Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.

Maternity care is an integrated care process, which consists of different services, involves different professionals and covers different time windows. To measure performance of maternity care based on clients' experiences, we developed and validated a questionnaire.We used the 8-domain WHO Res...

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Main Authors: Marisja Scheerhagen, Henk F van Stel, Erwin Birnie, Arie Franx, Gouke J Bonsel
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4324965?pdf=render
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author Marisja Scheerhagen
Henk F van Stel
Erwin Birnie
Arie Franx
Gouke J Bonsel
author_facet Marisja Scheerhagen
Henk F van Stel
Erwin Birnie
Arie Franx
Gouke J Bonsel
author_sort Marisja Scheerhagen
collection DOAJ
description Maternity care is an integrated care process, which consists of different services, involves different professionals and covers different time windows. To measure performance of maternity care based on clients' experiences, we developed and validated a questionnaire.We used the 8-domain WHO Responsiveness model, and previous materials to develop a self-report questionnaire. A dual study design was used for development and validation. Content validity of the ReproQ-version-0 was determined through structured interviews with 11 pregnant women (≥28 weeks), 10 women who recently had given birth (≤12 weeks), and 19 maternity care professionals. Structured interviews established the domain relevance to the women; all items were separately commented on. All Responsiveness domains were judged relevant, with Dignity and Communication ranking highest. Main missing topic was the assigned expertise of the health professional. After first adaptation, construct validity of the ReproQ-version-1 was determined through a web-based survey. Respondents were approached by maternity care organizations with different levels of integration of services of midwives and obstetricians. We sent questionnaires to 605 third trimester pregnant women (response 65%), and 810 women 6 weeks after delivery (response 55%). Construct validity was based on: response patterns; exploratory factor analysis; association of the overall score with a Visual Analogue Scale (VAS), known group comparisons. Median overall ReproQ score was 3.70 (range 1-4) showing good responsiveness. The exploratory factor analysis supported the assumed domain structure and suggested several adaptations. Correlation of the VAS rating and overall ReproQ score (antepartum, postpartum) supported validity (r = 0.56; 0.59, p<0.001 Spearman's correlation coefficient). Pre-stated group comparisons confirmed the expected difference following a good vs. adverse birth outcome. Fully integrated organizations performed slightly better (median = 3.78) than less integrated organizations (median = 3.63; p<0.001). Participation rate of women with a low educational level and/or a non-western origin was low.The ReproQ appears suitable for assessing quality of maternity care from the clients' perspective. Recruitment of disadvantaged groups requires additional non-digital approaches.
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spelling doaj.art-68b33ee9c68a45dc831633c17164dad12022-12-21T20:12:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01102e011703110.1371/journal.pone.0117031Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.Marisja ScheerhagenHenk F van StelErwin BirnieArie FranxGouke J BonselMaternity care is an integrated care process, which consists of different services, involves different professionals and covers different time windows. To measure performance of maternity care based on clients' experiences, we developed and validated a questionnaire.We used the 8-domain WHO Responsiveness model, and previous materials to develop a self-report questionnaire. A dual study design was used for development and validation. Content validity of the ReproQ-version-0 was determined through structured interviews with 11 pregnant women (≥28 weeks), 10 women who recently had given birth (≤12 weeks), and 19 maternity care professionals. Structured interviews established the domain relevance to the women; all items were separately commented on. All Responsiveness domains were judged relevant, with Dignity and Communication ranking highest. Main missing topic was the assigned expertise of the health professional. After first adaptation, construct validity of the ReproQ-version-1 was determined through a web-based survey. Respondents were approached by maternity care organizations with different levels of integration of services of midwives and obstetricians. We sent questionnaires to 605 third trimester pregnant women (response 65%), and 810 women 6 weeks after delivery (response 55%). Construct validity was based on: response patterns; exploratory factor analysis; association of the overall score with a Visual Analogue Scale (VAS), known group comparisons. Median overall ReproQ score was 3.70 (range 1-4) showing good responsiveness. The exploratory factor analysis supported the assumed domain structure and suggested several adaptations. Correlation of the VAS rating and overall ReproQ score (antepartum, postpartum) supported validity (r = 0.56; 0.59, p<0.001 Spearman's correlation coefficient). Pre-stated group comparisons confirmed the expected difference following a good vs. adverse birth outcome. Fully integrated organizations performed slightly better (median = 3.78) than less integrated organizations (median = 3.63; p<0.001). Participation rate of women with a low educational level and/or a non-western origin was low.The ReproQ appears suitable for assessing quality of maternity care from the clients' perspective. Recruitment of disadvantaged groups requires additional non-digital approaches.http://europepmc.org/articles/PMC4324965?pdf=render
spellingShingle Marisja Scheerhagen
Henk F van Stel
Erwin Birnie
Arie Franx
Gouke J Bonsel
Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.
PLoS ONE
title Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.
title_full Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.
title_fullStr Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.
title_full_unstemmed Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.
title_short Measuring client experiences in maternity care under change: development of a questionnaire based on the WHO Responsiveness model.
title_sort measuring client experiences in maternity care under change development of a questionnaire based on the who responsiveness model
url http://europepmc.org/articles/PMC4324965?pdf=render
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