Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
Cooley Dickinson ObGyn and Midwifery, Cooley Dickinson Medical Group, Northampton, Massachusetts, USA.
J Womens Health (Larchmt). 2022 Oct;31(10):1411-1421. doi: 10.1089/jwh.2021.0643. Epub 2022 Sep 2.
Person-centered care has been increasingly recognized as an important aspect of health care quality, including in maternity care. Little is known about correlates and outcomes of person-centered care in maternity care in the United States. Data were from a prospective cohort of more than 3000 individuals who gave birth to a first baby in a Pennsylvania hospital. Person-centered maternity care was measured a 13-item rating scale administered 1-month postpartum. Content validity was established through exploratory factor analysis. The resulting scale had scores ranging from 13 to 54, with Cronbach's alpha of 0.86. Using linear and logistic regression models to control for covariates, we examined associations between participants' characteristics and person-centered maternity care and between person-centered maternity care and postpartum outcomes. Participants had a mean total score of 47.80 on the person-centered maternity care scale. Patient factors independently associated with more person-centered maternity care included older age, more positive attitude toward vaginal birth during pregnancy, and spontaneous vaginal birth. In adjusted models, higher person-centered maternity scale scores were strongly associated with many positive physical and mental health outcomes at 1 and 6 months postpartum. Our findings underscore the importance of person-centered maternity not just due to its intrinsic value but also because it may be associated with both mental and physical health outcomes through the postpartum period. Results suggest that policy efforts are necessary to ensure person-centered maternity care, especially for delivery hospitalization experience.
人本护理越来越被视为医疗质量的一个重要方面，包括在产科护理中。在美国，关于人本护理与产科护理的相关性和结果的了解甚少。
本研究的数据来自宾夕法尼亚州一家医院的 3000 多名初产妇的前瞻性队列研究。人本护理通过产后 1 个月的 13 项评分量表进行测量。通过探索性因子分析确定内容效度。该量表的评分范围为 13 至 54 分，克朗巴赫系数为 0.86。我们使用线性和逻辑回归模型来控制协变量，研究了参与者特征与人本护理的关系以及人本护理与产后结果的关系。
参与者在人本护理量表上的平均总分为 47.80 分。与更人本化的产科护理独立相关的患者因素包括年龄较大、怀孕期间对阴道分娩更积极的态度以及自然阴道分娩。在调整后的模型中，人本护理量表得分较高与产后 1 个月和 6 个月时许多身体和心理健康结果呈强相关。
我们的研究结果强调了人本护理的重要性，不仅因为其内在价值，还因为它可能通过产后期间与心理健康和身体健康结果相关。结果表明，有必要采取政策措施来确保人本护理，特别是分娩住院体验。
