从使用者角度看围产期保健服务质量：荷兰研究应用世界卫生组织的应答性概念。
Quality of perinatal care services from the user's perspective: a Dutch study applies the World Health Organization's responsiveness concept.
机构信息
Division of Obstetrics & Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Department Obstetrics & Gynaecology, Academic Collaboration Maternity Care Services, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands.
出版信息
BMC Pregnancy Childbirth. 2017 Sep 29;17(1):327. doi: 10.1186/s12884-017-1464-8.
BACKGROUND
The concept of responsiveness was introduced by the World Health Organization (WHO) to address non-clinical aspects of service quality in an internationally comparable way. Responsiveness is defined as aspects of the way individuals are treated and the environment in which they are treated during health system interactions. The aim of this study is to assess responsiveness outcomes, their importance and factors influencing responsiveness outcomes during the antenatal and delivery phases of perinatal care.
METHOD
The Responsiveness in Perinatal and Obstetric Health Care Questionnaire was developed in 2009/10 based on the eight-domain WHO concept and the World Health Survey questionnaire. After ethical approval, a total of 171 women, who were 2 weeks postpartum, were recruited from three primary care midwifery practices in Rotterdam, the Netherlands, using face-to-face interviews. We dichotomized the original five ordinal response categories for responsiveness attainment as 'poor' and good responsiveness and analyzed the ranking of the domain performance and importance according to frequency scores. We used a series of independent variables related to health services and users' personal background characteristics in multiple logistic regression analyses to explain responsiveness.
RESULTS
Poor responsiveness outcomes ranged from 5.9% to 31.7% for the antenatal phase and from 9.7% to 27.1% for the delivery phase. Overall for both phases, 'respect for persons' (Autonomy, Dignity, Communication and Confidentiality) domains performed better and were judged to be more important than 'client orientation' domains (Choice and Continuity, Prompt Attention, Quality of Basic Amenities, Social Consideration). On the whole, responsiveness was explained more by health-care and health related issues than personal characteristics.
CONCLUSION
To improve responsiveness outcomes caregivers should focus on domains in the category 'client orientation'.
背景
世界卫生组织（WHO）引入了响应性的概念，以国际可比的方式解决服务质量的非临床方面。响应性被定义为个人在卫生系统交互过程中受到的待遇和环境的方面。本研究旨在评估围产期保健的产前和分娩阶段的响应性结果、其重要性以及影响响应性结果的因素。
方法
2009/10 年，根据 WHO 概念的八个领域和世界卫生调查问卷，开发了《围产期和产科保健响应性问卷》。在获得伦理批准后，我们从荷兰鹿特丹的三个初级保健助产士实践中，共招募了 171 名产后 2 周的女性，使用面对面访谈的方式进行。我们将原始的五个有序响应类别二分法为“差”和“好”响应性，并根据频率得分分析了各领域表现和重要性的排名。我们使用了一系列与卫生服务和用户个人背景特征相关的自变量，在多项逻辑回归分析中解释响应性。
结果
在产前阶段，响应性差的结果范围为 5.9%至 31.7%，在分娩阶段为 9.7%至 27.1%。总体而言，在两个阶段，“尊重人”（自主性、尊严、沟通和保密性）领域的表现更好，被认为比“以客户为中心”领域（选择和连续性、及时关注、基本设施质量、社会考虑）更重要。总的来说，响应性更多地被医疗保健和健康相关问题而不是个人特征所解释。
结论
为了提高响应性结果，护理人员应关注“以客户为中心”类别的领域。
Zotero 插件