基于世界卫生组织“响应性”模型对德黑兰部分孕妇的孕期护理质量检查。

The examination of quality of pregnancy care based on the World Health Organization's "Responsiveness" model of selected pregnant women in Tehran.

作者信息

Marhamati Tahereh, Torkzahrani Shahnaz, Nasiri Malihe, Lotfi Razieh

机构信息

M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, International Branch, Tehran, Iran.

M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Electron Physician. 2017 Feb 25;9(2):3720-3727. doi: 10.19082/3720. eCollection 2017 Feb.

DOI:10.19082/3720

PMID:28465798

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5410897/

Abstract

INTRODUCTION

The World Health Organization (WHO) Responsiveness model showing the ability of health systems in fulfilling people's expectations in connection with nonclinical aspects is an appropriate pattern to assess healthcare. The purpose of this study was to determine the status of pregnancy care provisions based on the responsiveness model.

METHODS

This was a cross-sectional study conducted by randomly sampling 130 women visiting selected hospitals in Tehran in 2015. A researcher-made questionnaire based on the responsiveness model of WHO was used to collect data. We determined the face validity and content validity of the questionnaire, and its reliability was confirmed by Cronbach's alpha coefficient (0.94) and test-retest analysis (0.96). The obtained data were analyzed by SPSS version 20 descriptive statistics, t-test, one-way ANOVA, Pearson product-moment correlation coefficient, and Spearman correlation.

RESULTS

Total responsiveness from the perspective of service recipients was 69.46±14.65 from 100. The obtained scores showed that, in the range of 0 to 100, 73.02 were about basic amenities (the most score), 72.93 about dignity, 70.91 about communication, 70.76 about confidentiality, 66.30 about provision social needs, 65.96 about choice of provider, 65.92 about autonomy, and 52.65 about prompt attention (the lowest score), which are representing the average level of service quality. There were significant relationships between participating in preparation class of labor and dignity (p<0.001), autonomy (p=0.01), provision social needs (p=0.01), and overall responsiveness (p=0.03). It was obtained that there is a significant linear relationship between scores given to hospitals and dimensions of responsiveness (p=0.05). Findings indicated a significant relationship between insurance type and dimensions of choice of provider (p=0.03) and communication (p=0.03).

CONCLUSION

The mean score of service quality in the present investigation illustrated that nonclinical dimensions have been disregarded and it has potential to be better. So some grand plans are needed.

摘要

引言

世界卫生组织（WHO）的响应性模型展示了卫生系统在满足人们与非临床方面相关期望的能力，是评估医疗保健的合适模式。本研究的目的是根据响应性模型确定孕期护理服务的现状。

方法

这是一项横断面研究，2015年在德黑兰选定的医院对130名就诊女性进行随机抽样。使用基于WHO响应性模型自制的问卷收集数据。我们确定了问卷的表面效度和内容效度，其信度通过克朗巴哈α系数（0.94）和重测分析（0.96）得到证实。所得数据采用SPSS 20版进行描述性统计、t检验、单因素方差分析、皮尔逊积差相关系数和斯皮尔曼相关分析。

结果

从服务接受者的角度来看，总响应性得分为69.46±14.65（满分100分）。所得分数表明，在0至100分的范围内，73.02分是关于基本便利设施（得分最高），72.93分是关于尊严，70.91分是关于沟通，70.76分是关于保密性，66.30分是关于满足社会需求，65.96分是关于选择提供者，65.92分是关于自主性，52.65分是关于及时关注（得分最低），这些代表了服务质量的平均水平。参加分娩准备课程与尊严（p<0.001）、自主性（p=0.01）、满足社会需求（p=0.01）和总体响应性（p=0.03）之间存在显著关系。结果表明，医院得分与响应性维度之间存在显著的线性关系（p=0.05）。研究结果表明，保险类型与选择提供者维度（p=0.03）和沟通维度（p=0.03）之间存在显著关系。