Women with preeclampsia satisfaction toward health services and midwifery care at two large hospitals in Palestine.
Date
2022-05-28
Authors
Nariman Ahmad Odeh Barahma
ناريمان أحمد عودة براهمة
Journal Title
Journal ISSN
Volume Title
Publisher
Al-Quds University
Abstract
الخلفية : تسمم الحمل هو متلازمة خاصة بالحمل تتميز بداية بارتفاع ضغط الدم (> 140/90 مم زئبق) وبروتين في البول (> 0.3 جم / 24 ساعة) ويؤثر على 0.4٪ -15.6٪ من جميع حالات الحمل. ويرتبط تسمم الحمل بنتائج سيئة ومميتة للأمومة ، لذا فإن تحديد المخاطر جزء مهم من الرعاية خلال الحمل لتحسين العلاج. الهدف من رعاية الأمومة هو تحقيق الأمن والرفاهية على النحو الأمثل. رضا المريض هو تصور ديناميكي وذاتي لمدى توفير الرعاية الصحية المتوقعة, ويعكس حكم المريض على مختلف جوانب صحة الأم. الهدف هو تقييم مدى رضا النساء الحوامل المصابات بتسمم الحمل في مستشفيين كبيرين في فلسطين عن الخدمات الصحية المقدمة ورعاية القبالة ، خلال ثلاث مراحل ، خلال الحمل ، خلال الولادة ، وبعد الولادة.
المنهجية: تم اعتماد الدراسة المقطعية الوصفية مع أخذ عينة ملائمة 218 امرأة مصابة بتسمم الحمل , اللواتي سجلن في مستشفيين كبيرين في فلسطين. واحتوى الاستبيان الذاتي الذي طوره الباحث على سبعة أبعاد (الموقف والاحترام ، والمعلومات والتواصل ، والاستشارة ، والمشاركة في صنع القرار ، والعلاج ، والسياسات ، وجودة الخدمات) وتم استخدام الخصائص الديموغرافية لجمع البيانات ولتحليلها من خلال الحزمة الإحصائية للعلوم الاجتماعية الإصدار 20 .
النتائج: معظم المشاركين الذين تتراوح أعمارهم بين 23 و 37 عامًا (العدد = 149 ، 68٪) ، نصفهن كانو يعملن (العدد = 111 ، 50٪) ، أبلغوا عن خضوعهن لعملية قيصرية (العدد = 192 ، 88.1٪) ، ومسكنهم في المدن (العدد = 112 ، 51.4٪) ، ومعظمهم (العدد = 119 ، 55٪) حاصلون على درجة البكالوريوس أو أكثر. أظهرت الدراسة أن مستوى رضا النساء المصابات بتسمم الحمل تجاه الخدمات الصحية ورعاية القبالة خلال الحمل ,والولادة ,وبعد الولادة بمتوسط مرتفع على التوالي بقيم (2.45) ,( 2.51) ، (2.6)
وجدت الدراسة أن النساء الأكبر سنًا لديهن مستويات رضا اقل تجاه عنصر المشاركة في اتخاذ القرار ، مقارنة بالنساء الأصغر عمرا خلال مرحلتي الحمل والولادة وكانت القيمة الاحتمالية 0.021 ,وأما بالنسبة للنساء الاكبر عمرا لديهن مستويات رضا قليله تجاه عنصر الخصوصية مقارنه بالنساء الاقل عمرا خلال مرحلة ما بعد الولادة والقيمة الاحتمالية 0.007.
الرضا تجاه المستشفى الحكومي اقل من المستشفى الخاص اتجاه الدرجة الكليه للخدمات بقيمة احتماليه 0.000في المراحل الثلاثة .ومستوى الرضا تجاه عنصر التواصل والمعلومات خلال مرحلة الحمل (متوسط= 2.45)اقل من مستوى الرضا خلال مرحلة ما بعد الولادة (متوسط=2.55),بينما الرضا تجاه عنصر جودة الخدمات خلال مرحلة الحمل (متوسط=2.00)اقل رضى من مرحلة خلال الولادة (متوسط 2.58)وبعد الولادة (متوسط 2.66).الرضا تجاه عنصر العلاج اقل في مرحلة الولادة (متوسط =2.68)وخلال الحمل (متوسط=2.46).بينما الرضا اقل تجاه عنصري رغاية الام والخصوصية في مرحلة بعد الولاده ومرحلة الولادة بمتوسط على التوالي (2.54,2.63),(2.3,2.54) .وأخيرا ,الرضا تجاه عنصر الدرجة الكلية للخدمات خلال مرحلة الحمل (متوسط=2.45)اقل من الرضا خلال الولادة (متوسط=2.6).
