Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles, Brussels, Belgium; Research Centre in Health Systems and Policies, School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles, Brussels, Belgium.
Midwifery. 2024 Nov;138:104139. doi: 10.1016/j.midw.2024.104139. Epub 2024 Aug 8.
Patient experience is an important part of perinatal care quality. Migrant women in high-income countries often report more negative experiences than non-migrants, but evidence in Europe is patchy. In this study, we compared the experiences of two migrant populations with non-migrants, taking into account socioeconomic characteristics.
We surveyed mothers born in Belgium, North-Africa, and Sub-Saharan Africa (n = 877) using an adapted version of the Migrant-Friendly Maternity Care Questionnaire. Two patient experience scores were created using multiple correspondence analyses: a) information and communication with healthcare professionals and overall satisfaction with pregnancy care, and b) patient-centred aspects and satisfaction with delivery care. Through descriptive analyses and multivariable logistic regressions we estimated the associations of maternal characteristics with each score.
Overall, positive experiences were reported in terms of communication (83 %) and patient-centred care (86 %). North African immigrants with low language proficiency had higher odds of negative communication experience (especially problems understanding information) (ORa: 2.30, 95 %CI 1.17-4.50), regardless of socioeconomic position. Among women with language barriers, 88 % were never offered a professional interpreter, relying on family members for translation. Patient-centred care was not associated with maternal birth region but was rated more negatively by older mothers, those with longer residence in Belgium, and higher majority-language proficiency.
In Belgium, perinatal care experiences were generally positive, although communication with immigrants was suboptimal. Language barriers, single motherhood, and unstable housing increased communication issues. Our findings underline the necessity to improve information-exchange with immigrants and socioeconomically vulnerable women.
患者体验是围产期护理质量的重要组成部分。高收入国家的移民女性的体验往往比非移民女性更差，但欧洲的证据参差不齐。在这项研究中，我们比较了两个移民群体与非移民群体的体验，同时考虑了社会经济特征。
我们使用经过改编的移民友好型产妇护理问卷对在比利时、北非和撒哈拉以南非洲出生的母亲（n=877）进行了调查。使用多元对应分析创建了两个患者体验评分：a）与医疗保健专业人员的信息和沟通以及对妊娠护理的总体满意度，以及 b）以患者为中心的方面和对分娩护理的满意度。通过描述性分析和多变量逻辑回归，我们估计了产妇特征与每个评分的关联。
总体而言，沟通（83%）和以患者为中心的护理（86%）方面的体验较为积极。语言能力较低的北非移民更有可能出现沟通体验不佳的情况（尤其是在理解信息方面存在问题）（ORa：2.30，95%CI 1.17-4.50），而不论其社会经济地位如何。在存在语言障碍的女性中，88%的人从未获得过专业翻译，只能依靠家庭成员进行翻译。以患者为中心的护理与产妇出生地区无关，但与年龄较大的母亲、在比利时居住时间较长的母亲和主要语言能力较高的母亲的评价更差。
在比利时，围产期护理体验总体上是积极的，尽管与移民的沟通并不理想。语言障碍、单身母亲和不稳定的住房增加了沟通问题。我们的研究结果强调了改善与移民和社会经济弱势群体的信息交流的必要性。
