fear of internal lack of control, and (d.3) fear of an instrumental delivery and/or caesarean section. CONCLUSIONS AND IMPLICATIONS FOR PRACTISE The core of the hospital birth experience is constituted by the need to establish a supportive relationship based on mutual trust, exchange information that offers internal and external control and the security necessary to overcome feelings of fear, and obtain support and guidance from an involved partner.
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Research Article Women's experience of maternity high-dependency care following a complicated birth: A cross-sectional study. Intensive Crit Care Nurs 2019; 53:54-59. [PMID: 30878536 DOI: 10.1016/j.iccn.2019.02.003] [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: 10/09/2018] [Revised: 12/17/2018] [Accepted: 02/11/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE There is limited evidence around childbearing women's experience following a complicated birth requiring maternity high-dependency care. Our objective was to explore women's experience and wellbeing following a complicated birth within this context. RESEARCH METHODOLOGY/DESIGN A cross-sectional study captured women's experience through a postal survey four weeks post birth. SETTING A convenience sample of 112 women who received care in the first 24 hours of their stay in a Western Australian maternity high dependency unit. MAIN OUTCOME MEASURES A validated tool designed to explore patients' intensive care experience was modified and six items were added based upon the literature and in consultation with clinicians. RESULTS Women felt they were given choice (78%; n = 86); were not glad to be transferred to a ward (62%; n = 68) and were in pain during the first 24 hours of their admission (70%; n = 78). Women who did not feel scared were more likely than those who felt scared to have a clinician explain what had happened (95% vs 78%, P = 0.007); were more likely to feel in control (94% vs 75%, P = 0.006); and were less likely to feel helpless (27% vs 62%, P = <0.001). CONCLUSION The transfer experience to a postpartum ward requires further investigation as does the management of pain for these childbearing women regardless of their birth mode.
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Abstract
OBJECTIVE High-quality maternity care is key to long-term improvements in population health. However, even within developed welfare systems, some mothers and babies experience poorer care and outcomes. This study aimed to explore whether women's experiences of maternity care in Scotland differs by their physical or sociodemographic characteristics. DESIGN Secondary analysis of the 2015 Scottish Maternity Care Experience Survey. The questionnaire was based on the Care Quality Commission English maternity survey. SETTING National Health Service maternity care in Scotland. PARTICIPANTS The survey was distributed to 5025 women who gave birth in Scotland during February and March 2015 with 2036 respondents (41%). MAIN OUTCOME MEASURES The questionnaire explored aspects of care processes and interpersonal care experienced from the first antenatal contact (booking) to 6 weeks following the birth. The analysis investigated whether experiences were related to age, parity, deprivation, rurality, self-reported general health or presence of a health condition that limited daily activities. Analysis used mixed effect multilevel models incorporating logistic regression. RESULTS There were associations between parity, age and deprivation with gestation at booking indicating that younger women, women from more deprived areas and multiparous women booked later. Women reporting generally poorer health were more likely to describe poorer care experiences in almost every domain including continuity, pain relief in labour, communication with staff, support and advice, involvement in decision making, confidence and trust and overall rating of care. CONCLUSIONS We found few differences in maternity care experience for women based on their physical or socioeconomic characteristics. Our findings indicate that maternity care in Scotland is generally equitable. However, the link between poorer general health after childbirth and poorer experience of maternity care is an important finding requiring further study.
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Affiliation(s)
- Helen Cheyne
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Andrew Elders
- Nursing Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - David Hill
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emma Milburn
- Health and Care Analysis Division, Scottish Government, Edinburgh, UK
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Karlström A, Rising-Holmström M. Parental Groups During Pregnancy and the Child's First Year: Swedish Parents' Experiences. J Perinat Educ 2019; 28:19-27. [PMID: 31086472 PMCID: PMC6491150 DOI: 10.1891/1058-1243.28.1.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of the study was to assess parents' experience of parental support given before and after childbirth in a mid-Sweden region. A coherent education program implemented in a mid-Sweden region was evaluated. Data from two different samples of parents was collected through questionnaires. From the antenatal classes 563 women and men took part in the study. The other sample consisted of 176 parents from the child health care classes. The vast majority of parents from both groups were content with the sessions and their overall view was very positive. Both men and women felt strengthened before birth and in their parental role. New knowledge about breastfeeding and children's needs were gained. New thoughts about equal parenting and children's needs and development were achieved to a limited extent.
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Wyles K, Miller YD. Does it get better with age? Women's experience of communication in maternity care. Women Birth 2018; 32:e366-e375. [PMID: 30206041 DOI: 10.1016/j.wombi.2018.08.170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Communication with maternity care providers is one of the strongest predictors of the perceived quality of maternity care. There is evidence that older mothers experience better communication than younger mothers, but no evidence for why this occurs. AIM To identify differences between younger (<35 years) and older (35+ years) mother's perceived quality of communication and any apparent age-related differences. METHODS We analysed cross-sectional data from 2504 first-time mothers in the Having a Baby in Queensland Survey 2012. Binary logistic regression assessed associations between maternal age and perceived optimal communication (information, participation, and connection) from care providers during women's most recent pregnancy and birth. Multivariable logistic regression modelling determined the effect of potential confounders (model of care, mode of birth, maternal age, and risk perceptions) on associations between age and communication quality. FINDINGS After adjustment for confounders, older mothers were more likely to report experiencing optimal information (e.g., not receiving conflicting information) and connection with caregivers (e.g., comfortable asking questions) in both pregnancy and birth. There were no age-related differences in the perception of participation. Model of care and mode of birth were more influential than maternal age in predicting communication perceptions. Women who used midwifery or private obstetric models and had unassisted vaginal births were more likely to perceive optimal communication. CONCLUSION Given the benefits of communication on maternity care, redressing these age-related differences should be a focus of future communication training for care providers to ensure that women receive optimal communication, regardless of their age.
