Gaining insight into how women conceptualize satisfaction: Western Australian women’s perception of their maternity care experiences
Tóm tắt
The concept of maternal satisfaction is challenging, as women’s and clinicians’ expectations and experiences can differ. Our aim was to investigate women’s experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum. This mixed method study was conducted at a public maternity hospital in Western Australia. A questionnaire was sent to 733 women two weeks post birth, which included an invitation for an audio-recorded, telephone interview. Frequency distributions and univariate comparisons were employed for quantitative data. Thematic analysis of interview transcripts was undertaken to extract common themes. A total of 54 % (399 of 733) returned the questionnaire. Quantitative results indicated that women were less likely to feel: involved if they did not have a spontaneous vaginal birth (P = 0.020); supported by a midwife if they had a caesarean (P = <0.001); or supported by an obstetrician if they had a spontaneous vaginal birth (P = <0.001). Qualitative findings emerged from 63 interviews which highlighted the influence that organization of care, resources and facilities had on women’s satisfaction. These paradigms unfolded as three broad themes constructed by four sub-themes, each illustrating a dichotomy of experiences. The first theme ‘how care was provided’ encompassed: familiar faces versus a different one every time and the best place to be as opposed to so disappointed. The second theme ‘attributes of staff’ included: above and beyond versus caring without caring and in good hands as opposed to handled incorrectly. The third theme ‘engaged in care’ incorporated: explained everything versus did not know why and had a choice as opposed to did not listen to my needs. Quantitative analysis confirmed that the majority of women surveyed were satisfied. Mode of birth influenced women’s perception of being involved with their birth. Being able to explore the diversity of women’s experiences in relation to satisfaction with their maternity care in an urban, tertiary obstetric setting has offered greater insight into what women value: a sensitive, respectful, shared relationship with competent clinicians who recognise and strive to provide woman focused care across the childbirth continuum.
Tài liệu tham khảo
Sawyer A, Ayres S, Abbot J, Gyte G, Rabe H, Dudley L. Measures of satisfaction with care during labour and birth: a comparative review. BMC Pregnancy Childbirth. 2013;13:108. 3659073, 10.1186/1471-2393-13-108, 23656701
Jenkins M, Ford J, Morris J, Roberts C. Women’s expectations and experiences of maternity care in NSW-what women highlight as important. Women Birth. 2014;27(3):214–9. 10.1016/j.wombi.2014.03.002, 24746379
Rudman A, El-Khouri B, Waldenström U. Women’s satisfaction with intrapartum care - a pattern approach. J Adv Nurs. 2007;59(5):474–87. 10.1111/j.1365-2648.2007.04323.x, 17645495
Redshaw M. Women as consumers of maternity care: measuring “satisfaction” or “dissatisfaction”? Birth. 2008;1(35):73–6. 10.1111/j.1523-536X.2007.00215.x
Haines H, Hildingsson I, Pallant J, Rubertsson C. The role of women’s attitudinal profiles in satisfaction with the quality of their antenatal and intrapartum care. J Obstet Gynecol Neonatal Nurs. 2013;42(4):428–41. 10.1111/1552-6909.12221, 23773005
Brown S, Lumley J. Satisfaction with care in labor and birth: a survey of 790 Australian Women. Birth. 1994;21(1):4–13. 10.1111/j.1523-536X.1994.tb00909.x, 1:STN:280:DyaK2c3gs1ersg%3D%3D, 8155224
Brodribb W, Zodoroznyj M, Nesic M, Kruske S, Miller Y. Beyond the hospital door: a retrospective, cohort study of associations between birthing in the public or private sector and women’s postpartum care. BMC Health Serv Res. 2015;15:63. 10.1186/s12913-015-0689-3
Henderson J, Redshaw M. Women’s experience of induction of labor: a mixed methods study. Acta Obstet Gynecol Scand. 2013;92(10):1159–67. 23808325
Dunn E, Herlihy C. Comparison of maternal satisfaction following vaginal delivery after caesarean section and caesarean section after previous vaginal delivery. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):56–60. 10.1016/j.ejogrb.2004.11.010, 15950369
Hodnett E. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002;185(5 Suppl Nature):S160–72.
Hodnett E, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. Cochrane Database of Syst Rev. 2013;7:CD003766.
Christiaens W, Bracke P. Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective. BMC Pregnancy Childbirth. 2007;7:26. 2200649, 10.1186/1471-2393-7-26, 17963491
Hauck Y, Fenwick J, Downie J, Butt J. The influence of childbirth expectations on Western Australian women’s perceptions of their birth experience. Midwifery. 2007;23(3):235–47. 10.1016/j.midw.2006.02.002, 17097202
Matejić B, Milićević MŠ, Vasić V, Djikanović B. Maternal satisfaction with organized perinatal care in Serbian public hospitals. BMC Pregnancy Childbirth. 2014;14:14. 3916080, 10.1186/1471-2393-14-14, 24410839
Jenkins M, Ford J, Todd A, Forsyth R, Morris J, Roberts C. Women׳s views about maternity care: How do women conceptualise the process of continuity? Midwifery. 2015;31(1):25–30. 10.1016/j.midw.2014.05.007, 24861672
Waldenström U, Rudman A, Hildingsson I. Intrapartum and postpartum care in Sweden: women’s opinions and risk factors for not being satisfied. Acta Obstet Gynecol Scand. 2006;85(5):551–60. 10.1080/00016340500345378, 16752233
Walsh D. Childbirth embodiment: problematic aspects of current understandings. Sociol Health Illn. 2010;32(3):486–501. 10.1111/j.1467-9566.2009.01207.x, 20003040
Waldenström U, Hildingsson I, Rubertsson C, Rådestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17–27. 10.1111/j.0730-7659.2004.0270.x, 15015989
Larkin P, Begley C, Devane D. ‘Not enough people to look after you’: an explanation of women’s experiences of childbirth in the Republic of Ireland. Midwifery. 2012;1:91–105.
van Teijlingen E, Hundley V, Rennie A-M, Graham W, Fitzmaurice A. Maternity satisfaction studies and their limitations: “What is, must still be best”. Birth. 2003;30(2):75–82. 10.1046/j.1523-536X.2003.00224.x, 12752163
Creswell J, Plano CV. The foundations of mixed methods research. In: Creswell J, Plano Clark V, editors. Designing and conducting mixed methods research. London: Sage; 2011. p. 19–52.
