ResearchThe Role of Women's Attitudinal Profiles in Satisfaction with the Quality of their Antenatal and Intrapartum Care
Section snippets
Measurement
Several measurement tools compare expectations with experiences to determine levels of satisfaction (Hollins, Fleming, & Fleming, 2009; Symon, McGreavey, & Picken, 2003). The alignment between met and unmet expectations is an important constituent of the experience of an event and satisfaction with care; but a more essential relationship is between subjective importance and perceived reality. Subjective importance reflects how the person “wants” it to be, whereas expectancy ratings reflect how
Design
This exploratory study is one part of a prospective, longitudinal cohort investigation of aspects of pregnancy, birth, and early parenting of women from two hospitals in Sweden and Australia conducted during 2007 to 2009. Women were recruited in midpregnancy and followed up in late pregnancy and 2 months after birth.
Setting and System of Care
The cohorts came from two hospitals: one in the county of Västernorrland, Sweden, and one in the state of Victoria, Australia. The sites were close demographic matches. Both
Participation and Response
Of the 530 Swedish women who were eligible 519 were recruited (98% of those eligible), 386 women returned the questionnaire (74% response rate). The Australian site had 413 women eligible, 168 recruited (41% eligible) and 123 returns, making a response rate of 74% for the first questionnaire. The second questionnaire was completed by 323/368 Swedish women (84%) and 89/123 (72%) of the Australian women. The third questionnaire went to 386 Swedish women with 300 completed (77%) questionnaires and
Discussion
This study investigated perceived deficiencies in the quality of antenatal and intrapartum care by three attitudinal profiles of pregnant women. A number of aspects of antenatal care and intrapartum care exceeded the recommended QPP guidelines of 20% deficient ratings, with differences in responses identified across the profiles.
Overall, the self-determiners were the least likely to perceive problems with their antenatal and intrapartum care, whereas the fearful were the most likely. This
Conclusion
The application of attitudinal profiling was effective in identifying areas of greatest need for improvement in antenatal and intrapartum care for these three profiles of women. Improvements are clearly required in relation to communicating information and providing supportive, respectful care for women irrespective of their profile. Overall, the self-determiners perceived the least deficiency with their antenatal and intrapartum care and the fearful the most. When caring for a fearful woman,
Acknowledgement
Supported by the Australian Government Department of Health and Ageing through the University Departments of Rural Health Program and the Swedish Research Council.
Helen Haines, RN, RM, BN, MPH, PhD, is a lecturer in the Melbourne Medical School, Rural Health Academic Centre, The University of Melbourne, Shepparton, Victoria, Australia; Northeast Health Wangaratta, Victoria, Australia; and the Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Uppsala, Sweden.
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2021, Health Policy OPENCitation Excerpt :Due to the limits of health outcomes to measure service quality, often healthcare structure and process features are assessed as indirect indicators of quality [24,25]. Combination of direct and indirect measurement of satisfaction is evidenced for investigating interrelationships among clients’ perception of service quality, utility value, clients’ satisfaction, and their ultimate reactions to health care [26]. As the World Health Organization recommends monitoring and evaluating maternal satisfaction in health care sectors - to improve the quality and efficiency of health care during pregnancy, childbirth, and the puerperium [27], according to recommendations countries implement various tools to assess women’s satisfaction with maternal care services.
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Helen Haines, RN, RM, BN, MPH, PhD, is a lecturer in the Melbourne Medical School, Rural Health Academic Centre, The University of Melbourne, Shepparton, Victoria, Australia; Northeast Health Wangaratta, Victoria, Australia; and the Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Uppsala, Sweden.
Ingegerd Hildingsson, RN, RM, MSc, PhD, is a professor for Mid Sweden University, Östersund, Sweden; senior researcher in the Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden; and senior lecturer in the Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Uppsala, Sweden.
Julie Pallant, BA, PhD, is an associate professor and director of Graduate Studies in the Melbourne Medical School, Rural Health Academic Centre, The University of Melbourne, Shepparton, Victoria, Australia.
Christine Rubertsson, RN, RM, MSc, PhD, is an associate professor in the Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Uppsala, Sweden.
The authors report no conflict of interest or relevant financial relationships.