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Affiliation(s)
- Katy Wyles
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Yvette D Miller
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
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Translation, adaptation and psychometric validation of the preterm birth experience and satisfaction scale (P-BESS) into Spanish. Midwifery 2018; 66:148-154. [PMID: 30172992 DOI: 10.1016/j.midw.2018.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/14/2018] [Accepted: 08/12/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Preterm labour and birth are two of the most important issues in perinatal care. The birth of a preterm baby is often a stressful and traumatic time for parents. Assessment of satisfaction with maternity services is crucial and questionnaires are the most common method as long as they are well-constructed. Only one, The Preterm Birth Experience and Satisfaction Scale (P-BESS), developed in United Kingdom, has been designed for this specific birth type. OBJECTIVES To translate, transculturally adapt and assess the psychometric properties of the P-BESS into Spanish. DESIGN Cross-sectional study. SETTING Maternity unit of a tertiary level hospital in Spain. PARTICIPANTS A total of 182 woman who gave birth before 37 weeks of gestation. METHODS The instrument was translated and back translated. The P-BESS was tested for face validity and construct validity by carrying out an exploratory/confirmatory factor analysis. Reliability was estimated from the internal consistency, with the Cronbach's alpha (α), and the test-retest, with the intraclass correlation coefficient (ICC). FINDINGS The principal component analysis revealed the presence of three factors with eigenvalues greater than 1, explaining a total variance of 66.6%. A subsequent varimax rotation revealed the presence of strong loadings on each of the three components. Confirmatory factor analysis was performed, offering the model a very good fit to the data: chi-square was χ2(df=149)=362.727 (p = 0.000); the root mean square error of approximation (RMSEA)=0.089; the normed fix index (NFI )= 0.852 and the comparative fit index (CFI)=0.905. The total scale and subscales had good reliability with all Cronbach´s alpha above the acceptable level of 0.7. The total ICC was 0.994 (CI 95%, 0.988-0.997). CONCLUSIONS The Spanish version of P-BESS appears to be a robust, valid and reliable instrument for assessing satisfaction with care during preterm birth. IMPLICATIONS FOR PRACTICE the instrument provides a more comprehensive understanding of this complex experience. It allows the detection of areas of intervention in order to empower strategies to cope with preterm births and to maximise feelings of self-confidence and control.
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Turkmen S, Tjernström M, Dahmoun M, Bolin M. Post-partum duration of satisfaction with childbirth. J Obstet Gynaecol Res 2018; 44:2166-2173. [PMID: 30058272 DOI: 10.1111/jog.13775] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/08/2018] [Indexed: 11/28/2022]
Abstract
AIM Satisfaction with childbirth has become increasingly important among healthcare providers. We evaluated whether satisfaction levels change with time (up to 3 months after delivery). METHODS A prospective study of nulliparous women was designed to evaluate their levels of satisfaction with childbirth and care during birth in the maternity unit of a county hospital in Sundsvall, Sweden. Patient satisfaction with birth and health care was measured twice, during the first week after birth and 3 months later, with the Childbirth Experience Questionnaire (CEQ). Maternal and labor information were collected with a form filled in by the patients and completed with information from the patients' records. RESULTS A total of 78 primiparous women participated in the study and answered the questionnaire in the first week after labor, and 63 of them completed the study by answering the same questionnaire 3 months after delivery. The total CEQ score did not change after 3 months, but the scores for the subscales 'professional support' and 'participation' decreased 3 months after labor (P = 0.008 and P = 0.001, respectively). A visual analogue scale predicted the total CEQ scores at both 1 week (P < 0.001) and 3 months (P = 0.003). CONCLUSION Our results indicate that satisfaction with labor and birth among primiparous women was unchanged 3 months after labor.
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Affiliation(s)
- Sahruh Turkmen
- Department of Clinical Sciences, Obstetrics and Gynecology, Sundsvalls Research Unit, Umeå University, Umeå, Sweden.,Department of Obstetrics and Gynecology, Sundsvall County Hospital, Sundsvall, Sweden
| | - Maja Tjernström
- Department of Clinical Sciences, Obstetrics and Gynecology, Sundsvalls Research Unit, Umeå University, Umeå, Sweden
| | - Marju Dahmoun
- Department of Obstetrics and Gynecology, Sundsvall County Hospital, Sundsvall, Sweden
| | - Marie Bolin
- Department of Obstetrics and Gynecology, Sundsvall County Hospital, Sundsvall, Sweden
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Williams RA, Machin LL. Rethinking gamete donor care: A satisfaction survey of egg and sperm donors in the UK. PLoS One 2018; 13:e0199971. [PMID: 30036373 PMCID: PMC6056032 DOI: 10.1371/journal.pone.0199971] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 06/18/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Despite poor clinic communication and staff treatment being reported by donors, high rates of overall satisfaction are still reported in surveys. This study will evaluate the importance of communication and interaction between donors and fertility clinic staff in gamete donor care. METHODS We report on 120 egg and sperm donors' responses to a UK-wide online satisfaction survey. The survey focused on donors' interactions with fertility clinic staff pre-, during, and post- donation. Basic cross-tabulation was performed on the data using online survey software. Textual data was read and extracts identified, which illustrated and expanded on the findings from the numerical data. Diagrammatic modeling was also utilised to analyse the textual data, with particular focus to relationships between the donors and clinic staff, the main activities within the gamete donation process, and how these activities may affect donor satisfaction with the gamete donation process. RESULTS Donors expressed concern for the infertile couple and the resulting child; conveyed frustration at not receiving information on the expenses they could claim; felt lost in the system regarding the ease of making clinic appointments, and once made they were routinely not seen on time for these appointments. Donors also negatively commented on aftercare, the location and condition of the donation room, and information on contraception. In addition, Ovarian Hyperstimulation Syndrome was frequently reported, with these egg donors believing that clinic staff were not concerned with their physical or emotional well-being, but were instead disproportionately focused on extracting the eggs. CONCLUSIONS The multifaceted notion of donors highlights the complexity inherent to the gamete donation process, which comprises various aspects of uncertainty in the donation system, and ambiguity in the donation process. Categorising donors as Altruist, Customer, and Patient, conveys the particular importance of staff communication and treatment in donor care. These categories are not mutually exclusive however, in that an individual donor may experience more than one of these perspectives during the course of their gamete donation journey. Finally, there were a number of exemplar cases, where donors reported high satisfaction throughout, and these correlated with them being given a single point of contact at the clinic. Subject to resource constraints, we suggest that this practice should be implemented throughout clinics in the UK, so that donors have access to dedicated clinic staff who not only support them emotionally and physically throughout the gamete donation process, but also ensure that communication is open, clear, timely, and consistent.
