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报告在 COVID-19 大流行期间的信息共享和对产妇保健提供者的满意度:与社会经济地位的关联及向远程医疗的转变。

Reported information sharing and satisfaction with maternity care providers during the COVID-19 pandemic: Associations with socioeconomic status and shifts to telehealth.

机构信息

Department of Anthropology, Dartmouth College, Hanover, New Hampshire, USA.

Department of Anthropology, Washington University at St. Louis, St. Louis, Missouri, USA.

出版信息

Birth. 2023 Jun;50(2):396-406. doi: 10.1111/birt.12660. Epub 2022 Jun 13.

Abstract

BACKGROUND

The COVID-19 pandemic has dramatically affected pregnant people's prenatal care, labor, and delivery experiences. Given these rapid changes, providers have needed to be proactive in sharing information about COVID-19-related care impacts. The purpose of this study was to investigate: (a) Whether patient demographics or disrupted care (eg, canceled appointments and rapid shift to telehealth) is associated with patient-reported information sharing from the providers; and (b) Whether patient-reported provider information sharing or disruptions to care are associated with patient satisfaction with provider.

METHODS

Data come from a convenience sample of 1999 pregnant people living in the United States who completed an online survey between April 16 and May 7 2020.

RESULTS

Thirty-eight percent of participants said that their provider had not discussed how the pandemic would affect their care during pregnancy, labor, or delivery. Participants with lower education, less income, or whose appointments had been canceled or rescheduled because of the pandemic were significantly less likely to report information sharing. Provider satisfaction was significantly lower among participants who did not report information sharing, those who had appointments by way of telehealth, and those who reported that all their appointments had been rescheduled/canceled.

DISCUSSION

At the beginning of the pandemic, there were significant socioeconomic inequities in reported information sharing by the providers, which in turn was negatively associated with provider satisfaction. Providers need to be aware of the role implicit bias may play in information sharing-both generally and during public health crises-and consider ways to reduce the impacts of disrupted care delivery on patient satisfaction. If left unaddressed, perceived poor provider communication and associated low satisfaction with providers could contribute to adverse perinatal outcomes.

摘要

背景

COVID-19 大流行极大地影响了孕妇的产前护理、分娩和分娩体验。鉴于这些快速变化,提供者需要积极主动地分享有关 COVID-19 相关护理影响的信息。本研究的目的是调查:(a) 患者人口统计学特征或护理中断(例如,预约取消和快速转向远程医疗)是否与患者报告的提供者信息共享相关;以及(b) 患者报告的提供者信息共享或护理中断是否与患者对提供者的满意度相关。

方法

数据来自于 2020 年 4 月 16 日至 5 月 7 日期间在美国完成在线调查的 1999 名孕妇的便利样本。

结果

38%的参与者表示,他们的提供者没有讨论大流行将如何影响他们在怀孕期间、分娩期间或分娩期间的护理。受教育程度较低、收入较低、或因疫情取消或重新安排预约的参与者,报告信息共享的可能性明显较低。未报告信息共享、通过远程医疗预约或报告所有预约已重新安排/取消的参与者,对提供者的满意度显著降低。

讨论

在大流行开始时,提供者报告的信息共享存在显著的社会经济不平等,这反过来又与提供者满意度呈负相关。提供者需要意识到隐性偏见在信息共享方面的作用,无论是一般情况下还是在公共卫生危机期间,并考虑减少护理中断对患者满意度的影响的方法。如果不加以解决,患者对提供者沟通的看法不佳以及由此产生的对提供者的满意度低,可能会导致不良的围产期结局。

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