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

Czech version

Authors: L. Takács ¹; J. Seidlerová ²
Authors‘ workplace: 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: Ceska Gynekol 2013; 78(3): 269-275

Overview

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

Sources

1. Ayers, S., Eagle, A., Waring, H. The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study. Psychol Health Med, 2006, 11, p. 389–398.

2. Ballard, CG., Stanley, AK., Brockington, IF. Post-traumatic stress disorder (PSTD) after childbirth. Brit J Psychiat, 1995, 166, p. 525–528.

3. Brown, S., Lumley, J. Satisfaction with care in labor and birth: a survey of 790 Australian women. Birth, 1994, 21, p. 4–13.

4. Bryanton, J., Gagnon, AJ., Hatem, M., Johnston, C. Predictors of early parenting self-efficacy: results of a prospective cohort study. Nurs Res, 2008, 57(4), p. 252–259.

5. Creedy, DK., Shochet, IM., Horsfall, J. Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth, 2000, 27(2), p. 104–111.

6. Czarnocka, J., Slade, P. Prevalence and predictors of post-traumatic stress symptoms following childbirth. Brit J Clin Psychol, 2000, 39, p. 35–51.

7. Dewey, KG., Nommsen-Rivers, LA., Heinig, MJ., et al. Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics, 2003, 112, 3, p. 607–619.

8. Goodman, P., Mackey, MC., Tavakoli, AS. Factors related to childbirth satisfaction. J Adv Nurs, 2004, 46, p. 212–219.

9. Gottvall, K., Waldenström, U. Does a traumatic birth experience have an impact on future reproduction? Brit J Obstet Gynaec, 2002, 109, p. 254–260.

10. Grajeda, R., Perez-Escamilla, R. Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women. J Nutr, 2002, 132, 10, p. 3055–3060.

11. Hodnett, ED. Pain and women‘s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol, 2002, 186, p. 160–172.

12. Hodnett, ED., Osborn, RW. Effects of continuous intrapartum professional support on childbirth outcomes. Res Nurs Health, 1989, 12, p. 289–297.

13. Chen, DC., Nommsen-Rivers, L., Dewey, KG., Lönnerdal, B. Stress during labor and delivery and early lactation performance. Am J Clin Nutr, 1998, 68, p. 335–344.

14. Kashanian, M., Javadi, F., Haghighi, MM. Effect of continuous support during labor on duration of labor and rate of cesarean delivery. Int J Gynecol Obstet, 2010, 109(3), p. 198–200.

15. Klaus, M., Kennell, JH. The effects of continual social support during birth on maternal and infant morbidity. In: PG. Fedor-Freybergh, MLV. Vogel (Eds.), Prenatal and perinatal psychology and medicine. Encounter with the unborn. New Jersey: The Parthenon Publishing Group, 1988.

16. Langer, A., Campero, L., Garcia, C., Reynoso, S. Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers‘ wellbeing in a Mexican public hospital: a randomised clinical trial. Br J Obstet Gynaecol, 1998, 105(10), p. 1056–1063.

17. Lerman, S., Shahar, G., Czarkowski, K., et al. Predictors of satisfaction with obstetric care in high-risk pregnancy: The importance of patient-provider relationship. J Clin Psychol Med S, 2007, 14, p. 330–334.

18. Olde, E., van der Hart, O., Kleber, R., van Son, M. Posttraumatic stress following childbirth: a review. Clin Psychol Rev, 2006, 26, p. 1–16.

19. Phillips, LH., O’Hara, MW. Prospective study of postpartum depression: four and one-half year follow-up of women and children. J Abnorm Psychol, 1991, 100, p. 151–155.

20. Reynolds, JL. Post-traumatic stress disorder after childbirth: the phenomenon of traumatic birth. Can Med Assoc J, 1997, 156, p. 831–835.

21. Righetti-Veltema, M., Conne-Perréard, E., Bousquet, A., Manzano, J. Risk factors and predictive signs of postpartum depression. J Affect Disorders, 1998, 49(3), p. 167–180.

22. Ryding, EL. Investigation of 33 women who demanded a cesarean section for personal reasons. Acta Obstet Gyn Scan, 1993, 72, p. 280–285.

23. Séguin, L., Therrien, R., Champagne, F., Larouche, D. The components of women‘s satisfaction with maternity care. Birth, 1989, 16, p. 109–113.

24. Simkin, P. Just another day in a woman’s life? Part I. Women’s longterm perceptions of their first birth experience. Birth, 1991, 18, p. 203–211.

25. Simkin P. Just another day in a woman’s life? Part II. Nature and consistency of women’s long-term memories of their first birth experiences. Birth, 1992, 19, p. 64–80.

26. Sosa, R., Kennell, JH., Klaus, MH, Urrutia, JJ. The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. N Engl J Med, 1980, 303(11), p. 597–600.

27. Takács, L., Kodyšová, E., Seidlerová, J. Souvislost psychosociálních aspektů perinatální péče s některými zákroky a zdravotními komplikacemi v průběhu porodu. Čes Gynek, 2012, 77(3), s. 195–204.

28. Takács, L., Seidlerová, J. Psychosociální klima porodnice očima rodiček I. Výsledky celorepublikového průzkumu spokojenosti s perinatální péčí v ČR. Čes Gynek, 2013, 78(2), s. 157–168.

29. Tschudin, S., Alder, J., Hendriksen, S., et al. Previous birth experience and birth anxiety: predictors of caesarean section on demand? J Psychosom Obst Gyn, 2009, 30(3), p. 175–180.

30. Waldenström, U., Borg, IM., Olsson, B., et al. The childbirth experience: a study of 295 new mothers. Birth, 1996, 23, p. 144–153.

31. 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, p. 551–560.

32. 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, p. 36–47.

33. World Health Organization. Care in Normal Birth: A Practical Guide. World Health Organization, Maternal Health and Safe Motherhood Programme, Division of Family Health. Geneva, 1996.