Saeb Samia, Korst Lisa M, Farahnik Ferina, McCulloch Jeanette, Greene Naomi, Fridman Moshe, Gregory Kimberly D
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8700 Beverly Blvd. West Tower, Los Angeles, CA, USA.
Childbirth Research Associates, LLC, North Hollywood, CA, USA.
Matern Child Health J. 2025 Apr;29(4):457-464. doi: 10.1007/s10995-025-04043-4. Epub 2025 Feb 5.
In collaboration with community research partners, a national cross-sectional online Childbirth Experience Survey (CBEX) of pregnant and postpartum birthing people was administered in 2016. The linked antepartum-postpartum survey included items across 18 domains (e.g., labor management, pain management, newborn care and feeding), and identified 23 childbirth-specific postpartum patient-reported outcomes (PROs) that were associated with hospital satisfaction. CBEX was implemented in 16 California hospitals to identify hospital-specific opportunities for improvement in care. We analyzed postpartum qualitative survey responses (1) to evaluate the content validity to test the representativeness of existing CBEX domains, (2) to assess for any potential new domains or topics of interest within existing domains, and (3) to use these data to provide hospitals with actionable information for practice improvement.
This was an analysis of qualitative survey data based on the following CBEX item: "Is there anything else you would like to share about your birth experience?" Patients could provide multiple comments. Using Atlas.ti Version 8, we mapped participant responses to the 18 existing CBEX domains.
Of 525 surveys completed between Oct 2018 and Sept 2020, 172 patients responded to the qualitative item. A total of 235 comments were analyzed and all were able to be mapped to the 18 domains. Qualitative responses highlighted subtleties within several CBEX domains: (1) labor management: pressure from the care team to have a labor induction; (2) pain management: epidural effectiveness, timing, dosage, and education; (3) empathy and respect: issues related to students and residents; and (4) newborn feeding: rough physical handling of patients by nurses, specifically during lactation consults.
CBEX survey data is currently being utilized in hospitals to inform childbirth-specific quality improvement initiatives. By capturing detailed voluntary participant responses, CBEX provides the opportunity to document and explore nuanced aspects of the childbirth experience and subtleties that may be contributing to maternal dissatisfaction.
2016年，我们与社区研究合作伙伴合作，对孕妇和产后产妇进行了一项全国性的横断面在线分娩体验调查（CBEX）。这项产前与产后相联系的调查涵盖了18个领域的项目（如分娩管理、疼痛管理、新生儿护理与喂养），并确定了23项与医院满意度相关的特定分娩产后患者报告结局（PROs）。CBEX在加利福尼亚州的16家医院实施，以确定各医院在护理方面具体的改进机会。我们分析了产后定性调查的回复，目的如下：（1）评估内容效度，以检验现有CBEX领域的代表性；（2）评估现有领域内是否存在任何潜在的新领域或感兴趣的主题；（3）利用这些数据为医院提供可采取行动的信息，以改进实践。
这是一项基于以下CBEX项目对定性调查数据进行的分析：“关于您的分娩经历，您还有其他想分享的吗？”患者可以提供多条评论。我们使用Atlas.ti 8版本，将参与者的回复映射到18个现有的CBEX领域。
在2018年10月至2020年9月期间完成的525份调查中，有172名患者回复了定性项目。总共分析了235条评论，所有评论都能够映射到18个领域。定性回复突出了几个CBEX领域中的细微之处：（1）分娩管理：护理团队施加的引产压力；（2）疼痛管理：硬膜外麻醉的效果、时机、剂量和相关知识；（3）共情与尊重：与学生和住院医生相关的问题；（4）新生儿喂养：护士对患者的粗暴身体处理，尤其是在哺乳咨询期间。
目前，医院正在利用CBEX调查数据为特定分娩质量改进计划提供信息。通过收集详细的自愿参与者回复，CBEX提供了记录和探索分娩体验细微方面以及可能导致产妇不满的微妙之处的机会。
