Maternal and Fetal Health Research Centre, University of Manchester, Manchester, UK.
Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
BMC Pregnancy Childbirth. 2024 Jan 10;24(1):51. doi: 10.1186/s12884-023-06217-w.
In the United Kingdom, roughly 1 in 250 babies are stillborn each year. Most women who experience stillbirth become pregnant again - 80% within a year of loss. Presently, obstetric-led care is recommended; though there is a growing body of evidence to support provision of specialist services. The Rainbow Clinic is a specialist antenatal service providing care for pregnancies after loss incorporating clinical and psychological care. This study aimed to assess patient experience at the Rainbow Clinic and identify areas for clinical improvement. A 13-item questionnaire was distributed to pregnant women who attended the Rainbow Clinics at the Oxford Road and Wythenshawe sites of Saint Mary's Hospital, Manchester, UK between July 2016 and June 2021. Descriptive statistics and unpaired t-test were used for quantitative data and summative content analysis for qualitative data. Four-hundred and fifty-six women completed the questionnaire. The mean patient experience score per quarter was stable with an average of 21.1 (± 3.0) for the five years, with a maximum attainable score of 25. The COVID-19 pandemic had no effect on patient experience at the Rainbow Clinic (pre-pandemic vs. during-pandemic: mean 21.2 v 21.3; p = 0.75). Free-text responses demonstrated women felt positively about the antenatal care received. Identified areas for improvement included "more awareness of the [Rainbow] sticker" to ensure women with previous loss are identified; increased publicity of the Rainbow Clinic services; developing more clinics at different locations to improve accessibility; and continuing specialist input into intrapartum care. Specialist antenatal care provided by the Rainbow Clinic was rated as of a high standard. Potential future improvements include sticker alterations (or other mechanisms to identify women who have experienced a previous loss) and develop increased awareness of the clinic in other institutions.
在英国，每年大约有 1/250 的婴儿是死产。大多数经历过死产的女性会再次怀孕——80%是在失去孩子后的一年内。目前，建议提供产科主导的护理；尽管有越来越多的证据支持提供专业服务。彩虹诊所是一家专门的产前服务机构，为经历过流产的孕妇提供服务，包括临床和心理护理。本研究旨在评估彩虹诊所的患者体验，并确定临床改进的领域。在 2016 年 7 月至 2021 年 6 月期间，在英国曼彻斯特圣玛丽医院的牛津路和威森肖站点的彩虹诊所就诊的孕妇被分发了一份包含 13 个问题的问卷。使用描述性统计和未配对 t 检验对定量数据进行分析，对定性数据进行总结内容分析。共有 456 名女性完成了问卷。每季度的患者体验评分平均值保持稳定，五年平均为 21.1（±3.0），最高得分为 25。新冠疫情对彩虹诊所的患者体验没有影响（疫情前 vs. 疫情期间：平均 21.2 比 21.3；p=0.75）。自由文本回复表明，女性对接受的产前护理感到满意。确定的改进领域包括“提高对[彩虹]贴纸的认识”，以确保识别出有过流产史的女性；增加彩虹诊所服务的宣传；在不同地点开设更多诊所，以提高可及性；并继续由专业人员参与分娩期护理。彩虹诊所提供的专业产前护理被评为高标准。潜在的未来改进包括改变贴纸（或其他识别经历过流产的女性的机制），并提高其他机构对诊所的认识。
