Oakley A
Social Science Research Unit, University of London.
Health Serv Res. 1991 Dec;26(5):651-69.
Two recurrent unsolved problems of health services practice and policy in modern industrial countries are those of social class inequalities and user dissatisfaction. This article presents data related to these issues drawn from a sample of British childbearing women deemed "at risk" by health professionals. A third focus is on the relationship between past experiences of maternity care, and the patterns of service provision and perceptions of needs and satisfaction revealed in a subsequent pregnancy. Findings show a tendency for patterns of care to be differentiated by social class, with working class women generally receiving comparatively poor service. Satisfaction with general practitioner (community-based) prenatal care is higher than with hospital care. The more socially disadvantaged women in the sample are more likely to be dissatisfied with their medical care. The three major pregnancy needs highlighted by the sample women are for more continuity of care, more sympathetic medical care, and help with household finances. Adverse previous childbearing experiences are related to more dissatisfaction in the subsequent pregnancy.
现代工业国家卫生服务实践与政策中两个反复出现的未解决问题是社会阶层不平等和用户不满。本文呈现了与这些问题相关的数据，这些数据来自被卫生专业人员视为“有风险”的英国生育妇女样本。第三个重点是产前护理的过往经历与后续妊娠中所揭示的服务提供模式、需求认知及满意度之间的关系。研究结果显示，护理模式有因社会阶层而产生差异的趋势，工人阶级女性通常得到相对较差的服务。对全科医生（社区医疗）产前护理的满意度高于医院护理。样本中社会处境更不利的女性更有可能对其医疗护理不满。样本女性所强调的三大孕期需求是护理更具连续性、医疗护理更具同情心以及家庭财务方面的帮助。之前不良的生育经历与后续妊娠中更多的不满相关。
