Assessing Maternal Satisfaction: Patient-Centered Care, Hospital Environment, and Information-Seeking in Chanika Hospital in Tanzania
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants and Procedures
2.3. Measures
2.4. Data Analysis
3. Results
3.1. Participants’ Characteristics
3.2. Patient-Centered Experiences by Health Providers
3.3. Patient-Centered Experiences in General Care, Fair Treatment and Guarantee of Rights, Satisfaction with Hospital Environment, and Health Information-Seeking Behavior for Fetal Development
3.4. Satisfaction with Hospital Environment
3.5. Patient-Centered Satisfaction Score and Factors Influencing Maternal Satisfaction Scores
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- World Bank. Maternal Mortality Ratio. 2023. Available online: https://data.worldbank.org/indicator/SH.STA.MMRT?end=2020&locations=TZ&start=2000&view=chart (accessed on 15 February 2024).
- Cooke, A.; Mills, T.A.; Lavender, T. ‘Informed and uninformed decision making’—Women’s reasoning, experiences and perceptions with regard to advanced maternal age and delayed childbearing: A meta-synthesis. Int. J. Nurs. Stud. 2010, 47, 1317–1329. [Google Scholar] [CrossRef]
- Munguambe, K.; Boene, H.; Vidler, M.; Bique, C.; Sawchuck, D.; Firoz, T.; Makanga, P.T.; Qureshi, R.; Macete, E.; Menéndez, C. Barriers and facilitators to health care seeking behaviours in pregnancy in rural communities of southern Mozambique. Reprod. Health 2016, 13, 83–97. [Google Scholar] [CrossRef]
- Nassoro, M.M.; Chiwanga, E.; Lilungulu, A.; Bintabara, D. Maternal deaths due to obstetric haemorrhage in Dodoma Regional Referral Hospital, Tanzania. Obstet. Gynecol. Int. 2020, 2020, 8854498. [Google Scholar] [CrossRef]
- Bintabara, D.; Ernest, A.; Mpondo, B. Health facility service availability and readiness to provide basic emergency obstetric and newborn care in a low-resource setting: Evidence from a Tanzania National Survey. BMJ Open 2019, 9, e020608. [Google Scholar] [CrossRef]
- Wong, E.; Mavondo, F.; Fisher, J. Patient feedback to improve quality of patient-centred care in public hospitals: A systematic review of the evidence. BMC Health Serv. Res. 2020, 20, 530. [Google Scholar] [CrossRef]
- Miller, P.; Afulani, P.A.; Musange, S.; Sayingoza, F.; Walker, D. Person-centered antenatal care and associated factors in Rwanda: A secondary analysis of program data. BMC Pregnancy Childbirth 2021, 21, 290. [Google Scholar] [CrossRef]
- Ng, J.H.; Luk, B.H. Patient satisfaction: Concept analysis in the healthcare context. Patient Educ. Couns. 2019, 102, 790–796. [Google Scholar] [CrossRef]
- Raposo, M.L.; Alves, H.M.; Duarte, P.A. Dimensions of service quality and satisfaction in healthcare: A patient’s satisfaction index. Serv. Bus. 2009, 3, 85–100. [Google Scholar] [CrossRef]
- Gupta, S.; Yamada, G.; Mpembeni, R.; Frumence, G.; Callaghan-Koru, J.A.; Stevenson, R.; Brandes, N.; Baqui, A.H. Factors associated with four or more antenatal care visits and its decline among pregnant women in Tanzania between 1999 and 2010. PLoS ONE 2014, 9, e101893. [Google Scholar] [CrossRef]
- Mutaganzwa, C.; Wibecan, L.; Iyer, H.S.; Nahimana, E.; Manzi, A.; Biziyaremye, F.; Nyishime, M.; Nkikabahizi, F.; Hirschhorn, L.R.; Magge, H. Advancing the health of women and newborns: Predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda. Int. J. Qual. Health Care 2018, 30, 793–801. [Google Scholar] [CrossRef]
- Wekesah, F.M.; Mbada, C.E.; Muula, A.S.; Kabiru, C.W.; Muthuri, S.K.; Izugbara, C.O. Effective non-drug interventions for improving outcomes and quality of maternal health care in sub-Saharan Africa: A systematic review. Syst. Rev. 2016, 5, 137. [Google Scholar] [CrossRef]
- Bergh, K.; Bishu, S.; Taddese, H.B. Identifying the determinants of patient satisfaction in the context of antenatal care in Kenya, Tanzania, and Malawi using service provision assessment data. BMC Health Serv. Res. 2022, 22, 746. [Google Scholar] [CrossRef]
- OECD. Healthcare Quality Indicators. 2022. Available online: https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_HCQI (accessed on 15 February 2024).