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Affiliation(s)
- Richard A. Williams
- Department of Management Science, Management School, Lancaster University, Lancaster, United Kingdom
- Data Science Institute, Lancaster University, Lancaster, United Kingdom
| | - Laura L. Machin
- Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
- * E-mail:
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Liu R, Chao MT, Jostad-Laswell A, Duncan LG. Does CenteringPregnancy Group Prenatal Care Affect the Birth Experience of Underserved Women? A Mixed Methods Analysis. J Immigr Minor Health 2018; 19:415-422. [PMID: 26942939 DOI: 10.1007/s10903-016-0371-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We examined the birth experience of immigrant and minority women and how CenteringPregnancy (Centering), a model of group prenatal care and childbirth education, influenced that experience. In-depth interviews and surveys were conducted with a sample of racially diverse Centering participants about their birth experiences. Interview transcripts were analyzed thematically. Study participants (n = 34) were primarily low-income, Spanish-speaking immigrants with an average age of 29.7. On a scale from 1 (not satisfied) to 10 (very satisfied), women reported high satisfaction with birth (9.0) and care (9.3). In interviews, they expressed appreciation for the choice to labor with minimal medical intervention. Difficulties with communication arose from fragmented labor and delivery care by multiple providers. Centering provided women with pain coping skills, a familiar birth attendant, and knowledge to advocate for themselves. High reported satisfaction may obscure challenges to providing high quality childbirth care for marginalized women. Further study should examine the potential of Centering to positively impact underserved women's birth experiences.
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Affiliation(s)
- Rhianon Liu
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Maria T Chao
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Ariana Jostad-Laswell
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Larissa G Duncan
- Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison, 1300 Linden Drive, Madison, WI, 53706, USA.
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Abstract
In a qualitative study, 119 women completed an online, open-ended survey about their childbirth experiences. In response to the question, "What ways, if any, did you experience failure?," 65% of women identified feelings of failure. Overwhelmingly attributing the failures to themselves, participants reported that they experienced failures of mind, body, action/inaction, representing "what I feel," "who I am," and "what I did or didn't do" and leading some participants to conclude that they were "less of woman," "less of a mother," or ultimately failed the baby. Such perceived failures can be unintentionally perpetuated by a system that neglects to address the complex experiences and interpretations of birthing women. Helping women anticipate and process the psychosocial and emotional aspects of the birth experience may serve as a protective factor against women internalizing perceived failures as their own, and preventing long term consequences of such feelings. The findings of this study highlight the importance of assessing women's personal experiences and interpretations of childbirth during the prenatal phase to address expectations and increase preparedness.
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Predictors of Women's Satisfaction with Hospital-Based Intrapartum Care in Asmara Public Hospitals, Eritrea. Obstet Gynecol Int 2017; 2017:3717408. [PMID: 29445401 PMCID: PMC5763131 DOI: 10.1155/2017/3717408] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 09/06/2017] [Accepted: 10/02/2017] [Indexed: 11/18/2022] Open
Abstract
Background Exploring patient satisfaction contributes to provide quality maternity care, but there is paucity of epidemiologic data in Eritrea. Objectives To determine the predictors of women's satisfaction with intrapartum care in Asmara public maternity hospitals in Eritrea. Methods A cross-sectional study among 771 mothers who gave birth in three public Hospitals. Chi-square tests were done to analyze the difference in proportion and logistic regression to assess the predictors of satisfaction with intrapartum care. Results Overall, only 20.8% of the participants were satisfied with intrapartum service. The key predictors of satisfaction with intrapartum care were provision of clean bed and beddings (AOR = 18.87, 2.33–15.75), privacy during examinations (AOR = 10.22, 4.86–21.48), using understandable language (AOR = 8.72, 3.57–21.27), showing how to summon for help (AOR = 8.16, 4.30–15.48), showing baby immediately after birth (AOR = 8.14, 2.87–23.07), control of the delivery room (AOR = 6.86, 2.65–17.75), receiving back massage (AOR = 6.43, 3.23–12.81), toilet access and cleanliness (AOR = 6.09, 3.25–11.42), availability of chairs for relatives (AOR = 5.96, 3.14–11.30), allowing parents to stay during labour (AOR = 3.52, 1.299–9.56), and request for permission before any procedure (AOR = 2.39, 1.28–4.46). Conclusion To increase satisfaction with intrapartum care, maternity service providers need to address the general maternity ward cleanliness, improve the quality of physical facilities, and sensitize health providers for better communication with clients. Policy makers need to adopt strategies that ensure more women involvement in decision making and consideration of privacy and reassurance needs during the whole delivery process.
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Validity of instruments for measuring the satisfaction of a woman and her partner with care received during labour and childbirth: Systematic review. Midwifery 2017; 55:103-112. [DOI: 10.1016/j.midw.2017.09.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/12/2017] [Accepted: 09/17/2017] [Indexed: 12/21/2022]
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Martin CR, Hollins Martin C, Redshaw M. The Birth Satisfaction Scale-Revised Indicator (BSS-RI). BMC Pregnancy Childbirth 2017; 17:277. [PMID: 28851307 PMCID: PMC5575858 DOI: 10.1186/s12884-017-1459-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 08/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current study sought to develop a short birth satisfaction indicator utilising items from the Birth Satisfaction Scale-Revised (BSS-R) for use as a brief measure of birth satisfaction and as a possible key performance indicator for perinatal service delivery evaluation. Building on the recently developed BSS-R, the study aimed to develop a simplified version of the instrument to assess birth satisfaction easily that could work as a short evaluative measure of clinical service delivery for labour and birth that is consistent with policy documents, placing women at the centre of the birth experience. METHODS The six item Birth Satisfaction Scale-Revised Indicator (BSS-RI) was embedded within the 2014 National Maternity Survey for England. A random selection of mothers who had given birth in a two week period in England were surveyed three months after the birth. Using a two-stage design and split-half dataset, exploratory factor analysis, confirmatory factor analysis, internal consistency, convergent, divergent and known-groups discriminant validity evaluation were conducted in a secondary analysis of the survey data. RESULTS Using this large population based survey of recent mothers the short revised measure was found to comprise two distinct domains of birth satisfaction, 'stress and emotional response to labour and birth' and 'quality of care'. The psychometric qualities of the tool were robust as were the indices of validity and reliability evaluated. CONCLUSION The BSS-RI represents a short easily administered and scored measure of women's satisfaction with care and the experience of labour and birth. The instrument is potentially useful for researchers, service evaluation and policy makers.
