Rudman Ann, El-Khouri Bassam, Waldenström Ulla
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
J Adv Nurs. 2007 Sep;59(5):474-87. doi: 10.1111/j.1365-2648.2007.04323.x. Epub 2007 Jul 20.
This paper is a report of a study to investigate women's satisfaction with intrapartum care along three distinct dimensions simultaneously (interpersonal care, information and involvement in decision-making and physical birth environment) and to describe the characteristics of women with different patterns of satisfaction.
Patient satisfaction is an important outcome in the evaluation and development of healthcare services. Studies of satisfaction have often used single global ratings but such ratings may not capture the multidimensionality of care during childbirth.
A cluster analytic technique was used to establish a finite set of response patterns. Data were obtained from a longitudinal population-based Swedish survey including 2605 women who completed questionnaires in early pregnancy, and 2 months and 1 year after the birth. Data collection commenced in March 1999 and was completed in April 2002.
Nine different clusters, or patterns of satisfaction/dissatisfaction, were found. Nearly half of the women (47%) were in clusters that were satisfied or very satisfied with at least one dimension of care, 20% in clusters that were fairly satisfied (average), and 33% in less than satisfied clusters. Fifteen per cent were mainly dissatisfied with the physical environment, 8% mainly with interpersonal care, 7% only with information and decision-making and 3% with all dimensions. Women in the different clusters differed statistically significantly in psychological health in early pregnancy, emotional reactions during labour and in labour outcomes, but not in background characteristics.
Looking at different dimensions of care instead of a single global measure gave a richer, more diverse, and also a more negative picture of women's experiences of intrapartum care.
本文报告一项研究，旨在同时从三个不同维度（人际关怀、信息及参与决策、分娩物理环境）调查女性对分娩期护理的满意度，并描述具有不同满意度模式的女性特征。
患者满意度是医疗服务评估与发展中的一项重要结果。满意度研究通常采用单一的总体评分，但此类评分可能无法涵盖分娩期间护理的多维度性。
采用聚类分析技术来确定有限的一组反应模式。数据取自瑞典一项基于人群的纵向调查，包括2605名在孕早期、产后2个月及产后1年完成问卷的女性。数据收集于1999年3月开始，2002年4月完成。
发现了九种不同的聚类，即满意度/不满意度模式。近一半的女性（47%）处于对至少一个护理维度感到满意或非常满意的聚类中，20%处于相当满意（中等）的聚类中，33%处于不满意的聚类中。15%主要对物理环境不满意，8%主要对人际关怀不满意，7%仅对信息及决策不满意，3%对所有维度都不满意。不同聚类中的女性在孕早期的心理健康、分娩期间的情绪反应及分娩结局方面存在统计学显著差异，但在背景特征方面无差异。
审视护理的不同维度而非单一的总体衡量指标，能更全面、更多样化且更负面地呈现女性对分娩期护理的体验。