- Centers for Medicare & Medicaid Services. HCAHPS Quality Assurance Guidelines; HHS: Baltimore, MD, USA, 2021. [Google Scholar]
- UK National Health Service. Imperial Survey Core Questionnaire. 2013. Available online: https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england (accessed on 15 February 2024).
- Yuill, C.; McCourt, C.; Cheyne, H.; Leister, N. Women’s experiences of decision-making and informed choice about pregnancy and birth care: A systematic review and meta-synthesis of qualitative research. BMC Pregnancy Childbirth 2020, 20, 343. [Google Scholar] [CrossRef]
- Stapleton, H.; Kirkham, M.; Thomas, G. Qualitative study of evidence based leaflets in maternity care. BMJ 2002, 324, 639. [Google Scholar] [CrossRef]
- Edwards, A.; Elwyn, G.; Mulley, A. Explaining risks: Turning numerical data into meaningful pictures. BMJ 2002, 324, 827–830. [Google Scholar] [CrossRef]
- Thorne, S.E.; Paterson, B.L. Health care professional support for self-care management in chronic illness: Insights from diabetes research. Patient Educ. Couns. 2001, 42, 81–90. [Google Scholar] [CrossRef]
- Say, R.E.; Thomson, R. The importance of patient preferences in treatment decisions—Challenges for doctors. BMJ 2003, 327, 542–545. [Google Scholar] [CrossRef]
- Hwang, B.-D.; Kim, Y.-J. Evaluation of patient-centered healthcare provision in hospitals and general hospitals-based on patient experience assessment. Korean J. Health Serv. Manag. 2018, 12, 1–11. [Google Scholar] [CrossRef]
- Ward, J.K.; Armitage, G. Can patients report patient safety incidents in a hospital setting? A systematic review. BMJ Qual. Saf. 2012, 21, 685–699. [Google Scholar] [CrossRef]
- Elias, R.M.; Fischer, K.M.; Siddiqui, M.A.; Coons, T.; Meyerhofer, C.A.; Pretzman, H.J.; Greig, H.E.; Stevens, S.K.; Burton, M.C. A taxonomic review of patient complaints in adult hospital medicine. J. Patient Exp. 2021, 8, 23743735211007351. [Google Scholar] [CrossRef]
- Nowotny, B.M.; Loh, E.; Davies-Tuck, M.; Hodges, R.; Wallace, E.M. Identifying quality improvement opportunities using patient complaints: Feasibility of using a complaints taxonomy in a metropolitan maternity service. J. Patient Saf. Risk Manag. 2019, 24, 184–195. [Google Scholar] [CrossRef]
- Tanyi, P.L.; Pelser, A. Towards an “age-friendly-hospital”: Older persons’ perceptions of an age-friendly hospital environment in Nigeria. Cogent Med. 2020, 7, 1853895. [Google Scholar] [CrossRef]
- Adhikary, G.; Shawon, M.S.R.; Ali, M.W.; Shamsuzzaman, M.; Ahmed, S.; Shackelford, K.A.; Woldeab, A.; Alam, N.; Lim, S.S.; Levine, A. Factors influencing patients’ satisfaction at different levels of health facilities in Bangladesh: Results from patient exit interviews. PLoS ONE 2018, 13, e0196643. [Google Scholar] [CrossRef] [PubMed]