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Affiliation(s)
- Colin R Martin
- Faculty of Society and Health, Buckinghamshire New University, Uxbridge, UK
| | | | - Maggie Redshaw
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK.
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van Stenus CMV, Gotink M, Boere-Boonekamp MM, Sools A, Need A. Through the client's eyes: using narratives to explore experiences of care transfers during pregnancy, childbirth, and the neonatal period. BMC Pregnancy Childbirth 2017; 17:182. [PMID: 28606067 PMCID: PMC5467260 DOI: 10.1186/s12884-017-1369-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The client experience is an important outcome in the evaluation and development of perinatal healthcare. But because clients meet different professionals, measuring such experiences poses a challenge. This is especially the case in the Netherlands, where pregnant women are often transferred between professionals due to the nation's approach to risk selection. This paper explores questions around how clients experience transfers of care during pregnancy, childbirth, and the neonatal period, as well as how these experiences compare to the established quality of care aspects the Dutch Patient Federation developed. METHOD Narratives from 17 Dutch women who had given birth about their experiences with transfers were collected in the Netherlands. The narratives, for which informed consent was obtained, were collected on paper and online. Storyline analysis was used to identify story types. Story types portray patterns that indicate how clients experience transfers between healthcare providers. A comparative analysis was performed to identify differences and similarities between existing quality criteria and those clients mentioned. RESULTS Four story types were identified: 1) Disconnected transfers of care lead to uncertainties; 2) Seamless transfers of care due to proper collaboration lead to positive experiences; 3) Transfers of care lead to disruption of patient-provider connectedness; 4) Transfer of care is initiated by the client to make pregnancy and childbirth dreams come true. Most of the quality aspects derived from these story types were identified as being similar or complementary to the Dutch Patient Federation list. A 'new' aspect identified in the clients' stories was the influencing role of prior experiences with transfers of care on current expectations, fears, and wishes. CONCLUSIONS Transfers of care affect clients greatly and influence their experiences. Good communication, seamless transfers, and maintaining autonomy contribute to more positive experiences. The stories also show that previous experiences influence client's expectations for the next pregnancy, childbirth, and transfers of care.
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Affiliation(s)
- Cherelle M V van Stenus
- Institute for Innovation and Governance Studies, Departments of Public Administration, and Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
| | - Mark Gotink
- Department of Youth Healthcare, GGD Twente, P.O. Box 1400, 7500 BK, Enschede, The Netherlands
| | - Magda M Boere-Boonekamp
- Institute for Innovation and Governance Studies, Department of Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Anneke Sools
- Institute for Innovation and Governance Studies. Department of Psychology, Health and Technology, 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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Marhamati T, Torkzahrani S, Nasiri M, Lotfi R. The examination of quality of pregnancy care based on the World Health Organization's "Responsiveness" model of selected pregnant women in Tehran. Electron Physician 2017; 9:3720-3727. [PMID: 28465798 PMCID: PMC5410897 DOI: 10.19082/3720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 09/19/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The World Health Organization (WHO) Responsiveness model showing the ability of health systems in fulfilling people's expectations in connection with nonclinical aspects is an appropriate pattern to assess healthcare. The purpose of this study was to determine the status of pregnancy care provisions based on the responsiveness model. METHODS This was a cross-sectional study conducted by randomly sampling 130 women visiting selected hospitals in Tehran in 2015. A researcher-made questionnaire based on the responsiveness model of WHO was used to collect data. We determined the face validity and content validity of the questionnaire, and its reliability was confirmed by Cronbach's alpha coefficient (0.94) and test-retest analysis (0.96). The obtained data were analyzed by SPSS version 20 descriptive statistics, t-test, one-way ANOVA, Pearson product-moment correlation coefficient, and Spearman correlation. RESULTS Total responsiveness from the perspective of service recipients was 69.46±14.65 from 100. The obtained scores showed that, in the range of 0 to 100, 73.02 were about basic amenities (the most score), 72.93 about dignity, 70.91 about communication, 70.76 about confidentiality, 66.30 about provision social needs, 65.96 about choice of provider, 65.92 about autonomy, and 52.65 about prompt attention (the lowest score), which are representing the average level of service quality. There were significant relationships between participating in preparation class of labor and dignity (p<0.001), autonomy (p=0.01), provision social needs (p=0.01), and overall responsiveness (p=0.03). It was obtained that there is a significant linear relationship between scores given to hospitals and dimensions of responsiveness (p=0.05). Findings indicated a significant relationship between insurance type and dimensions of choice of provider (p=0.03) and communication (p=0.03). CONCLUSION The mean score of service quality in the present investigation illustrated that nonclinical dimensions have been disregarded and it has potential to be better. So some grand plans are needed.
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Affiliation(s)
- Tahereh Marhamati
- M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, International Branch, Tehran, Iran
| | - Shahnaz Torkzahrani
- M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Ph.D. in Biostatistics, Assistant Professor, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Lotfi
- Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran
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Baas CI, Wiegers TA, de Cock TP, Erwich JJHM, Spelten ER, de Boer MR, Hutton EK. Client-Related Factors Associated with a "Less than Good" Experience of Midwifery Care during Childbirth in the Netherlands. Birth 2017; 44:58-67. [PMID: 27905662 DOI: 10.1111/birt.12266] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND A "less than good" experience during childbirth can affect a mother's early interaction with her child and may significantly influence a woman's emotional well-being. In this study, we focus on clients who experienced midwifery care provided during childbirth as "less than good" care. The aim of this study was to understand the relationship between client-related factors and the experience of midwifery care during childbirth to improve this care. METHODS This study was part of the "DELIVER study" where mothers report on the care they received. We used generalized estimation equations to control for correlations within midwife practices. Forward multivariate logistic regression analyses were conducted to model the client-related factors associated with the experienced midwifery care during childbirth. RESULTS We included the responses of 2,377 women. In the multivariable logistic regression model, odds of reporting "less than good care" were significantly higher for women who experienced an unplanned cesarean birth (OR 2.21 [CI 1.19-4.09]), an instrumental birth (OR 1.55 [CI 1.08-2.23]), and less control during the dilation phase (OR 0.98 [CI 0.97-0.99]) and pushing phase (OR 0.98 [CI 0.97-0.99]). DISCUSSION Birth-related factors were more likely than maternal characteristics to be associated with the experience of midwifery care during childbirth. We conclude that there is room for midwives to improve their care for women during childbirth particularly in improving the patient centeredness of the care provider, using strategies to enhance sense of control, and focusing on the particular needs of those who experience instrumental vaginal or unplanned cesarean births.
