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多方面干预措施改善尼日利亚二级医院产妇护理满意度的结果。

Outcomes of a multifaceted intervention to improve maternal satisfaction with care in secondary hospitals in Nigeria.

机构信息

Women's Health and Action Research Centre (WHARC) , Benin City, Nigeria.

The Centre of Excellence in Reproductive Health Innovation, University of Benin , Benin City, Nigeria.

出版信息

Glob Health Action. 2020 Dec 31;13(1):1856470. doi: 10.1080/16549716.2020.1856470.

Abstract

: Data in Nigeria suggests a high level of dissatisfaction among women attending maternity care in health facilities due to long wait times, disrespectful care, and poor attention by healthcare personnel. : To examine the effectiveness of a multifaceted intervention in improving self-reported indicators of maternal healthcare satisfaction by women who use referral facilities in two regions of Nigeria. : The design was quasi-experimental and consisted of two intervention facilities and two control facilities. The interventions included strategic planning, staff re-training, a computerized appointment system, health education/feedback, maternal death reviews and surveillance, and advocacy. A random sample of 2262 women was selected (1205 in the intervention sites and 1057 in the two control sites) to respond to a 24-item questionnaire on service satisfaction as they exited the health facilities. Adjusted Poisson and binary regression analyses were used to assess and compare proportions of reported satisfaction by women between the intervention and control sites. : Women in the intervention sites were 54% more likely than those in control sites to report overall satisfaction with services. They were significantly less likely to report inadequate security arrangements in accessing the health facilities (p < .1); and three times more likely to agree that health workers were extremely thorough and careful in attending to them (p < .1). : The interventions had positive effects on improving women's satisfaction with care. The findings from this study have implications for the design and implementation of interventions that address women's concerns relating to the provision of care and consequently improve service utilization.

摘要

在尼日利亚的数据表明,由于等待时间长、医护人员不尊重、护理质量差等原因,在医疗机构接受产妇护理的女性满意度较低。本研究旨在探讨一项多方面干预措施对提高尼日利亚两个地区转诊机构中使用该服务的女性对产妇保健满意度的自我报告指标的有效性。

该研究采用准实验设计,包括两个干预设施和两个对照设施。干预措施包括战略规划、员工再培训、计算机预约系统、健康教育/反馈、产妇死亡审查和监测以及宣传。随机抽取了 2262 名女性(干预组 1205 名,对照组 1057 名),在离开医疗机构时回答了一份关于服务满意度的 24 项问卷。采用调整后的泊松和二项回归分析评估和比较了干预组和对照组女性报告的满意度比例。

与对照组相比,干预组的女性对服务的总体满意度高 54%。她们报告在获取医疗设施方面的安全措施不足的可能性显著降低(p<.1);并且有三倍的可能性同意卫生工作者在照顾她们时非常彻底和小心(p<.1)。

这些干预措施对提高女性对护理的满意度有积极影响。本研究的结果为设计和实施解决女性对护理提供的关注问题的干预措施提供了启示,从而提高了服务利用率。

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