Kosiva Alexandra, Xydias Emmanouil M, Ziogas Apostolos C, Tsakos Elias, Thanasas Ioannis, Lykeridou Aikaterini
Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, GRC.
Department of Obstetrics and Gynaecology, EmbryoClinic IVF, Thessaloniki, GRC.
Cureus. 2023 Sep 28;15(9):e46129. doi: 10.7759/cureus.46129. eCollection 2023 Sep.
Background The midwife's role throughout pregnancy and delivery management is essential, with multiple healthcare systems even following a midwife-led model of care. Of particular interest is the improvement and optimisation of midwifery postpartum care, which in Greece is empirically known to have decreased in quality, both due to the economic crisis and the recent pandemic. Aims To collect patient-reported outcomes with regard to the quality of midwifery services in Greece, ascertain baseline patient characteristics that may affect quality assessment, identify key areas for improvement, and propose patient subgroups who would most benefit from more specialized care. Setting and design A prospective, cross-sectional, questionnaire-based survey using the Measurement of Midwifery quality postpartum (MMAYpostpartum) questionnaire was conducted in public and private postpartum care centers in Greece. Methods The MMAYpostpartum questionnaire was distributed to 316 eligible women who received postpartum midwifery care in a healthcare center in Greece during the past three years. Multivariate linear regression was performed to examine significant correlations between baseline parameters and questionnaire scores. Results Ultimately, 204 answers were collected and analyzed. The patient's mean age was 35.5 years, and the mean body mass index (BMI) was 23.5. Overall, submitted scores were lower than those observed in the literature. A statistically significant correlation between older age, delivery at a public hospital, a history of hospitalization during pregnancy, and a lower midwifery service score was demonstrated. No other factors had a statistically significant effect on the quality score. Conclusions Delivery at public healthcare centers, older maternal age, and a history of hospitalization during pregnancy are significant predictors of a lower perceived quality of midwifery care. Thus, such patient subgroups may constitute potential targets for more meticulous midwifery care when resource setting prohibits the overall improvement of quality. Further research is required to collect additional data on patient insight and to test the present observations in a clinical setting.
背景 助产士在整个孕期及分娩管理过程中的作用至关重要，甚至有多个医疗保健系统采用以助产士为主导的护理模式。特别值得关注的是助产士产后护理的改进与优化，在希腊，由于经济危机和近期的疫情，据经验所知，其质量有所下降。目的 收集有关希腊助产服务质量的患者报告结果，确定可能影响质量评估的患者基线特征，识别关键改进领域，并提出最能从更专业护理中受益的患者亚组。设置与设计 在希腊的公立和私立产后护理中心进行了一项前瞻性、横断面、基于问卷的调查，使用产后助产质量测量（MMAYpostpartum）问卷。方法 将MMAYpostpartum问卷分发给在过去三年中在希腊一家医疗中心接受产后助产护理的316名符合条件的女性。进行多变量线性回归以检查基线参数与问卷分数之间的显著相关性。结果 最终，收集并分析了204份答案。患者的平均年龄为35.5岁，平均体重指数（BMI）为23.5。总体而言，提交的分数低于文献中观察到的分数。结果表明，年龄较大、在公立医院分娩、孕期有住院史与较低的助产服务分数之间存在统计学上的显著相关性。没有其他因素对质量分数有统计学上的显著影响。结论 在公立医疗中心分娩、产妇年龄较大以及孕期有住院史是助产护理质量感知较低的重要预测因素。因此，当资源设置禁止整体质量改进时，这类患者亚组可能构成更细致助产护理的潜在目标。需要进一步研究以收集关于患者见解的更多数据，并在临床环境中测试当前的观察结果。
