Global Satisfaction With Perinatal Hospital Care: Stability and Relationship to Anxiety, Depression, and Stressful Medical Events

Abstract

To evaluate the stability of global maternal satisfaction with perinatal hospital care during the post-partum period and its relationship to anxiety, depression, and stressful medical events, a cohort study of 300 mothers delivering at a university hospital was performed during the first month postpartum. Satisfaction, measured on a 4-point Likert scale (0-3), declined from 2.75 +/- 0.03 (mean +/- standard error) before hospital discharge to 2.48 +/- 0.04 at 1 month postpartum (P = .000), and only 69.5% of mothers very much satisfied predischarge remained so at 1 month (P = .000). Predischarge satisfaction declined with greater medical events (adjusted odds ratio [AOR] = 0.85, 95% confidence interval [CI] = 0.74, 0.97, P < .05) and with concomitant anxiety (AOR= 0.92, CI= 0.89, 0.95, P< .001); reduced satisfaction at 1 month was associated with high anxiety (AOR = 0.97, CI = 0.95, 0.98) and depression (AOR = 0.96, CI = 0.93, 0.99) at that time. Thus, perinatal satisfaction may be time-dependent and associated with contemporaneous medical and psychological changes.

Determinants of patients' experiences and satisfaction with fertility care

“…Hall and Dornan (29) already described strong evidence that health status is a causal determinant of patient satisfaction. Also, higher levels of anxiety (17,18,30) and depression (16) are frequently found to be associated with dissatisfaction with care. For fertility care in particular, the role of social attributes, such as anxiety, about treatment as well as marital stress, has been reported to relate to negative patient experiences and lower satisfaction (10,26,27).…”

“…Part 2: determinants of patients' experiences and satisfaction with fertility care The Souter questionnaire was complemented with questions regarding determinants of patients' experiences and satisfaction. Potential determinants were gathered from general and fertility literature (10,13,(15)(16)(17)(18)(19)(20)(21)(22) and expected to exist within three groups:…”

The assessment of satisfaction with care in the perinatal period

“…Factors reported to be related to dissatisfaction with the childbirth experience include unexpected medical problems, multiple physical symptoms, a complicated perinatal course, short and long perinatal lengths of stay, and instrumental or operative delivery [2,60,61,66,67]. However, some studies of obstetric populations have failed to reveal relationships between health status and satisfaction [68].…”

“…In the perinatal period, several authors have noted that satisfaction may change with time. Relatively high levels of satisfaction tend to be elicited immediately after delivery, declining with time for periods of up to 2 years [63,65,67,[118][119][120]. Also of note is that satisfaction at 36 weeks prenatally may be lower than that at 48 h postpartum [53].…”

“…Also of note is that satisfaction at 36 weeks prenatally may be lower than that at 48 h postpartum [53]. Declining satisfaction with the childbirth experience has been reported in association with difficult childbirth and changing mood, such as anxiety, depressive symptoms and worry during pregnancy [66,67]. Women whose assessment of the childbirth experience become more negative with time appear more likely to have high levels of anxiety and depression and changes in satisfaction may accompany changes in mood [66,67].…”