- Nguyen, T.; Nguyen, H.; Dang, A. Determinants of patient satisfaction: Lessons from large-scale inpatient interviews in Vietnam. PLoS ONE 2020, 15, e0239306. [Google Scholar] [CrossRef] [PubMed]
- Singh, S.; Kaur, P.; Rochwani, R. Patient satisfaction levels in a tertiary care medical college hospital in Punjab, North India. Int. J. Res. Dev. Health 2013, 1, 172–182. [Google Scholar]
- Srivastava, A.; Avan, B.I.; Rajbangshi, P.; Bhattacharyya, S. Determinants of women’s satisfaction with maternal health care: A review of literature from developing countries. BMC Pregnancy Childbirth 2015, 15, 97. [Google Scholar] [CrossRef]
- Kebede, D.B.; Belachew, Y.B.; Selbana, D.W.; Gizaw, A.B. Maternal satisfaction with antenatal care and associated factors among pregnant women in Hossana town. Int. J. Reprod. Med. 2020, 2020, 2156347. [Google Scholar] [CrossRef] [PubMed]
- Ghiasi, A. Health information needs, sources of information, and barriers to accessing health information among pregnant women: A systematic review of research. J. Matern.-Fetal Neonatal Med. 2021, 34, 1320–1330. [Google Scholar] [CrossRef] [PubMed]
- Javanmardi, M.; Noroozi, M.; Mostafavi, F.; Ashrafi-Rizi, H. Internet usage among pregnant women for seeking health information: A review article. Iran. J. Nurs. Midwifery Res. 2018, 23, 79. [Google Scholar]
- Lagan, B.M.; Sinclair, M.; George Kernohan, W. Internet use in pregnancy informs women’s decision making: A web-based survey. Birth 2010, 37, 106–115. [Google Scholar] [CrossRef]
- Lu, Y.; Zhang, Z.; Min, K.; Luo, X.; He, Z. Pregnancy-related information seeking in online health communities: A qualitative study. In Proceedings of the International Conference on Information, Beijing, China, 17–31 March 2021; pp. 18–36. [Google Scholar]
- Nörby, U.; Noël-Cuppers, B.; Hristoskova, S.; Desai, M.; Härmark, L.; Steel, M.; El-Haddad, C.; Douarin, L. Online information discrepancies regarding safety of medicine use during pregnancy and lactation: An IMI ConcePTION study. Expert Opin. Drug Saf. 2021, 20, 1117–1124. [Google Scholar] [CrossRef] [PubMed]
- Lwoga, E.T.; Chigona, W. Characteristics and factors that differentiate Internet users and non-users as information seekers: The case of rural women in Tanzania. Inf. Dev. 2017, 33, 447–462. [Google Scholar] [CrossRef]
- Heri, R.; Yahya-Malima, K.I.; Malqvist, M.; Mselle, L.T. Women’s Expectations of and Satisfaction with Antenatal Care Services in a Semi-Urban Setting in Tanzania and Associated Factors: A Cross-Sectional Survey. Healthcare 2023, 11, 2321. [Google Scholar] [CrossRef] [PubMed]
