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[卢瓦尔河地区围产期健康网络“安全分娩”中424名患者的妊娠与分娩满意度]

[Pregnancy and delivery satisfaction of 424 patients in Perinatal Health Network « Sécurité Naissance » of Pays-de-la-Loire area].

作者信息

Branger B, Le Coz F, Gillard P, Merot E, Winer N

机构信息

Réseau « Sécurité naissance - Naître ensemble » des Pays-de-la-Loire, 2, rue de la Loire, 44200 Nantes, France.

Clinique de l'Anjou, 49933 Angers, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2014 May;43(5):361-70. doi: 10.1016/j.jgyn.2013.03.011. Epub 2013 Apr 23.

Abstract

BACKGROUND

One method of evaluating a perinatal policy measuring user satisfaction is an important issue. The objective of the study was to measure satisfaction with the monitoring of pregnancy, childbirth and maternity stay.

METHODS

Each volunteer maternity received a list of all births during one week in March-April 2008. The first mailing of questionnaires was conducted by post with stamped envelopes for the reply, after 2months in May and June 2008. A second reminder was made in July 2008. Responses to questions were coded using a Likert scale with four degrees with "very satisfied", "satisfied," "not very satisfied" and "not satisfied" with a quote by 4 to 1. The results are presented with the proportions of satisfied women, with radar diagrams. Transformation of responses with scores of 20 was established.

RESULTS

In total, 424 responses were obtained in 22 maternities (/24), on 524 questionnaires sent (response rate 80.9 %). A comparison of mothers who responded to those who did not respond showed an over-representation of senior and middle managers and department. The average response time from birth was ten weeks±1 (8-26). The early prenatal care (known as the 4th month) was ignored (the word) by 58 % of women, but satisfying for those who have had while preparing for the birth, information on ultrasounds, tests on blood testing were satisfactory. A total of 13.2 % of women were hospitalized, and 94.9 % of cases, the information was obtained with 96.5 % satisfaction for the explanations. Mothers were met for the monitoring of pregnancy to 95.4 %. At delivery, the reception was well received with 94.7 % of satisfaction, like attention paid to patients with 93.5 % satisfied. The satisfaction score for delivery in general (with or without cesarean) was 16.5±4.0 (out of 20) with 92.5 % satisfied. The score for the cesarean section was 16.3 versus 16.6 for the low channels (not significant [NS]) in the case of anesthesia of 16.5 versus 16.7 (NS) in case of episiotomy of 15.9 versus 16.9 (P<0.05). The length of postpartum stay was found too short in case of 4.8 % (4.7 days), correct in 78.6 % (4.8 days), too long in 15.9 % (4.8 days). The satisfaction score for delivery in general (with or without cesarean) was 16.5 out of 20 with 92.5 % of satisfied. Also, 73.1 % of mothers tended to agree about the useful information for baby; 77.8 % thought that breastfeeding went well. The total score for pregnancy and childbirth is averaging 16.1, with 95.7 % of satisfied. The dissatisfying factors for 17 women have been linked in univariate to a department, the choice of maternity proximity and the existence of an episiotomy. Multivariate analysis was not significant criteria of discontent.

CONCLUSION

Users respond to this type of investigation and seem satisfied with the care provided, in accordance with published data. The analysis of satisfaction and sources of dissatisfaction can improve treatments. The limits of the notion of satisfaction are analyzed.

摘要

背景

评估围产期政策中衡量用户满意度的一种方法是一个重要问题。本研究的目的是衡量对孕期、分娩及产后住院护理的满意度。

方法

每位参与的产妇都收到了一份2008年3月至4月某一周内所有分娩情况的清单。2008年5月和6月,在两个月后通过邮寄问卷并附上回邮邮票信封的方式进行首次问卷调查。2008年7月进行了第二次提醒。对问题的回答采用李克特量表进行编码,分为“非常满意”“满意”“不太满意”和“不满意”四个等级,比例为4∶1。结果以满意女性的比例呈现,并绘制雷达图。对得分20分的回答进行了转换。

结果

在22家产科机构(共24家)中,共收到424份回复,发出问卷524份(回复率80.9%)。对回复者与未回复者进行比较,发现高级和中级管理人员及部门代表过多。从分娩到回复的平均时间为10周±1周(8 - 26周)。58%的女性忽略了早期产前护理(即第4个月),但对那些在分娩准备过程中接受过超声检查、血液检测等信息的女性来说是满意的。共有13.2%的女性住院,在94.9%的病例中,对相关解释的满意度为96.5%。95.4%的产妇接受了孕期监测。分娩时,接待工作的满意度为94.7%,对患者的关注满意度为93.5%。总体分娩满意度评分(包括剖宫产和顺产)为16.5±4.0(满分20分),满意度为92.5%。剖宫产的评分为16.3分,低位产道分娩评分为16.6分(无显著差异[NS]);麻醉方面,剖宫产评分为16.5分,低位产道分娩评分为16.7分(无显著差异);会阴切开术方面,剖宫产评分为15.9分,低位产道分娩评分为16.9分(P<0.05)。4.8%的产妇认为产后住院时间过短(4.7天),78.6%认为合适(4.8天),15.9%认为过长(4.8天)。总体分娩满意度评分(包括剖宫产和顺产)为满分20分中的16.5分,满意度为92.5%。此外,73.1%的母亲认为关于婴儿的信息有用;77.8%认为母乳喂养情况良好。孕期和分娩的总评分为16.1分,满意度为95.7%。17名女性的不满意因素在单因素分析中与科室、产科机构的选择及会阴切开术的实施有关。多因素分析未发现显著的不满标准。

结论

用户对这类调查做出了回应,并且似乎对所提供的护理感到满意,这与已发表的数据一致。对满意度及不满意来源的分析可以改善治疗。分析了满意度概念的局限性。

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