Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
BMJ Glob Health. 2022 Mar;7(3). doi: 10.1136/bmjgh-2021-008017.
To institutionalise respectful maternity care, frequent data on the experience of childbirth care is needed by health facility staff and managers. Telephone interviews have been proposed as a low-cost alternative to derive timely and actionable maternal self-reports of experience of care. However, evidence on the validity of telephone interviews for this purpose is limited.
Eight indicators of positive maternity care experience and 18 indicators of negative maternity care experience were investigated. We compared the responses from exit interviews with women about their childbirth care experience (reference standard) to follow-up telephone interviews with the same women 14 months after childbirth. We calculated individual-level validity metrics including, agreement, sensitivity, specificity, area under the receiver operating characteristic curve (AUC). We compared the characteristics of women included in the telephone follow-up interviews to those from the exit interviews.
Demographic characteristics were similar between the original exit interview group (n=388) and those subsequently reached for telephone interview (n=294). Seven of the eight positive maternity care experience indicators had reported prevalence higher than 50% at both exit and telephone interviews. For these indicators, agreement between the exit and the telephone interviews ranged between 50% and 92%; seven positive indicators met the criteria for validation analysis, but all had an AUC below 0.6. Reported prevalence for 15 of the 18 negative maternity care experience indicators was lower than 5% at exit and telephone interviews. For these 15 indicators, agreement between exit and telephone interview was high at over 80%. Just three negative indicators met the criteria for validation analysis, and all had an AUC below 0.6.
The telephone interviews conducted 14 months after childbirth did not yield results that were consistent with exit interviews conducted at the time of facility discharge. Women's reports of experience of childbirth care may be influenced by the location of reporting or changes in the recall of experiences of care over time.
为使产妇护理尊重文化规范化，医疗机构工作人员和管理人员需要经常获得分娩护理体验方面的数据。电话访谈已被提议作为一种低成本的替代方法，以便及时获得产妇对护理体验的自我报告，并采取相应措施。然而，关于电话访谈在这方面的有效性的证据有限。
我们调查了 8 项积极的产妇护理体验指标和 18 项消极的产妇护理体验指标。我们将分娩后妇女对分娩护理体验的面谈（参考标准）与分娩后 14 个月对同一妇女进行的后续电话访谈进行比较。我们计算了个体水平的有效性指标，包括一致性、敏感性、特异性、接收者操作特征曲线下的面积（AUC）。我们比较了电话随访访谈中纳入的妇女的特征与面谈中纳入的妇女的特征。
在原始面谈组（n=388）和随后进行电话访谈的组（n=294）中，人口统计学特征相似。在面谈和电话访谈中，8 项积极的产妇护理体验指标中有 7 项的报告发生率均高于 50%。对于这些指标，面谈和电话访谈之间的一致性在 50%至 92%之间；有 7 项积极指标符合验证分析的标准，但 AUC 均低于 0.6。在面谈和电话访谈中，18 项消极产妇护理体验指标中有 15 项的报告发生率均低于 5%。对于这 15 项指标，面谈和电话访谈之间的一致性均在 80%以上。只有 3 项消极指标符合验证分析的标准，AUC 均低于 0.6。
分娩后 14 个月进行的电话访谈与分娩时在医疗机构出院时进行的面谈结果不一致。产妇对分娩护理体验的报告可能会受到报告地点或随时间推移对护理体验的记忆变化的影响。
