Development and validation of a person-centered abortion scale: the experiences of care in private facilities in Kenya

May Sudhinaraset,Nadia Diamond-Smith,Patience A Afulani,Beth Phillips,Amanda Landrian,Sun Cotter

doi:10.1186/s12905-020-01071-w

Abstract

BackgroundThere is a need for a standardized way to measure person-centered care for abortion. This study developed and validated a measure of person-centered abortion care.MethodsItems for person-centered abortion care were developed from literature reviews, expert review, and cognitive interviews, and administered with 371 women who received a safe abortion service from private health clinics in Nairobi, Kenya. Exploratory factor analyses were performed and stratified by surgical abortion procedures and medication abortion. Bivariate linear regressions assessed for criterion validity.ResultsWe developed a 24-item unifying scale for person-centered abortion care including two sub-scales. The two sub-scales identified were: 1) Respectful and Supportive Care (14 items for medication abortion, 15 items for surgical abortion); and 2) Communication and Autonomy (9 items for both medication and surgical abortion). The person-centered abortion care scale had high content, construct, criterion validity, and reliability.ConclusionsThis validated scale will facilitate measurement and further research to better understand women’s experiences during abortion care and to improve the quality of women’s overall reproductive health experiences to improve health outcomes.

Highlights

There is a need for a standardized way to measure person-centered care for abortion
The broad range of indicators evidenced in this review demonstrates that abortion care quality is multidimensional and emphasizes the need for progress in the field to move beyond a clinical-only perspective [13]
Demographic characteristics A total of 353 women completed all person-centered abortion care (PCAC) scale items; their demographic characteristics are presented in Table 2, stratified by abortion procedure type

Summary

Introduction

There is a need for a standardized way to measure person-centered care for abortion. This study developed and validated a measure of person-centered abortion care. Positive patient experience is a critical component in ensuring quality abortion care for women, linked to health outcomes such as decreases in severe abortion complications and seeking timely care [1]. Improving women’s experiences within broader efforts to improve quality of abortion services is critical in protecting women’s reproductive rights and needs. One overlooked aspect of quality of abortion care is person-centered care, or care that is respectful of and responsive to women’s preferences, needs and values [1]. A recent review of person-centered care for abortion services found many instances where women are treated poorly [7], in contexts with restrictive laws. Treating women with respect and dignity during abortion care is important from a human rights perspective, and because women’s experiences can impact outcomes, adherence to post-abortion guidance, and future healthseeking decisions by the patient and women who hear of her experiences [7, 9]

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