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Affiliation(s)
- Carien I Baas
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Therese A Wiegers
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - T Paul de Cock
- Department of Midwifery Science, EMGO+VUMc, Amsterdam, the Netherlands
| | - Jan Jaap H M Erwich
- Department of Obstetrics and Gynaecology, University of Groningen, Groningen, the Netherlands.,University Medical Centre Groningen, Groningen, the Netherlands
| | - Evelien R Spelten
- Department of Public Health, Rural Health School, La Trobe University, Melbourne, Vic., 3086, Australia
| | | | - Eileen K Hutton
- Department of Midwifery Science, EMGO+VUMc, Amsterdam, the Netherlands.,Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
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Burcher P, Cheyney MJ, Li KN, Hushmendy S, Kiley KC. Cesarean Birth Regret and Dissatisfaction: A Qualitative Approach. Birth 2016; 43:346-352. [PMID: 27411933 DOI: 10.1111/birt.12240] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND The most consistently noted difference between unplanned cesarean and vaginal births is patient dissatisfaction or regret. This has been explored in multiple quantitative studies. However, the causes of this dissatisfaction remain elusive as a result of the limitations of survey instruments that restrict possible choices. METHODS Using open-ended, semi-structured interviews (n = 14), the purpose of this study was to identify potentially alterable factors that contribute to cesarean section regret when the surgery is performed during labor. In interviews that took place between 2 and 6 weeks postpartum, patients who had undergone an unscheduled cesarean birth during labor and had volunteered for the study were asked to share the story of their birth. Each participant was prompted to describe her understanding of the indication for her cesarean, and reflect on what felt positive and negative about her experience. Using consensus coding, three investigators independently evaluated the transcribed interviews, identifying recurring themes that were then discussed until consensus on the major themes was achieved. RESULTS Four key themes emerged from patients' unplanned cesarean narratives: poor communication, fear of the operating room, distrust of the medical team, and loss of control. Lack of or incomplete trust in care providers was a new factor not previously recognized as a cause of distress or dissatisfaction in the literature to date. CONCLUSION The four factors identified in this study are all potentially ameliorable, suggesting that changes in physician behavior may reduce patient dissatisfaction with unplanned cesarean birth.
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Simon RM, Johnson KM, Liddell J. Amount, Source, and Quality of Support as Predictors of Women's Birth Evaluations. Birth 2016; 43:226-32. [PMID: 26991407 DOI: 10.1111/birt.12227] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND This paper examines the separate effects of the perceived amount, source, and quality of support during labor and delivery on women's positive and negative evaluations of their birth experiences. METHODS Data come from the Listening to Mothers I and II (LTM) surveys (n = 2,765). Women's perception of support was regressed separately onto indices of positive and negative words that women associated with their labor and delivery. RESULTS The total number of support sources, type of support person, and quality of support all impacted women's birth evaluations across different regression models, controlling for demographics, birth interventions, and other birth characteristics. Support overall had a greater effect on increasing women's positive evaluations, but was not as protective against negative evaluations. Support from medical and birth professionals (doctors, nurses, doulas) had the greatest effect on women's positive evaluations. Good partner support was complexly related: it was associated with less positive evaluations but also appeared to have a protective effect against negative birth evaluations. DISCUSSION Support in childbirth is a complex concept with multiple dimensions that matter for women's birth evaluations. Support from nursing staff, doctors, and doulas is important for enabling positive evaluations while support from partners is more complexly related to women's evaluations. Research on support for laboring women should more extensively address the division of labor between different sources of support.
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Affiliation(s)
- Richard M Simon
- Sociology Department, University of Alabama, Huntsville, Huntsville, AL, USA
| | | | - Jessica Liddell
- City, Community, and Culture Program, Tulane University, New Orleans, LA, USA
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Perriman N, Davis D. Measuring maternal satisfaction with maternity care: A systematic integrative review. Women Birth 2016; 29:293-9. [DOI: 10.1016/j.wombi.2015.12.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 12/16/2015] [Accepted: 12/29/2015] [Indexed: 12/01/2022]
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Lewis L, Hauck YL, Ronchi F, Crichton C, Waller L. Gaining insight into how women conceptualize satisfaction: Western Australian women's perception of their maternity care experiences. BMC Pregnancy Childbirth 2016; 16:29. [PMID: 26846257 PMCID: PMC4743199 DOI: 10.1186/s12884-015-0759-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 11/23/2015] [Indexed: 11/16/2022] Open
Abstract
Background The concept of maternal satisfaction is challenging, as women’s and clinicians’ expectations and experiences can differ. Our aim was to investigate women’s experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum. Methods This mixed method study was conducted at a public maternity hospital in Western Australia. A questionnaire was sent to 733 women two weeks post birth, which included an invitation for an audio-recorded, telephone interview. Frequency distributions and univariate comparisons were employed for quantitative data. Thematic analysis of interview transcripts was undertaken to extract common themes. Results A total of 54 % (399 of 733) returned the questionnaire. Quantitative results indicated that women were less likely to feel: involved if they did not have a spontaneous vaginal birth (P = 0.020); supported by a midwife if they had a caesarean (P = <0.001); or supported by an obstetrician if they had a spontaneous vaginal birth (P = <0.001). Qualitative findings emerged from 63 interviews which highlighted the influence that organization of care, resources and facilities had on women’s satisfaction. These paradigms unfolded as three broad themes constructed by four sub-themes, each illustrating a dichotomy of experiences. The first theme ‘how care was provided’ encompassed: familiar faces versus a different one every time and the best place to be as opposed to so disappointed. The second theme ‘attributes of staff’ included: above and beyond versus caring without caring and in good hands as opposed to handled incorrectly. The third theme ‘engaged in care’ incorporated: explained everything versus did not know why and had a choice as opposed to did not listen to my needs. Conclusions Quantitative analysis confirmed that the majority of women surveyed were satisfied. Mode of birth influenced women’s perception of being involved with their birth. Being able to explore the diversity of women’s experiences in relation to satisfaction with their maternity care in an urban, tertiary obstetric setting has offered greater insight into what women value: a sensitive, respectful, shared relationship with competent clinicians who recognise and strive to provide woman focused care across the childbirth continuum.