الخلاصة: وجدت الدراسة رضا كبيرًا تجاه الخدمات الصحية ورعاية القبالة بشكل عام. ومع ذلك ،النساء الاكبر سنا ؛ خدمات المستشفيات الحكومية, المعلومات والاتصالات,. وجودة الخدمات والدرجة الكلية للخدمات أثناء فترة ما قبل الولادة ؛ عنصر العلاج أثناء الولادة ؛ نهج رعاية الأم ، وتم تسليط الضوء على بنود الخصوصية في فترة ما بعد الولادة. يجب مراعاة هذه المتغيرات وتحسينها للنساء المصابات بتسمم الحمل .
توصية: أشارت النتائج إلى أن تعزيز صحة النساء المصابات بتسمم الحمل و يتطلب تعاون مقدمي الرعاية الصحية والقابلات وواضعي السياسات لرفع جودة الخدمات المقدمة للنساء, في فترات ما قبل الولادة والولادة وبعدها, مع الاهتمام بشكل خاص بالخدمات المقدمة في المستشفيات الحكومية.. كما أبلغت النتائج مديري المستشفى باحتياجات المرأة من التدريس والإرشاد حول ظروفها وكذلك الحفاظ على الخصوصية من خلال الرعاية المقدمة. يوصى بإجراء دراسات مماثلة في مناطق مختلفة في فلسطين ، باستخدام نفس الأداة ، لتعزيز صحة المرأة وإعطاء المزيد من الأفكار حول رضا النساء الحوامل للمجموعة المعرضة للخطر .
Background: Preeclampsia (PE) is a pregnancy-specific syndrome characterized by new-onset hypertension (>140/90 mm Hg) and proteinuria (> 0.3 g/24 hours) that affects 0.4 % -15.6 % of all pregnancies. Preeclampsia is associated with worse maternal and fatal outcomes, so risk identification is an important part of antenatal care to optimize treatment. The purpose of maternity care is to achieve optimal security and well-being. Patient satisfaction is a dynamic and subjective perception of the extent to which expected healthcare is provided. It reflects the patient`s judgment of various aspects of maternal health. The aim was to assess the extent to which pregnant women with preeclampsia attending two large hospitals in Palestine are satisfied with the health care services provided and midwifery care, during three stages, antenatal, delivery, and post-partum. Methodology: Descriptive cross-sectional study was adopted with a convenience sampling of 218 women with preeclampsia who booked in two large hospitals in Palestine. A self-administered questionnaire developed by the researcher contained seven dimensions (Attitude and respect, information and communication, counseling, decision making involvement, treatment, policies, and Quality of Services) and demographic characteristics were used for data collection and for analysis SPSS version 20. Results: Most participant aged between 23-37 years old (n=149, 68%), half of them worked (n=111, 50%), reported had a cesarean section (n=192, 88.1%), lived in city (n=112, 51.4%), and most of them (n=119, 55%), had bachelor degree or more. The study showed that the level of women with preeclampsia satisfaction toward health services and midwifery care during antenatal Care, delivery, and post-partum is high with a mean (2.45, 2.51, 2.6) respectively with P-value 0.000. The study found that older-aged women had slightly less satisfaction levels toward decision Making Involvement item, compared to younger women, in antenatal, and during delivery stages, with P- value 0.021. The older aged women had slightly less satisfaction levels toward privacy item, compared to younger women, with a post-partum stage P-value 0.007. The satisfaction was less in the government hospital than in the private hospital in total degree of services with P-value 0.000 in three stages. The satisfaction toward information and communication item during antenatal care (Mean=2.45) is significantly lower than satisfaction during Post-Partum (Mean=2.55), while satisfaction toward quality of services during antenatal care (Mean=2.00) is significantly lower than satisfaction during delivery (Mean=2.58) and post-partum (Mean=2.66). The satisfaction toward treatment item in less satisfaction during delivery (Mean=2.68) than in antenatal care (Mean=2.46). While, the less satisfaction toward approach of mother care and privacy items in the post-partum stage than during delivery with a mean (Mean=2.54 & 2, 63); (Mean=2.3& 2,54) respectively. Finally, the satisfaction toward the total degree of service item during antenatal care (Mean=2.45) is lower than satisfaction during delivery (Mean=2.51) and during Post-Partum (Mean=2.6). Conclusion: The study found a high satisfaction toward health services and midwifery care in general. However, older age women; government hospital services; information and communication & quality of services & total degree of service items during antenatal; treatment item during delivery; approach of mother care, and privacy items in post-partum were highlighted. These variables should be considered and improved for women with preeclampsia Recommendation: The findings suggested that promoting health of the women with preeclampsia requires collaboration of healthcare providers, midwives and policy makers to raise the quality of services provided for the women at the antenatal, delivery and postnatal periods with particular concern to the services provided at the government hospitals. The results also informed the hospital administrators about the women's needs for teaching and counseling about their conditions as well as preserving privacy through the provided care. Similar studies are recommended to be done in different areas in Palestine, using the same tool, to promote women's health and to give more insights about the satisfaction of the pregnant women in the high risk group.
