Service Quality Gap of Care During Childbirth and Postpartum and Its Relationship with Childbirth Satisfaction

Danehchin, Niloofar; Javadifar, Nahid; Iravani, Mina; Dastoorpoor, Maryam

doi:10.30476/jhsss.2021.92294.1334

Service Quality Gap of Care During Childbirth and Postpartum and Its Relationship with Childbirth Satisfaction

Document Type : Original Article

Authors

Niloofar Danehchin ¹

Nahid Javadifar ²

Mina Iravani ²

Maryam Dastoorpoor ³

¹ Department of Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

² Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

³ Department of Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

https://doi.org/10.30476/jhsss.2021.92294.1334

Abstract

Background: The purpose of the present study was to evaluate the quality gap of maternity service in the labor and postpartum wards and its relationship with childbirth satisfaction.
Methods: This cross-sectional study was carried out on 332 pregnant women referring to the labor and delivery wards of the two selected hospitals affiliated to Ahwaz University of Medical Sciences in 2020. Pregnant mothers were selected by convenience sampling method and data were collected using SERVQUAL and Mackey Childbirth Satisfaction Rating Scale in labor and postpartum wards. Data analysis was carried out using descriptive and inferential statistics.
Results: The quality gap of maternity service in the postpartum ward (-0.35) was higher than that in the labor ward (-0.28). There was a significant difference between the mothers’ expectations and perceptions in all dimensions of the SERVQUAL except for the responsiveness dimension. The highest and lowest gap in the quality of service in labor and postpartum wards was related to empathy (-0.41 and -0.48, respectively) and the responsiveness dimensions (-0.07 and -1, respectively). There was a significant inverse correlation between the gap in the empathy dimension with overall childbirth satisfaction in the labor ward. There was a correlation between empathy and overall childbirth satisfaction and the physician’s satisfaction in the postpartum ward (P<0.05).
Conclusion: Empathy is the most important variable affecting the quality of services provided in the maternity wards and it is necessary to improve this skill in maternity health care providers.