ANC (n = 707) | PNC (n = 691) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total (n = 707) | Yes (n = 355) | No (n = 352) | χ2 | p | Total (n = 691) | Yes (n = 626) | No (n = 65) | χ2 | p | ||
% | % | % | % | % | |||||||
Age (years) | 10s | 6.5 | 7.6 | 5.4 | 2.56 | 0.278 | 6.5 | 6.5 | 6.2 | 0.02 | 0.991 |
20s | 60.0 | 61.1 | 58.8 | 60.1 | 60.1 | 60.0 | |||||
30s | 33.5 | 31.3 | 35.8 | 33.4 | 33.4 | 33.8 | |||||
Marriage duration | Less than 3 years | 50.1 | 52.7 | 47.4 | 1.94 | 0.176 | 50.1 | 50.3 | 47.7 | 0.16 | 0.698 |
More than 3 years | 49.9 | 47.3 | 52.6 | 499.9 | 49.7 | 52.3 | |||||
Education | Less than elementary | 48.9 | 45.1 | 52.8 | 4.27 | 0.042 | 49.1 | 49.0 | 49.2 | 0.00 | 1.000 |
More than elementary | 51.1 | 54.9 | 47.2 | 50.9 | 51.0 | 50.8 | |||||
Times giving birth | First born | 36.6 | 38.3 | 34.9 | 0.86 | 0.391 | 36.9 | 37.1 | 35.4 | 0.07 | 0.893 |
Multiple births | 63.4 | 61.7 | 65.1 | 63.1 | 62.9 | 64.6 |
Health Provider | ||||
---|---|---|---|---|
Nurse | Midwife | Doctor | ||
% | % | % | ||
Respect/courtesy | Never/sometimes | 8.5 | 4.5 | 14.3 |
Usually/always | 91.5 | 95.5 | 85.7 | |
Listening | Never/sometimes | 9.1 | 4.4 | 13.0 |
Usually/always | 90.9 | 95.6 | 87.0 | |
Explaining hospital procedures | Never/sometimes | 23.3 | 16.4 | 29.7 |
Usually/always | 76.7 | 83.6 | 70.3 | |
Handling requests | Never/sometimes | 36.6 | 34.9 | 60.4 |
Usually/always | 63.4 | 65.1 | 39.6 |
ANC (n = 707) | PNC (n = 691) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total (n = 707) | Yes | No | OR | 95% CI | p | Total (n = 691) | Yes | No | OR | 95% CI | p | |||
% | % | % | % | % | % | |||||||||
General Care | ||||||||||||||
Explanation before medication/ test/treatment | Never/sometimes | Ref. | 25.7 | 7.6 | 44.0 | 24.2 | 26.0 | 6.2 | ||||||
Usually/always | 74.3 | 92.4 | 56.0 | 9.6 | 6.1–14.9 | <0.001 | 75.8 | 74.0 | 93.8 | 0.2 | 0.1–0.5 | 0.001 | ||
Explaining side effects | Never/sometimes | Ref. | 44.8 | 16.9 | 73.0 | 89.9 | 91.7 | 72.3 | ||||||
Usually/always | 55.2 | 83.1 | 27.0 | 13.3 | 9.2–19.1 | <0.001 | 10.1 | 8.3 | 27.7 | 0.63 | 0.4–1.1 | 0.094 | ||
Involvement in treatment decision-making | Never/sometimes | Ref. | 90.1 | 87.6 | 92.6 | 89.9 | 91.7 | 72.3 | ||||||
Usually/always | 9.9 | 12.4 | 7.4 | 1.8 | 1.1–3.0 | 0.027 | 10.1 | 8.3 | 27.7 | 0.2 | 0.1–0.4 | <0.001 | ||
Considering embarrassment during treatment | Never/sometimes | Ref. | 5.8 | 6.8 | 4.8 | 5.9 | 5.9 | 6.2 | ||||||
