Social psychological predictors of satisfaction with intrapartum and postpartum care – what matters to women in Czech maternity hospitals?

Lea Takács 1 , Jitka Mlíková Seidlerová 2 , Lenka Šulová 1 , and Simona Horáková Hoskovcová 1
  • 1 Department of Psychology Faculty of Arts and Philosophy, Charles University, Nám. J. Palacha 2,116 38, Prague 1, Czech Republic
  • 2 Internal Department II, Faculty of Medicine in Pilsen, Charles University, Czech Republic

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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  • [1] Hojat M, Louis DZ, Maxwell K, Markham F, Wender R, Gonnella JS. Patient perceptions of physician empathy, satisfaction with physician, interpersonal trust, and compliance. Int J Med Educ 2010;1:83-87.

  • [2] Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ 1995;152:1423-1433.

  • [3] Horwitz RI, Horwitz SM. Adherence to treatment and health outcomes. Arch Intern Med 1993;153:1863-1868.

  • [4] Dubina MI, O’Neill JL, Feldman SR. Effect of patient satisfaction on outcomes of care. Expert Rev Pharmacoecon Outcomes Res 2009;9:393-395.

  • [5] Scott KD, Klaus PH, Klaus MH. The obstetrical and postpartum benefits of continuous support during childbirth. J Womens Health Gend Based Med 1999;8:1257-1264.

  • [6] Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database Syst Rev 2007;3:CD003766.

  • [7] Campbell DA, Lake MF, Falk M, Backstrand JR. A randomized control trial of continuous support in labor by a lay doula. J Obstet Gynecol Neonatal Nurs 2006;35:456-464.

  • [8] Goodman P, Mackey MC, Tavakoli AS. Factors related to childbirth satisfaction. J Adv Nurs 2004;46:212-219.

  • [9] Redshaw M. Women as consumers of maternity care: measuring “satisfaction” or “dissatisfaction”? Birth 2008;35:73-76.

  • [10] Waldenström U, Borg IM, Olsson B, Skold M, Wall S. The childbirth experience: a study of 295 new mothers. Birth 1996;23:144-153.

  • [11] Singh J. The patient satisfaction concept: a review and reconceptualization. Advances in Consumer Research 1989;16:176-179.

  • [12] Bramadat IJ, Driedger M. Satisfaction with childbirth: theories and methods of measurement. Birth 1993;20:22-29.

  • [13] Linder-Pelz SU. Toward a theory of patient satisfaction. Soc Sci Med 1982;16:577-582.

  • [14] Williams B. Patient satisfaction: a valid concept? Soc Sci Med 1994;38:509-516.

  • [15] Hodnett ED. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol 2002;186:S160-S172.

  • [16] Stadlmayr W, Amsler F, Lemola S, Stein S, Alt M, Bürgin D, Surbek D, Bitzer J. Memory of childbirth in the second year: the long-term effect of a negative birth experience and its modulation by the perceived intranatal relationship with caregivers. J Psychosom Obstet Gynaecol 2006;27:211-224.

  • [17] Takács L, Seidlerová J. Psychosocial climate in maternity hospitals from the perspective of parturients I. Results from a national survey on perinatal care satisfaction using a representative sample of 1195 Czech parturients. Ceska Gynekol 2013;78:157-168.

  • [18] Takács L, Seidlerová J, Hoskovcová S, Šulová L, Štětovská I, Kolumpková M, et al. Psychosocial aspect of contemporary Czech obstetrics. The quality of perinatal care from the perspective of parturients. Faculty of Arts, Charles University;2012: ISBN 978-80-7308-431-8.

  • [19] Takács L. The psychosocial needs of newborn children in the context of perinatal care. Ceska Gynekol 2012;77:15-21.

  • [20] Štembera Z, Velebil P. Prognosis of the level of perinatal care in the Czech Republic in near future II. From the World Health Organization point of view. Ceska Gynekol 2011;76:10-14.

  • [21] Takács L, Smolík F, Sněhotová J., Horáková Hoskovcová S. Diagnostics of the psychosocial climate in maternity hospitals – development and psychometric evaluation of the KLI-P Questionnaire. Cesk Psychol 2013;57:73-91.

  • [22] Brown S, Lumley J. Satisfaction with care in labor and birth: a survey of 790 Australian women. Birth 1994;21:4-13.

  • [23] Séguin L, Therrien R, Champagne F, Larouche D. The components of women’s satisfaction with maternity care. Birth 1989;16:109-113.

  • [24] Waldenström U, Rudman A, Hildingsson I. Intrapartum and postpartum care in Sweden: women’s opinions and risk factors for not being satisfied. Acta Obstet Gynecol Scand 2006;85:551-560.

  • [25] Lerman S, Shahar G, Czarkowski K, Kurshan N, Magriples U, Mayes L, Epperson CN. Predictors of Satisfaction with Obstetric Care in High-risk Pregnancy: The Importance of Patient- Provider Relationship. J Clin Psychol Medical Settings 2007; 14:330-334.

  • [26] Wilcock A, Kobayashi L, Murray I. Twenty-five years of obstetric patient satisfaction in North America: a review of the literature. J Perinat Neonatal Nurs 1997;10:36-47.

  • [27] Slade P, MacPherson SA, Hume A, Maresh M. Expectations, experiences and satisfaction with labour. Br J Clin Psychol 1993;32:469-483.

  • [28] Waldenström U, Nilsson CA. Women’s satisfaction with birth center care: a randomized, controlled study. Birth 1993;20:3-13.

  • [29] Hall JA, Dornan MC. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med 1990;30:811-818.

  • [30] Morhason-Bello IO, Adedokun BO, Ojengbede OA. Social support during childbirth as a catalyst for early breastfeeding initiation for first-time Nigerian mothers. Int Breastfeed J 2009;4:16.

  • [31] Grajeda R, Pérez-Escamilla R. Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women. J Nutr 2002;132:3055-3060.

  • [32] Dewey KG. Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr 2001;131:3012S- 3015S.

  • [33] Benoit C, Westfall R, Treloar A, Phillips R, Jansson SM. Social factors linked to postpartum depression: A mixed-methods longitudinal study. J Mental Health 2007;16:719-730.

  • [34] Creedy DK, Shochet IM, Horsfall J. Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth 2000;27:104-111.

  • [35] Olde E, van der Hart O, Kleber R, van Son M. Posttraumatic stress following childbirth: a review. Clin Psychol Rev 2006;26:1-16.

  • [36] Czarnocka J, Slade P. Prevalence and predictors of post-traumatic stress symptoms following childbirth. Br J Clin Psychol 2000;39:35-51.

  • [37] Bryanton J, Gagnon AJ, Hatem M, Johnston C. Predictors of early parenting self-efficacy: results of a prospective cohort study. Nurs Res 2008;57:252-259.

  • [38] Ayers S, Eagle A, Waring H. The effects of childbirthrelated post-traumatic stress disorder on women and their relationships: a qualitative study. Psychol Health Med 2006;11:389-398.

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