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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 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
 Stewart MA. Effective physician-patient communication and
health outcomes: a review. CMAJ 1995;152:1423-1433.
 Horwitz RI, Horwitz SM. Adherence to treatment and health
outcomes. Arch Intern Med 1993;153:1863-1868.
 Dubina MI, O’Neill JL, Feldman SR. Effect of patient satisfaction
on outcomes of care. Expert Rev Pharmacoecon Outcomes Res
 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.
 Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support
for women during childbirth. Cochrane Database Syst Rev
 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.
 Goodman P, Mackey MC, Tavakoli AS. Factors related to
childbirth satisfaction. J Adv Nurs 2004;46:212-219.
 Redshaw M. Women as consumers of maternity care:
measuring “satisfaction” or “dissatisfaction”? Birth
 Waldenström U, Borg IM, Olsson B, Skold M, Wall S. The
childbirth experience: a study of 295 new mothers. Birth
 Singh J. The patient satisfaction concept: a review and
reconceptualization. Advances in Consumer Research
 Bramadat IJ, Driedger M. Satisfaction with childbirth: theories
and methods of measurement. Birth 1993;20:22-29.
 Linder-Pelz SU. Toward a theory of patient satisfaction. Soc Sci
 Williams B. Patient satisfaction: a valid concept? Soc Sci Med
 Hodnett ED. Pain and women’s satisfaction with the experience
of childbirth: a systematic review. Am J Obstet Gynecol
 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.
 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
 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.
 Takács L. The psychosocial needs of newborn children in the
context of perinatal care. Ceska Gynekol 2012;77:15-21.
 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.
 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.
 Brown S, Lumley J. Satisfaction with care in labor and birth: a
survey of 790 Australian women. Birth 1994;21:4-13.
 Séguin L, Therrien R, Champagne F, Larouche D. The
components of women’s satisfaction with maternity care. Birth
 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
 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;
 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.
 Slade P, MacPherson SA, Hume A, Maresh M. Expectations,
experiences and satisfaction with labour. Br J Clin Psychol
 Waldenström U, Nilsson CA. Women’s satisfaction with
birth center care: a randomized, controlled study. Birth
 Hall JA, Dornan MC. Patient sociodemographic characteristics
as predictors of satisfaction with medical care: a meta-analysis.
Soc Sci Med 1990;30:811-818.
 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
 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.
 Dewey KG. Maternal and fetal stress are associated with
impaired lactogenesis in humans. J Nutr 2001;131:3012S-
 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.
 Creedy DK, Shochet IM, Horsfall J. Childbirth and the
development of acute trauma symptoms: incidence and
contributing factors. Birth 2000;27:104-111.
 Olde E, van der Hart O, Kleber R, van Son M. Posttraumatic
stress following childbirth: a review. Clin Psychol Rev
 Czarnocka J, Slade P. Prevalence and predictors of
post-traumatic stress symptoms following childbirth. Br J Clin
 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.
 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