Abstract

Introduction: The analysis of patients’ satisfaction with healthcare is recognised as being useful in the evaluation of health outcomes and perceived quality of care. Little is known, however, about how the psychological status of women who experience perinatal complications may affect their perceived satisfaction with care. Methods: We assessed healthcare satisfaction in 52 women who had undergone intrauterine surgery during a complicated monochorionic twin pregnancy and examined the influence that fetal loss and sociodemographic, clinical, and psychological factors had on the degree of satisfaction. Data were gathered in an individual interview and through the administration of the Medical Patient Satisfaction Questionnaire, Beck Depression Inventory, and State–Trait Anxiety Inventory. Relationships between variables were analysed using a chi-square test, Spearman’s rho, Student’s t test, and the Mann–Whitney U test, in accordance with the metric nature of the variables and the assumptions fulfilled. Results: Age and level of education were not associated with the degree of healthcare satisfaction. Negative but non-significant correlations were observed between the level of satisfaction and symptoms of anxiety and depression. Satisfaction with healthcare was high in the sample as a whole, although it was significantly higher among women who had not experienced fetal loss. There were no differences in satisfaction with services involving direct contact with medical staff, whereas satisfaction with indirect services was lower among women who had experienced perinatal loss. Conclusions: Due to the unique characteristics of this population, specialised care teams of both professional healthcare and indirect services are needed. Although administrative aspects of healthcare are regarded as being of secondary importance, this may not be the case with more vulnerable populations.

Highlights

  • The analysis of patients’ satisfaction with healthcare is recognised as being useful in the evaluation of health outcomes and perceived quality of care

  • The placental anastomosis that connects the circulation of both twins can lead to particular complications such as twin-twin transfusion syndrome (TTTS), which can lead to the death of one or both fetuses if untreated

  • The aim of the present study is to examine the influence of perinatal loss and of certain sociodemographic, clinical, and psychological factors on the degree of satisfaction with care among women who have undergone intrauterine surgery due to complications during a monochorionic twin pregnancy

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Summary

Introduction

The analysis of patients’ satisfaction with healthcare is recognised as being useful in the evaluation of health outcomes and perceived quality of care. The placental anastomosis that connects the circulation of both twins can lead to particular complications such as twin-twin transfusion syndrome (TTTS), which can lead to the death of one or both fetuses if untreated These complications affect one in five monochorionic pregnancies. Pector and Smith-Levitin [6] suggest that despite the intensity of their grief for the deceased multiple, parents will often be denied “permission” from health professionals and family and friends to express this grief Instead they will be encouraged to focus upon the “positives” of a surviving baby. There is no funeral or other kind of farewell ritual that might help parents to mourn their loss [7,8] Together, these aspects can heighten the emotional impact of the perinatal loss on the mother and may lead to a complicated grief reaction and/or the development of a psychological disorder [9]. Other studies [6,10] draw attention to the fact that grieving for a loss can cause an inability to attach to the survivor(s)

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