Usually/always | 94.2 | 93.2 | 95.2 | 0.7 | 0.4–1.3 | 0.274 | 94.1 | 94.1 | 93.8 | 1.0 | 0.4–3.0 | 0.937 | ||
Efforts to reduce pain | Never/sometimes | Ref. | 31.0 | 20.3 | 41.8 | 29.4 | 30.7 | 16.9 | ||||||
Usually/always | 69.0 | 79.7 | 58.2 | 2.8 | 2.0–4.0 | <0.001 | 70.6 | 69.3 | 83.1 | 0.5 | 0.2–0.9 | 0.023 | ||
Fair treatment and guaranteeing of rights | ||||||||||||||
Unfair treatment experience | Never/sometimes | Ref. | 94.9 | 94.6 | 95.2 | 94.90 | 95.40 | 90.80 | ||||||
Usually/always | 5.1 | 5.4 | 4.8 | 1.1 | 0.6–2.2 | 0.752 | 5.10 | 4.60 | 9.20 | 0.5 | 0.2–1.2 | 0.115 | ||
Possibility of filing complaints | Never/sometimes | Ref. | 98.4 | 98.9 | 98.0 | 98.6 | 98.6 | 98.5 | ||||||
Usually/always | 1.6 | 1,1 | 2.0 | 0.6 | 0.2–1.9 | 0.361 | 1.4 | 1.4 | 1.5 | 0.9 | 0.2–7.5 | 0.948 | ||
Patient’s interests first | Never/sometimes | Ref. | 28.4 | 45.6 | 11.1 | 98.6 | 98.6 | 98.5 | ||||||
Usually/always | 71.6 | 54.4 | 88.9 | 0.1 | 0.1–0.2 | <0.001 | 1.4 | 1.4 | 1.5 | 0.5 | 0.2–0.9 | 0.028 | ||
Seeking health information behavior for fetal development | ||||||||||||||
Internet search | Never/sometimes | Ref. | 80.5 | 75.2 | 85.8 | 80.0 | 79.9 | 81.5 | ||||||
Usually/always | 19.5 | 24.8 | 14.2 | 2.0 | 1.4–2.9 | <0.001 | 20.0 | 20.1 | 18.5 | 1.1 | 0.6–2.1 | 0.749 | ||
Use of mobile app | Never/sometimes | Ref. | 85.7 | 79.7 | 91.8 | 85.4 | 85.0 | 89.2 | ||||||
Usually/always | 14.3 | 20.3 | 8.2 | 2.8 | 1.8–4.5 | <0.001 | 14.6 | 15.0 | 10.8 | 1.4 | 0.6–3.3 | 0.359 |
ANC (n = 707) | PNC (n = 691) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total (n = 707) % | Yes % | No % | OR | 95% CI | p | Total (n = 691) % | Yes % | No % | OR | 95% CI | p | |||
Hospital cleanliness | Never/sometimes | Ref. | 6.4 | 5.6 | 7.1 | 6.4 | 6.1 | 9.2 | ||||||
Usually/always | 93.6 | 94.4 | 92.9 | 1.3 | 0.7–2.4 | 0.425 | 93.6 | 93.9 | 90.8 | 1.6 | 0.6–3.9 | 0.324 | ||
Safe and comfortable hospital environment | Never/sometimes | Ref. | 5.1 | 3.7 | 6.5 | 5.2 | 5.4 | 3.1 | ||||||
Usually/always | 94.9 | 96.3 | 93.5 | 1.8 | 0.9–3.7 | 0.087 | 94.8 | 94.6 | 96.9 | 0.6 | 0.1–2.4 | 0.423 | ||
Excellence of water quality | Unsatisfied | Ref. | 20.1 | 11.5 | 28.7 | 20.1 | 18.1 | 40.0 | ||||||
Satisfied | 79.9 | 88.5 | 71.3 | 3.1 | 2.1–4.6 | <0.001 | 79.9 | 81.9 | 60.0 | 3.0 | 1.8–5.2 | <0.001 | ||
Adequacy of drinking water | Unsatisfied | Ref. | 91.9 | 92.4 | 91.5 | 91.9 | 91.7 | 93.8 | ||||||
Satisfied | 8.1 | 7.6 | 8.5 | 0.9 | 0.5–1.5 | 0.654 | 8.1 | 8.3 | 6.2 | 1.4 | 0.5–3.9 | 0.547 | ||
Adequacy of water for handwashing | Unsatisfied | Ref. | 8.2 | 9.9 | 6.5 | 8.4 | 7.3 | 18.5 | ||||||
