Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
BMJ Glob Health. 2021 Nov;6(12). doi: 10.1136/bmjgh-2021-007415.
Person-centred maternity care (PCMC), which refers to care that is respectful and responsive to women's preferences needs, and values, is core to high-quality maternal and child health. Provider-reported PCMC provision is a potentially valid means of assessing the extent of PCMC and contributing factors. Our objectives are to assess the psychometric properties of a provider-reported PCMC scale, and to examine levels and factors associated with PCMC provision.
We used data from two cross-sectional surveys with 236 maternity care providers from Ghana (n=150) and Kenya (n=86). Analysis included factor analysis to assess construct validity and Cronbach's alpha to assess internal consistency of the scale; descriptive analysis to assess extent of PCMC and bivariate and multivariable linear regression to examine factors associated with PCMC.
The 9-item provider-reported PCMC scale has high construct validity and reliability representing a unidimensional scale with a Cronbach's alpha of 0.72. The average standardised PCMC score for the combined sample was 66.8 (SD: 14.7). PCMC decreased with increasing report of stress and burnout. Compared with providers with no burnout, providers with burnout had lower average PCMC scores (β: -7.30, 95% CI:-11.19 to -3.40 for low burnout and β: -10.86, 95% CI: -17.21 to -4.51 for high burnout). Burnout accounted for over half of the effect of perceived stress on PCMC.
The provider PCMC scale is a valid and reliable measure of provider self-reported PCMC and highlights inadequate provision of PCMC in Kenya and Ghana. Provider burnout is a key driver of poor PCMC that needs to be addressed to improve PCMC.
以患者为中心的孕产护理（PCMC）是指对产妇偏好、需求和价值观予以尊重和回应的护理，它是母婴健康的核心。提供者报告的 PCMC 提供情况是评估 PCMC 程度和促成因素的一种潜在有效方法。我们的目标是评估提供者报告的 PCMC 量表的心理测量特性，并研究 PCMC 提供的程度和相关因素。
我们使用了来自加纳（n=150）和肯尼亚（n=86）的两项横断面调查中 236 名产妇保健提供者的数据。分析包括因子分析以评估结构效度和克朗巴赫 α 以评估量表的内部一致性；描述性分析以评估 PCMC 的程度以及进行单变量和多变量线性回归以研究与 PCMC 相关的因素。
9 项提供者报告的 PCMC 量表具有较高的结构效度和可靠性，代表了一个具有 0.72 克朗巴赫 α 的单维量表。综合样本的平均标准化 PCMC 得分为 66.8（SD：14.7）。随着压力和倦怠报告的增加，PCMC 会降低。与无倦怠的提供者相比，倦怠的提供者的平均 PCMC 评分较低（低倦怠的平均 PCMC 评分较低为 -7.30，95%置信区间：-11.19 至-3.40，高倦怠的平均 PCMC 评分较低为 -10.86，95%置信区间：-17.21 至-4.51）。倦怠占感知压力对 PCMC 影响的一半以上。
提供者 PCMC 量表是一种有效的、可靠的提供者自我报告的 PCMC 衡量工具，突显了肯尼亚和加纳 PCMC 提供不足的问题。提供者倦怠是导致 PCMC 不良的关键因素，需要加以解决以改善 PCMC。
