Social psychological predictors of satisfaction with intrapartum and postpartum care - what matters to women in Czech maternity hospitals?

Objective: To identify the social psychological factors affecting women's evaluation of care provided in Czech maternity hospitals using following criteria: satisfaction with intrapartum and postpartum care, willingness to return to a given hospital and to recommend the hospital to others. Methods: 762 women completed a 71-item original Czech questionnaire KLI-P designed to measure the psychosocial climate in both delivery and after-birth unit on six scales. The sample was representative of the Czech parturients population. Multivariate logistic regression was used to investigate the predictive value of the questionnaire scales for maternal satisfaction, willingness to return to and to recommend a given hospital. Results: For delivery unit, the satisfaction predictors were: helpfulness and empathy of midwives (chi(2)= 48.9), communication of information and availability of caregivers (chi(2)= 16.6), helpfulness and empathy of physicians (chi(2)= 10.9), symmetrical and respectful attitude of staff members (chi(2)= 9.7) and physical comfort and services (chi(2)= 7.6). The predictors of satisfaction with after-birth unit included helpfulness and empathy of the staff (chi(2)>= 42.1), communication of information and availability of caregivers (chi(2)= 52.5), physical comfort and services (chi(2)= 30.6), control and involvement in decision-making (chi(2)= 6.6) and parity (chi(2)= 8.6). The factors influencing women's willingness to return to and to recommend a hospital differed from the predictors of general satisfaction. Conclusions: The satisfaction factors revealed in this research correspond predominantly to the results of studies conducted in other countries (warm, non-formal and supportive approach, sufficient and well-timed provision of information and explanation, availability of caregivers, physical environment). However, participation in decision making, which has been repeatedly shown to be among the strongest predictors of childbirth satisfaction, was not important for the Czech parturients' satisfaction with intrapartal care. This finding can be explained by different attitudes and expectations of both parturients and caregivers in a post-totalitarian country.