Keywords

Quality gap

Care

Childbirth

Postpartum

Xatisfaction

Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet (London, England). 2016;387(10017):462-74. doi: 10.1016/S0140-6736(15)00838-7.
Graham W, Woodd S, Byass P, et al. Diversity and divergence: the dynamic burden of poor maternal health. Lancet. 2016;388(10056):2164-2175. doi.org/10.1016/S0140-6736(16)31533-1.
World Health Organization. Sexual and reproductive health. Standards for improving quality of maternal and newborn care in health facilities. 2016 [Available from: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/improving-mnh-health-facilities/en/.
Donabedian A. Evaluating the quality of medical care. 1966. Milbank Q. 2005;83(4):691-729. doi: 10.1111/j.1468-0009.2005.00397.x. PMID: 16279964.
Chakraborty R, Majumdar A. Measuring consumer satisfaction in health care sector: The applicability of SERVQUAL. Journal of Arts, Science & Commerce.2011; 2: 149-160.
Zun AB, Ibrahim MI, Hamid AA. Level of Satisfaction on Service Quality Dimensions Based on SERVQUAL Model Among Patients Attending 1 Malaysia Clinic in Kota Bharu, Malaysia. Oman Med J. 2018;33(5):416-22. doi: 10.5001/omj.2018.76. PMID: 30210721.
Moudatsou M, Stavropoulou A, Philalithis A, Koukouli S. The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel). 2020;8(1):26. doi: 10.3390/healthcare8010026. PMID: 32019104.
World Health Organization. WHO global strategy on people-centred and integrated health services: Interim report. Geneva: World Health Organization; 2015. 48p. Report No.: WHO/HIS/SDS/2015.6. https://apps.who.int/iris/handle/10665/155002
Wilson AN, Spotswood N, Hayman GS, et al. Improving the quality of maternal and newborn care in the Pacific region: A scoping review. Lancet Reg Health West Pac. 2020 , 23;3:100028. doi: 10.1016/j.lanwpc.2020.100028. PMID: 34327381.
Farhud DD, Kamali MS, Marzban M. Annuality of birth, delivery types and sex ratio in Tehran, Iran. Anthropol Anz. 1986;44(2):137-41. PMID: 3740819.
Bahadori F, Hakimi S, Heidarzade M. The trend of caesarean delivery in the Islamic Republic of Iran. East Mediterr Health J. 2014;19 Suppl 3:S67-S70. PMID: 24995763.
Azami-Aghdash S, Ghojazadeh M, Dehdilani N, Mohammadi M, Asl Amin Abad R. Prevalence and Causes of Cesarean Section in Iran: Systematic Review and Meta-Analysis. Iran J Public Health. 2014;43(5):545-55. PMID: 26060756. PMID: 26060756.
Jafari E, Mohebbi P, Rastegari L, Mazloomzadeh S. The Comparison of Physiologic and Routine Method of Delivery in Mother’s Satisfaction Level in Ayatollah Mosavai Hospital, Zanjan, Iran, 2012. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2013;16(73):9-18. doi: 10.22038/IJOGI.2013.1949.
Hoseini BL, Saeidi M, Beheshti Norouzi Z, Kiani MA, Rakhshani MH. Assessment of Maternal Satisfaction with the Quality of Obstetric Care Provided in the Maternity Unit of Mobini Hospital, Sabzevar, Iran. International Journal of Pediatrics. 2019;7(5):9369-77. doi: 10.22038/IJP.2019.36862.3283.
Gholipour R, Shahoei R, Ghaderkhani G, Zakaryaee S, Bahmani S. The Quality of Postpartum Care from the Perspective of the Recipients of the Comprehensive Health Center Service Using the SERVQUAL Pattern. Avicenna Journal of Nursing and Midwifery Care. 2019;27(4):281-91. doi: 10.30699/ajnmc.27.4.281.
Tabatabaei SM, Behmanesh Pour F, Share Mollashahi S, Sargazi Moakhar Z, Zaboli M. The Quality Gap in the Services Provided by Rural Maternity Units in Southeast of Iran. Health Scope. 2015;4(4):e25344. doi: 10.17795/jhealthscope-25344.
Vizvari P, Moradi M, Asadi L. Assessment of Customer Satisfaction with Quality of Services Provided in Maternity Ward of Shahid Sayyad Shirazi Hospital in Gorgan, Iran. Journal of Clinical and Basic Research. 2018;2(3):39-44. doi: 10.29252/jcbr.2.3.39.
Ko C-H, Chou C-M. Apply the SERVQUAL Instrument to Measure Service Quality for the Adaptation of ICT Technologies: A Case Study of Nursing Homes in Taiwan. Healthcare. 2020;8:108. doi: 10.3390/healthcare8020108. PMID: 32344589.
Parasuraman AP, Zeithaml V, Berry L. SERVQUAL: A multiple- Item Scale for measuring consumer perceptions of service quality. Journal of retailing. 1988;64:12-40.
Abari AAF, Yarmohammadian MH, Esteki M. Assessment of quality of education a non-governmental university via SERVQUAL model. Procedia - Social and Behavioral Sciences. 2011;15:2299-304. doi.org/10.1016/j.sbspro.2011.04.097. PMID: 32344589.
Goodman P, Mackey M, Tavakoli A. Factors related to childbirth satisfaction. Journal of advanced nursing. 2004;46:212-9. doi: 10.1111/j.1365-2648.2003.02981.x. PMID: 15056335.
Moudi Z, Tavousi M. Evaluation of Mackey Childbirth Satisfaction Rating Scale in Iran: What Are the Psychometric Properties? Nurs Midwifery Stud. 2016;5(2):e29952-e. doi: 10.17795/nmsjournal29952. PMID: 27556053.
Endeshaw B. Healthcare service quality-measurement models: a review. Journal of Health Research. 2020;35(2):106-17. doi: 10.1108/jhr-07-2019-0152.
Charitou A, Fifli P, Vivilaki VG. Is empathy an important attribute of midwives and other health professionals?: A review. Eur J Midwifery. 2019; 12;3:4. doi: 10.18332/ejm/100612. PMID: 33537583.
Rouleau D, Fournier P, Philibert A, Mbengue B, Dumont A. The effects of midwives’ job satisfaction on burnout, intention to quit and turnover: a longitudinal study in Senegal. Human Resources for Health. 2012;10(1):9. doi.org/10.1186/1478-4491-10-9.
Wilkinson H, Whittington R, Perry L, Eames C. Examining the relationship between burnout and empathy in healthcare professionals: A systematic review. Burnout research. 2017;6:18-29. doi: 10.1016/j.burn.2017.06.003. PMID: 28868237.
Roohi G, Asayesh H, Abdollahi A. Evaluation of the client's expectations and perceptions gap about the quality of primary health services in Gorgan health center. jumsjmj. 2011;9(3):41-7. doi: 10.29252/jmj.9.3.7.
Lu SJ, Kao HO, Chang BL, et al. Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan. BMC Health Serv Res. 2020 ;29;20(1):908. doi: 10.1186/s12913-020-05764-8. PMID: 32993641.
Gajewska P, Piskrzyńska K. Measuring Quality of Maternity Services Using the Servqual Method. Regional Formation and Development Studies. 2021;20(3):50-9. doi :10.15181/rfds.v20i3.1343.
Oliaee Z, Jabbari A, Ehsanpour S. An investigation on the quality of midwifery services from the viewpoint of the clients in Isfahan through SERVQUAL model. Iranian journal of nursing and midwifery research. 2016;21(3):291-6. doi: 10.4103/1735-9066.180377. PMID: 27186207.
Mocumbi S, Högberg U, Lampa E, et al. Mothers' satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique. BMC Pregnancy Childbirth. 2019 ; 19;19(1):303. doi: 10.1186/s12884-019-2449-6. PMID: 31426758.
Wang Y, Lo H-P, Yang Y. An Integrated Framework for Service Quality, Customer Value, Satisfaction: Evidence from China's Telecommunication Industry. Information Systems Frontiers. 2004;6(4):325-40. doi:10.1023/B:ISFI.0000046375.72726.67.
Padma P, Rajendran C, Lokachari PS. Service quality and its impact on customer satisfaction in Indian hospitals. Benchmarking: An International Journal. 2010;17:807-41. doi.org/10.1108/14635771011089746.
Zarei E, Daneshkohan A, Pouragha B, Marzban S, Arab M. An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran. Glob J Health Sci. 2014;7(1):1-9. doi: 10.5539/gjhs.v7n1p1. PMID: 25560338.
Essiam JO. Service Quality and Patients Satisfaction with Healthcare Delivery: Empirical Evidence from Patients of the Out Patient Department of a Public University Hospital in Ghana. European Journal of Business and Management. 2013;5:52-9.
White CN, Buchanan TW. Empathy for the Stressed. Adaptive Human Behavior and Physiology. 2016;2(4):311-24. doi.org/10.1007/s40750-016-0049-5.