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Affiliation(s)
- Lucy Lewis
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, 6102, Western Australia, Australia. .,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Yvonne L Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, 6102, Western Australia, Australia. .,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Fiona Ronchi
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Caroline Crichton
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
| | - Liana Waller
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia.
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Baas CI, Erwich JJHM, Wiegers TA, de Cock TP, Hutton EK. Women's Suggestions for Improving Midwifery Care in The Netherlands. Birth 2015; 42:369-78. [PMID: 26467657 DOI: 10.1111/birt.12185] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The experience of the care a woman receives during pregnancy and childbirth has an immediate and long-lasting effect on her well being. The involvement of patients and clients in health care has increased over the last decades. The Dutch maternity care system offers an excellent opportunity to explore and involve women's suggestions for the improvement of midwifery care in the current maternity care model. METHODS This qualitative study is part of the "DELIVER" study. Clients were recruited from 20 midwifery practices. Purposive sampling was used to select the practices. The clients received up to three questionnaires, in which they could respond to the question; "Do you have any suggestions on how your midwife could improve his/her provision of care?" The answers were analyzed with a qualitative thematic content analysis, using the software program MAXQDA. RESULTS Altogether, 3,499 answers were provided. One overarching concept emerged: clients' desire for individualized care. Within this concept, suggestions could be clustered around 1) provider characteristics: interpersonal skills, communication, and competence, and 2) service characteristics: content and quantity of care, guidance and support, continuity of care provider, continuity of care, information, and coordination of care. CONCLUSIONS Informed by the suggestions of women, care to women and their families could be improved by the following: 1) more continuity of the care provider during the prenatal, natal, and postnatal periods, 2) more information and information specifically tailored for the person, 3) client-centered communication, and 4) a personal approach with 5) enough time spent per client.
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Affiliation(s)
- Carien I Baas
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Jan Jaap H M Erwich
- Department of Obstetrics and Gynecology, Staff-Specialist Maternal and Fetal medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Therese A Wiegers
- Netherlands institute for health services research (NIVEL), Utrecht, The Netherlands
| | - T Paul de Cock
- Department of Midwifery Science, EMGO+VUMc, Amsterdam, The Netherlands
| | - Eileen K Hutton
- Department of Midwifery Science, EMGO+VUMc, Amsterdam, The Netherlands
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Women's Satisfaction of Maternity Care in Nepal and Its Correlation with Intended Future Utilization. Int J Reprod Med 2015; 2015:783050. [PMID: 26640814 PMCID: PMC4657080 DOI: 10.1155/2015/783050] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 10/14/2015] [Accepted: 10/19/2015] [Indexed: 11/17/2022] Open
Abstract
The impact of rapid increase in institutional birth rate in Nepal on women's satisfaction and planned future utilization of services is less well known. This study aimed to measure women's satisfaction with maternity care and its correlation with intended future utilisation. Data came from a nationally representative facility-based survey conducted across 13 districts in Nepal and included client exit interviews with 447 women who had either recently delivered or had experienced complications. An eight-item quality of care instrument was used to measure client satisfaction. Multivariate probit model was used to assess the attribution of different elements of client satisfaction with intended future utilization of services. Respondents were most likely to suggest maintaining clean/hygienic health facilities (42%), increased bed provision (26%), free services (24%), more helpful behaviour by health workers (18%), and better privacy (9%). Satisfaction with the information received showed a strong correlation with the politeness of staff, involvement in decision making, and overall satisfaction with the care received. Satisfaction with waiting time (p = 0.035), information received (p = 0.02), and overall care in the maternity care (<0.001) showed strong associations with willingness to return to facility. The findings suggest improving physical environment and interpersonal communication skills of service providers and reducing waiting time for improving client satisfaction and intention to return to the health facility.
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Kaye DK, Nakimuli A, Kakaire O, Osinde MO, Mbalinda SN, Kakande N. Gaps in continuity of care: patients' perceptions of the quality of care during labor ward handover in Mulago hospital, Uganda. BMC Health Serv Res 2015; 15:190. [PMID: 25943551 PMCID: PMC4424429 DOI: 10.1186/s12913-015-0850-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/24/2015] [Indexed: 11/21/2022] Open
Abstract
Background Client satisfaction is a common outcome measure for quality of care and goal for quality improvement in healthcare. We assessed women’s perceptions of the structure, process and outcome of intrapartum care in Mulago hospital, specifically, labor ward duty shift handovers. Methods Data was collected through 40 in-depth interviews conducted on two occasions: during the time of hospitalization and within 4–6 months after childbirth. Participants were women who delivered at the hospital, of whom some had life-threatening obstetric complications. Data was analyzed by thematic analysis. Results Maternity duty handovers were associated with patient dissatisfaction, particularly the process of hand-over, the decision-making that follows handovers and failure of communication of information to patients and their caretakers. Consequently, duty handovers were perceived inadequate. They were described as gaps in the continuity of care, and contributed to poor quality of care, birth trauma and mothers’ dissatisfaction with the childbirth experience. Conclusion The handover process and practices should be standardized using protocols and checklists. Health workers need training on handover practices, team work and communication skills (so as to improve patient-health provider and provider-provider interaction.
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Affiliation(s)
- Dan K Kaye
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Annettee Nakimuli
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Othman Kakaire
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Michael O Osinde
- Department of Obstetrics and Gynecology, Jinja Regional Hospital, Jinja, Uganda.
| | - Scovia N Mbalinda
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Nelson Kakande
- Clinical, Operations and Health Services Research Program, Joint Clinical Research Centre, P. O. Box 10005, Kampala, Uganda.
