Psychosocial climate in maternity hospitals from the perspective of parturients II.
Predictors of women‘s satisfaction with perinatal care in the Czech Republic

Česká verzia

Authors: L. Takács ¹; J. Seidlerová ²
Authors place of work: Katedra psychologie FF UK, Praha, vedoucí katedry doc. PhDr. I. Gillernová, CSc. ¹; II. interní klinika LF UK, Plzeň, přednosta prof. MUDr. J. Filipovský, CSc. ²
Published in the journal: Ceska Gynekol 2013; 78(3): 269-275

Summary

Objective:
To identify the key determinants of parturients‘ satisfaction with care provided in the Czech maternity hospitals and to draw up recommendation for good practice.

Design:
Original study.

Setting:
Department of Psychology, Faculty of Philosophy, Charles University, Prague.

Methods:
Statistical analysis of data from the representative sample of Czech parturients (n = 1195) who gave birth from 2005 to 2012 in Czech maternity hospitals was conducted. Ordinal logistical regression (cumulative logit model) was used to identify predictors of women‘s satisfaction with intrapartum and postpartum care and their willingness to return and give birth in the same hospital as well as to recommend the hospital to others. The independent variables were the individual items of the KLI-P questionnaire measuring psychosocial climate in maternity hospitals and socio-demographic and anamnestic characteristics of parturients.

Results:
Among the most important determinants of parturient‘s satisfaction with care at delivery unit were well-timed provision of information concerning a treatment plan (OR = 2,79; p < 0,0001), privacy during the first stage of labour (OR = 2,81; p < 0,0001), kind and helpful attitude of physicians (OR = 2,67; p < 0,0001) and confidence in physicians (OR = 2,68; p = 0,0001). Among the most important determinants of satisfaction with care at after-birth unit were well-timed provision of information concerning a treatment plan (OR = 2,25; p < 0,0001), active breastfeeding support (OR = 2,19;p < 0,0001), availability of caregivers (OR = 2,16;p < 0,0001), multiparity (OR = 1,52; p = 0,0001), respect shownby staff employed in mother care (OR = 2,02; p = 0,0004) and kind and helpful attitude of staff employed in newborn care (OR = 1,86; p = 0,0005). When considering the future place of birth and recommendation of the hospital to others, women predominantly take into account the care provided at delivery unit. Intrapartal care evaluation was affected to a lesser degree by satisfaction with midwives as compared to satisfaction with physicians.

Conclusion:
Analyses of the most important predictors of satisfaction with perinatal care indicate the need for practice to focus on enhancing psychosocial competences (particularly communication skills) of health care providers, more active breastfeeding support and communication of consistent information (especially concerning newborn care) by caregivers at after-birth unit.

Keywords:
maternal-child nursing – psychosocial factors – patient satisfaction – psychosocial climate – medical psychology

Zdroje

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