Polit D, Beck C. Designing and conducting mixed methods studies to generate evidence for nursing. In: Polit D, Beck C, editors. Generating and assessing evidence for nursing practice. Sydney: Lippincott, Williams & Wilkins; 2012. p. 149–62.
Johnson B, Onwuegbuzie A, Turner L. Toward a definition of mixed methods research. J Mix Methods Res. 2007;1(2):112–33. 10.1177/1558689806298224
Hutchinson M, Joyce A. Western Australia’s mothers and babies, 2011: Twenty-ninth annual report of the Western Australian midwives’ notification system. Western Australia: Department of Health; 2014.
Lewis L, Hauck Y, Ritchie S, Barnett L, Nunan H, Rivers C. Australian women’s perception of their preparation for and actual experience of a recent scheduled caesarean birth. Midwifery. 2014;30(3):e131–6. 10.1016/j.midw.2013.12.009, 24445077
Streubert H. The conduct of qualitative research: common essential elements. In: Carpenter D, Streubert H, editors. Qualitative research in nursing. Sydney: Lippincott, Williams & Wilkins; 2011. p. 20–31.
The National Health and Medical Research Council, The Australian Research Council, The Australian Vice-Chancellors’ Committee. National Statement on Ethical Conduct in Human Research 2007 (Updated March 2015). Commonwealth of Australia, Canberra. 2015. http://www.nhmrc.gov.au/guidelines-publications/e72. Accessed 10 November 2015.
Norwood S. Data analysis and qualitative research. In: Norwood S, editor. Research essentials: foundations for evidence-based practice. Sydney: Pearson; 2010. p. 340–58.
Creswell J. Standards of validation and evaluation. In: Creswell J, editor. Qualitative inquiry and research design: choosing among five approaches. Los Angeles: Sage; 2013. p. 243–68.
Clark K, Beatty S, Reibel T. Maternity care: A narrative overview of what women expect across their care continuum. Midwifery. 2015; doi: 10.1016/j.midw.2014.12.009. [Epub ahead of print].
Hildingsson, I. Women’s birth expectations, are they fulfilled? Findings from a longitudinal Swedish cohort study. Women Birth. 2015; doi: org/10.10.16/j.wombi.2015.01.011. [Epub ahead of print].
Hoffmann T, Légaré F, Simmons M, McNamara K, McCaffery K, Trevena L, et al. Shared decision making: what do clinicians need to know and why should they bother? Med J Aust. 2014;201(1):35–9. 10.5694/mja14.00002, 24999896
Anusic I, Yap S, Lucas R. Does personality moderate reaction and adaptation to major life events? Analysis of life satisfaction and affect in an Australian national sample. J Res Pers. 2014;51:69–77. 10.1016/j.jrp.2014.04.009
Attanasio L, Kozhimannil K. Positive childbirth experiences in US hospitals: a mixed methods analysis. Matern Child Health J. 2014;18(5):1280–90. 3966989, 10.1007/s10995-013-1363-1, 24072597
Bibeau A. Interventions during labor and birth in the United States: a qualitative analysis of women’s experiences. Sex Reprod Healthc. 2014;5(4):167–73. 10.1016/j.srhc.2014.10.003, 25433825
Carlsson I, Ziegert K, Sahlberg-Blom E, Nissen E. Maintaining power: women’s experiences from labour onset before admittance to maternity ward. Midwifery. 2012;28(1):86–92. 10.1016/j.midw.2010.11.011, 21237538
Fair C, Taylor E. The relationship between prenatal control, expectations, experienced control, and birth satisfaction among primiparous women. Midwifery. 2012;28(1):39–44. 10.1016/j.midw.2010.10.013, 21458895
Green M, Baston H. Feeling in control during labor: concepts correlates, and consequences. Birth. 2003;30(4):235–47. 10.1046/j.1523-536X.2003.00253.x, 14992154
Shafiei T, Small R, McLachlan H. Women’s views and experiences of maternity care: a study of immigrant Afgan women in Melbourne Australia. Midwifery. 2012;28(2):198–203. 10.1016/j.midw.2011.02.008, 21458892
Andersson E, Christensson K, Hildingsson I. Mothers’ satisfaction with group antenatal care versus individual antenatal care – a clinical trial. Sex Reprod Healthc. 2013;4(3):113–20. 10.1016/j.srhc.2013.08.002, 24041732
Johanson R, Newburn M, Macfarlane A. Has the medicalisation of childbirth gone too far? BMJ. 2002;324(7342):892–5. 1122835, 10.1136/bmj.324.7342.892, 11950741
Henderson J, Redshaw M. Who is well after childbirth? Factors related to positive outcome. Birth. 2013;40(1):1–9. 10.1111/birt.12022, 24635418
Simmonds A, Peter E, Hodnett E, McGills Hall. Understanding the moral nature of intrapartum nursing. J Obstet Gynecol Neonatal Nurs. 2013;42(2):148–55. 10.1111/1552-6909.12016, 23374158