Background: Preeclampsia (PE) is a pregnancy-specific syndrome characterized by new-onset hypertension (>140/90 mm Hg) and proteinuria (> 0.3 g/24 hours) that affects 0.4 % -15.6 % of all pregnancies. Preeclampsia is associated with worse maternal and fatal outcomes, so risk identification is an important part of antenatal care to optimize treatment. The purpose of maternity care is to achieve optimal security and well-being. Patient satisfaction is a dynamic and subjective perception of the extent to which expected healthcare is provided. It reflects the patient`s judgment of various aspects of maternal health. The aim was to assess the extent to which pregnant women with preeclampsia attending two large hospitals in Palestine are satisfied with the health care services provided and midwifery care, during three stages, antenatal, delivery, and post-partum. Methodology: Descriptive cross-sectional study was adopted with a convenience sampling of 218 women with preeclampsia who booked in two large hospitals in Palestine. A self-administered questionnaire developed by the researcher contained seven dimensions (Attitude and respect, information and communication, counseling, decision making involvement, treatment, policies, and Quality of Services) and demographic characteristics were used for data collection and for analysis SPSS version 20. Results: Most participant aged between 23-37 years old (n=149, 68%), half of them worked (n=111, 50%), reported had a cesarean section (n=192, 88.1%), lived in city (n=112, 51.4%), and most of them (n=119, 55%), had bachelor degree or more. The study showed that the level of women with preeclampsia satisfaction toward health services and midwifery care during antenatal Care, delivery, and post-partum is high with a mean (2.45, 2.51, 2.6) respectively with P-value 0.000. The study found that older-aged women had slightly less satisfaction levels toward decision Making Involvement item, compared to younger women, in antenatal, and during delivery stages, with P- value 0.021. The older aged women had slightly less satisfaction levels toward privacy item, compared to younger women, with a post-partum stage P-value 0.007. The satisfaction was less in the government hospital than in the private hospital in total degree of services with P-value 0.000 in three stages. The satisfaction toward information and communication item during antenatal care (Mean=2.45) is significantly lower than satisfaction during Post-Partum (Mean=2.55), while satisfaction toward quality of services during antenatal care (Mean=2.00) is significantly lower than satisfaction during delivery (Mean=2.58) and post-partum (Mean=2.66). The satisfaction toward treatment item in less satisfaction during delivery (Mean=2.68) than in antenatal care (Mean=2.46). While, the less satisfaction toward approach of mother care and privacy items in the post-partum stage than during delivery with a mean (Mean=2.54 & 2, 63); (Mean=2.3& 2,54) respectively. Finally, the satisfaction toward the total degree of service item during antenatal care (Mean=2.45) is lower than satisfaction during delivery (Mean=2.51) and during Post-Partum (Mean=2.6). Conclusion: The study found a high satisfaction toward health services and midwifery care in general. However, older age women; government hospital services; information and communication & quality of services & total degree of service items during antenatal; treatment item during delivery; approach of mother care, and privacy items in post-partum were highlighted. These variables should be considered and improved for women with preeclampsia Recommendation: The findings suggested that promoting health of the women with preeclampsia requires collaboration of healthcare providers, midwives and policy makers to raise the quality of services provided for the women at the antenatal, delivery and postnatal periods with particular concern to the services provided at the government hospitals. The results also informed the hospital administrators about the women's needs for teaching and counseling about their conditions as well as preserving privacy through the provided care. Similar studies are recommended to be done in different areas in Palestine, using the same tool, to promote women's health and to give more insights about the satisfaction of the pregnant women in the high risk group.