Satisfied | 91.8 | 90.1 | 93.5 | 6.4 | 0.4–1.1 | 0.110 | 91.6 | 92.7 | 81.5 | 2.9 | 1.4–5.7 | 0.003 | ||
Hospital laundry cleaning | Unsatisfied | Ref. | 39.0 | 31.8 | 46.3 | 38.1 | 40.1 | 18.5 | ||||||
Satisfied | 61.0 | 68.2 | 53.7 | 1.8 | 1.4–2.5 | <0.001 | 61.9 | 59.9 | 81.5 | 0.3 | 0.2–0.6 | 0.001 | ||
Adequacy of water quality for medical service | Unsatisfied | Ref. | 61.2 | 76.3 | 46.0 | 62.7 | 59.6 | 92.3 | ||||||
Satisfied | 38.8 | 23.7 | 54.0 | 0.3 | 0.2–0.4 | <0.001 | 37.3 | 40.4 | 7.7 | 8.1 | 3.2–20.5 | <0.001 |
Patient-Centered Satisfaction Score | Total (n = 707) | ANC (n = 707) | U(p) | PNC (n = 691) | U(p) | ||
---|---|---|---|---|---|---|---|
Yes (n = 355) | No (n = 352) | Yes (n = 626) | No (n = 65) | ||||
Mean(SD) | 8.4 (1.5) | 8.4 (1.6) | 8.5 (1.4) | 611,066 (0.741) | 8.4 (1.5) | 8.9 (1.4) | 16,072 (0.004) |
Model 1 | Model 2 | |||||
---|---|---|---|---|---|---|
β | S.E | p | β | S.E | p | |
Age | −0.02 | 0.01 | 0.731 | −0.01 | 0.01 | 0.771 |
Marriage period of 3 years or more | −0.06 | 0.14 | 0.154s | −0.05 | 0.13 | 0.231 |
More than elementary education | −0.07 | 0.12 | 0.082 | −0.04 | 0.11 | 0.238 |
Patient-centered experiences with nurse | −0.01 | 0.03 | 0.915 | |||
Patient-centered experiences with midwife | 0.11 | 0.04 | 0.021 | |||
Patient-centered experiences with doctor | −0.06 | 0.02 | 0.165 | |||
General care | −0.04 | 0.02 | 0.369 | |||
Satisfaction with hospital environment | 0.25 | 0.05 | <0.001 | |||
Satisfaction with hospital water quality | 0.13 | 0.02 | <0.001 | |||
Rights guaranteed | −0.04 | 0.05 | 0.304 |
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Jang, S.; Lee, S.; Sohn, A. Assessing Maternal Satisfaction: Patient-Centered Care, Hospital Environment, and Information-Seeking in Chanika Hospital in Tanzania. J. Pers. Med. 2024, 14, 455. https://doi.org/10.3390/jpm14050455
Jang S, Lee S, Sohn A. Assessing Maternal Satisfaction: Patient-Centered Care, Hospital Environment, and Information-Seeking in Chanika Hospital in Tanzania. Journal of Personalized Medicine. 2024; 14(5):455. https://doi.org/10.3390/jpm14050455
Chicago/Turabian StyleJang, Sarang, Sangmi Lee, and Aeree Sohn. 2024. "Assessing Maternal Satisfaction: Patient-Centered Care, Hospital Environment, and Information-Seeking in Chanika Hospital in Tanzania" Journal of Personalized Medicine 14, no. 5: 455. https://doi.org/10.3390/jpm14050455
APA StyleJang, S., Lee, S., & Sohn, A. (2024). Assessing Maternal Satisfaction: Patient-Centered Care, Hospital Environment, and Information-Seeking in Chanika Hospital in Tanzania. Journal of Personalized Medicine, 14(5), 455. https://doi.org/10.3390/jpm14050455