Andrissi Laura, Petraglia Felice, Giuliani Alessandro, Severi Filiberto Maria, Angioni Stefano, Valensise Herbert, Vannuccini Silvia, Comoretto Nunziata, Tambone Vittoradolfo
Institute of Philosophy of Scientific and Technological Activity, University Campus Bio-Medico, Rome, Italy.
Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy.
PLoS One. 2015 Apr 23;10(4):e0124353. doi: 10.1371/journal.pone.0124353. eCollection 2015.
The study focuses on the perceived nature / technique opposition in pregnancy and delivery emerging from gynaecologist/ midwife/ pregnant woman relationships. We developed a cross-sectional survey to identify, by means of a multidimensional data-driven approach, the main latent concepts structuring the between items correlation correspondent to the different general opinions present in the data set. The obtained results can set the basis to improve patient satisfaction while decreasing healthcare costs.
The sample is made of 90 pregnant women within 24-48 hours after natural or operative birth, from three maternity units in Italy. Women filled in a questionnaire about their relationship with gynaecologist and midwife during pregnancy and hospital stay for delivery.
Participation rate approached 100%. The emerging factorial structure gave a proof-of-concept of the hypothesis of 'nature vs. technique' as the main dimension shaping women opinions. The results highlighted the role of midwife as the 'link' between the natural and technical dimension of birth. The quality of welcome and the establishing of an empathic relation between mother and healthcare professional was shown to decrease further request of care in the post-partum period.
The "fault plane" between nature and technique is a very critical zone for litigation. Women are particularly sensitive to the consideration and attention they receive at their admission in the hospital, as well as to the quality of human relationship with midwife. The perceived quality of welcome scaled with a decreased need of additional care and, more in general, with a more faithful attitude towards health professionals. We hypothesize that increasing the quality of welcome can exert an effect on both welfare costs and litigation. This opens the way (through an extension of this pilot study to wider populations) to relevant ameliorative actions on quality of care at practically null cost.
本研究聚焦于妇科医生/助产士/孕妇关系中在妊娠和分娩过程中出现的自然/技术对立观念。我们开展了一项横断面调查，通过多维度数据驱动方法，确定构成与数据集中不同总体意见相对应的项目间相关性的主要潜在概念。所获结果可为提高患者满意度同时降低医疗成本奠定基础。
样本由意大利三个产科单位中自然分娩或手术分娩后24至48小时内的90名孕妇组成。这些女性填写了一份关于她们在孕期及住院分娩期间与妇科医生和助产士关系的问卷。
参与率接近100%。新出现的因子结构证明了“自然与技术”假说作为塑造女性观点的主要维度的概念。结果凸显了助产士作为分娩自然维度与技术维度之间“纽带”的作用。研究表明，入院时受到的欢迎质量以及母婴与医护人员之间共情关系的建立，可减少产后护理需求。
自然与技术之间的“断层带”是引发医疗纠纷的关键区域。女性对入院时受到的关怀和关注以及与助产士的人际关系质量尤为敏感。感知到的欢迎质量与额外护理需求的减少相关，总体而言，与对医护人员更忠诚的态度相关。我们推测，提高欢迎质量可对福利成本和医疗纠纷产生影响。这为（通过将本试点研究扩展至更广泛人群）以几乎零成本开展相关改善护理质量的行动开辟了道路。