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Clark K, Beatty S, Reibel T. Maternity care: A narrative overview of what women expect across their care continuum. Midwifery 2015; 31:432-7. [DOI: 10.1016/j.midw.2014.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/12/2014] [Accepted: 12/31/2014] [Indexed: 11/15/2022]
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Ford JB, Hindmarsh DM, Browne KM, Todd AL. Are women birthing in New South Wales hospitals satisfied with their care? BMC Res Notes 2015; 8:106. [PMID: 25890303 PMCID: PMC4378554 DOI: 10.1186/s13104-015-1067-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 03/18/2015] [Indexed: 11/26/2022] Open
Abstract
Background Surveys of satisfaction with maternity care have been conducted using overnight inpatient surveys and dedicated maternity surveys in a number of Australian settings, however none have been used to report on satisfaction with maternity care among women in New South Wales. The aims of this study were to investigate the association between: 1) parity (first and subsequent births) and patient experience of hospital care at birth, and 2) other patient, birth and hospital characteristics and experience of hospital care at birth. Methods Data were from the New South Wales (NSW) Ministry of Health surveys of overnight hospital inpatients, including maternity patients, between 2007 and 2011. Questionnaires were mailed to a sample of patients three months after receiving inpatient services involving at least 1 night in a public hospital. Experience of care included 12 items grouped into: satisfaction with care, staff and information. Results were weighted to overall hospital facility populations and age-standardised. Frequencies and chi-square tests were used. Results Analysis of responses from 5,367 obstetric patients revealed three quarters of women were satisfied with care provided in hospital. Compared with women who had previously given birth, first-time mothers were more likely to recommend their birth hospital to friends and family (60.5% versus 56.4%; P < 0.05), less likely to have experienced differing messages from staff (44.8% vs 59.4%; P < 0.001), and less likely to feel they had received sufficient information about feeding (58.8% vs 65.0%; P < 0.001) and caring for their babies (52.4% vs 65.2%; P < 0.001). While metropolitan women were more likely to rate their birth hospital positively (76.0% vs. 71.3%; P < 0.05) than their rural counterparts, rural women tended to rate the care they received (68.1% vs. 63.4%; P < 0.05), and doctors (70.7% vs 61.1%; P < 0.05) and nurses (73.5% vs. 66.9%; P < 0.001) more highly than metropolitan women. Conclusions The overall picture of maternity care satisfaction in New South Wales is a positive one, with three quarters of women satisfied with care. Further resources could be dedicated to ensuring consistency and amount of information provided, particularly to first-time mothers. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1067-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jane B Ford
- C/- University Department of Obstetrics and Gynaecology, Kolling Institute, University of Sydney, Building 52, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.
| | - Diane M Hindmarsh
- Bureau of Health Information, PO Box 1770, Chatswood, Sydney, NSW, 2057, Australia.
| | - Kim M Browne
- Bureau of Health Information, PO Box 1770, Chatswood, Sydney, NSW, 2057, Australia.
| | - Angela L Todd
- C/- University Department of Obstetrics and Gynaecology, Kolling Institute, University of Sydney, Building 52, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.
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Takács L, Seidlerová JM, Šulová L, Hoskovcová SH. Social psychological predictors of satisfaction with intrapartum and postpartum care - what matters to women in Czech maternity hospitals? Open Med (Wars) 2015; 10:119-127. [PMID: 28352687 PMCID: PMC5152969 DOI: 10.1515/med-2015-0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 11/28/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify the social psychological factors affecting women's evaluation of care provided in Czech maternity hospitals using following criteria: satisfaction with intrapartum and postpartum care, willingness to return to a given hospital and to recommend the hospital to others. METHODS 762 women completed a 71-item original Czech questionnaire KLI-P designed to measure the psychosocial climate in both delivery and after-birth unit on six scales. The sample was representative of the Czech parturients population. Multivariate logistic regression was used to investigate the predictive value of the questionnaire scales for maternal satisfaction, willingness to return to and to recommend a given hospital. RESULTS For delivery unit, the satisfaction predictors were: helpfulness and empathy of midwives (Χ2=48.9), communication of information and availability of caregivers (Χ2=16.6), helpfulness and empathy of physicians (Χ2=10.9), symmetrical and respectful attitude of staff members (Χ2=9.7) and physical comfort and services (Χ2=7.6). The predictors of satisfaction with after-birth unit included helpfulness and empathy of the staff (Χ2≥42.1), communication of information and availability of caregivers (Χ2=52.5), physical comfort and services (Χ2=30.6), control and involvement in decision-making (Χ2=6.6) and parity (Χ2=8.6). The factors influencing women's willingness to return to and to recommend a hospital differed from the predictors of general satisfaction. CONCLUSIONS The satisfaction factors revealed in this research correspond predominantly to the results of studies conducted in other countries (warm, non-formal and supportive approach, sufficient and well-timed provision of information and explanation, availability of caregivers, physical environment). However, participation in decision making, which has been repeatedly shown to be among the strongest predictors of childbirth satisfaction, was not important for the Czech parturients' satisfaction with intrapartal care. This finding can be explained by different attitudes and expectations of both parturients and caregivers in a post-totalitarian country.
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Affiliation(s)
- Lea Takács
- Department of Psychology Faculty of Arts and Philosophy, Charles University, Nám. J. Palacha 2,116 38, Prague 1, Czech Republic; tel: +420 221 619 667, fax: +420 221 619 678
| | | | - Lenka Šulová
- Department of Psychology, Faculty of Arts and Philosophy, Charles University, Prague, Czech Republic
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Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Measuring parents' experiences and satisfaction with care during very preterm birth: a questionnaire development study. BJOG 2014; 121:1294-301. [PMID: 24953082 PMCID: PMC4282037 DOI: 10.1111/1471-0528.12925] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 11/27/2022]
Abstract
Objective To develop a questionnaire to assess parents' experiences and satisfaction with care during very preterm birth. Design Questionnaire development. Setting Parents whose babies had been cared for at five tertiary neonatal units in England. Population A total of 145 women who gave birth before 32 weeks of gestation, and 85 of their partners. Methods A 30-item questionnaire was developed on the basis of qualitative interviews with parents of very preterm babies, a literature review and discussion with relevant experts. The questionnaire was posted to a second group of parents, and its reliability and validity were explored. Main outcome measures The Preterm Birth Experience and Satisfaction Scale (P-BESS) was correlated with two global questions measuring satisfaction with care during the birth. Internal consistency was measured using Cronbach's α. Results Parents of 458 babies were invited to take part and 147 (32%) responded. Two women and 22 partners were excluded or ineligible, leaving 145 women and 85 partners. Factor analysis produced three clear dimensions: Staff professionalism and empathy, Information and explanations, and Confidence in staff. The total scale and three subscales showed high reliability. Strong positive correlations were found between the questionnaire scales and the two global questions, indicating convergent validity. For women whose partners were present at the birth, a fourth factor was identified ‘Partner Involvement’. Conclusions The P-BESS appears to be a valid measure of satisfaction with care during very preterm birth.
