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עמוד בית
Tue, 23.07.24

Original Articles

IMAJ | volume

Journal 5, May 2001
pages: 352-356

Patient perception of involvement in medical care during labor and delivery

    Summary

    Background: Patients who feel involved in their treatment have better outcomes than those who do not.

    Objective: To identify determinants of perceived patient involvement in obstetric care.

    Methods: A retrospective study was undertaken in 1,452 (83%) of 1,750 women sampled in November 1995 from maternity wards of 14 general hospitals in Israel. A postal and telephone survey using a self-administered questionnaire included the following variables: hospital (identity number), patients' age, self-reported complications, previous deliveries, education, ethnicity, and number of obstetric interventions performed and/or considered. The main outcome measured was the reported involvement in decisions for obstetric interventions.

    Results: Reported full involvement varied from 72% for epidural analgesia to 13% for forceps/vacuum extraction. Factor analysis identified two dimensions of perceived involvement: one for routine” interventions (enema, monitor­ing, IV line and episiotomy), which are performed in Israel mostly by midwives, and another for "special" interventions (forceps/vacuum extraction, epidural or other analgesia, and cesarian section) performed by physicians. Logistic regression identified hospitals, younger age, number of interventions, and Arab ethnicity as correlates of a perceived non-involvement in decisions for "special" interventions.

    Conclusions: Clinical setting, age and ethnicity affected patient perception of involvement in decisions for obstetric interventions.

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