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Affiliation(s)
- A Sawyer
- Centre for Maternal and Child Health Research, School of Health Sciences, City University London, London, UK
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Butler MM, Brosnan MC, Drennan J, Feeney P, Gavigan O, Kington M, O'Brien D, Sheehy L, Walsh MC. Evaluating midwifery-led antenatal care: Using a programme logic model to identify relevant outcomes. Midwifery 2014; 30:e34-41. [DOI: 10.1016/j.midw.2013.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 10/01/2013] [Accepted: 10/05/2013] [Indexed: 10/26/2022]
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Murphy A, Wells J, Chesser-Smyth P, Sheahan L, Foley M. An Exploratory Survey of Low-Risk Pregnant Women’s Perceptions of Antenatal Care and Services in Southern Ireland. INTERNATIONAL JOURNAL OF CHILDBIRTH 2014. [DOI: 10.1891/2156-5287.4.3.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ireland currently has the highest birthrate of the 27 European Union countries which has led to an increase in demand for maternity services. In the Irish Republic, most maternity units have traditionally followed the medical-led model of care, which, as a result, has limited women’s choice for maternity care. Although various different midwifery-led schemes are available, concerns exist regarding the knowledge and accessibility of these schemes.The aim of this descriptive, exploratory survey was to explore and determine the views of “low-risk” pregnant women (n= 394) regarding their antenatal care and services. A purposive homogeneous sample comprised the first phase of a mixed methods study and data were analyzed using Predictive Analytics Software. The findings identified a lack of awareness and understanding of the concept of a low-risk pregnancy. Consequently, women identified an overall lack of information and an inability to access available options for their care.
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Andersson E, Christensson K, Hildingsson I. Mothers’ satisfaction with group antenatal care versus individual antenatal care – A clinical trial. SEXUAL & REPRODUCTIVE HEALTHCARE 2013; 4:113-20. [DOI: 10.1016/j.srhc.2013.08.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 07/07/2013] [Accepted: 08/12/2013] [Indexed: 10/26/2022]
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Sawyer A, Ayers S, Abbott J, Gyte G, Rabe H, Duley L. Measures of satisfaction with care during labour and birth: a comparative review. BMC Pregnancy Childbirth 2013; 13:108. [PMID: 23656701 PMCID: PMC3659073 DOI: 10.1186/1471-2393-13-108] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/02/2013] [Indexed: 12/17/2022] Open
Abstract
Background Satisfaction is the one of the most frequently reported outcome measures for quality of care. Assessment of satisfaction with maternity services is crucial, and psychometrically sound measures are needed if this is to inform health practices. This paper comparatively reviews current measures of satisfaction with care during labour and birth. Methods A review of the literature was conducted. Studies were located through computerised databases and hand searching references of identified articles and reviews. Inclusion criteria were that the questionnaire was a multi-item scale of satisfaction with care during labour and birth, and some form of psychometric information (either information about questionnaire construction, or reliability, or validity) had to be reported. Results Nine questionnaires of satisfaction with care during labour and birth were identified. Instruments varied in psychometric properties and dimensions. Most described questionnaire construction and tested some form of reliability and validity. Measures were generally not based on the main theoretical models of satisfaction and varied in scope and application to different types of samples (e.g. satisfaction following caesarean section). For an in-depth measure of satisfaction with intrapartum care, the Intrapartal-Specific Quality from the Patient’s Perspective questionnaire (QPP-I) is recommended. Brief measures with good reliability and validity are provided by the Six Simple Questions (SSQ) or Perceptions of Care Adjective Checklist (PCACL-R). Conclusions Despite the interest in measures of satisfaction there are only a small number of validated measures of satisfaction with care during labour and birth. It is important that brief, reliable and valid measures are available for use in general and specific populations in order to assist research and inform practice.
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Affiliation(s)
- Alexandra Sawyer
- School of Health Sciences, City University London, 20 Bartholomew Close, London, UK
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Arnold L, Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Parents' first moments with their very preterm babies: a qualitative study. BMJ Open 2013; 3:e002487. [PMID: 23550091 PMCID: PMC3641451 DOI: 10.1136/bmjopen-2012-002487] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/01/2013] [Accepted: 03/04/2013] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To assess parents' first experiences of their very preterm babies and the neonatal intensive care unit (NICU). DESIGN Qualitative study using semistructured interviews. PARTICIPANTS 32 mothers and 7 fathers of very preterm babies (<32 weeks gestation). SETTING Three neonatal units in tertiary care hospitals in South East England. RESULTS Five themes were identified. The first describes parents' blurred recall of the birth. The second shows the anticipation of seeing and touching their baby for the first time was characterised by contrasting emotions, with some parents feeling scared and others excited about the event. The third theme describes parents' first sight and touch of their babies and their 'rollercoaster' of emotions during this time. It also highlights the importance of touch to trigger and strengthen the parent-baby bond. However, some parents were worried that touching or holding the baby might transmit infection or interfere with care. The fourth theme captures parents' impressions of NICU and how overwhelming this was particularly for parents who had not toured NICU beforehand or whose first sight of their baby was on NICU. The final theme captures unique experiences of fathers, in particular that many felt excluded and confused about their role. CONCLUSIONS This study informs family-centred care by providing insight into the experiences of parents of very preterm infants at a time when they are most in need of support. Clinical implications include the importance of offering parents preparatory tours of the NICU and including fathers.
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Affiliation(s)
- Leah Arnold
- School of Psychology, University of Sussex, Brighton, East Sussex, UK
| | - Alexandra Sawyer
- School of Psychology, University of Sussex, Brighton, East Sussex, UK
| | - Heike Rabe
- Academic Department of Paediatrics, Brighton and Sussex University Hospitals Trust, Royal Alexandra Children's Hospital, Brighton, UK
| | - Jane Abbott
- Bliss (The Special Care Baby Charity), London, UK
| | | | - Lelia Duley
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Susan Ayers
- School of Health Sciences, City University London, London, UK
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