689例上海市孕产妇对产前诊断的认知及其影响因素研究

Perception and its influencing factors of prenatal diagnosis in 689 pregnant women in Shanghai

目的了解上海市产前诊断机构能力建设及就诊孕产妇满意度情况。方法2018年12月至2020年3月对在上海市10家产前诊断机构就诊的689例孕产妇进行问卷调查,并建立多分类有序Logistic回归模型对满意度及其影响因素进行研究。结果研究对象认为产前诊断风险较低的占65.67%,倾向于选择超声检查等无创方式进行产前诊断的占66.24%,通过医务人员介绍获得产前诊断相关信息的占75.11%;本研究孕产妇对服务收费的满意度低于对医生诊疗技术和服务态度的满意度(F=1510.50,P<0.001);多分类有序Logistic模型显示35岁以上的孕产妇对服务收费的满意度更高,其OR值及95%CI为1.92(1.26~2.93),P<0.001;硕士及以上学历的孕产妇对医生诊疗技术和服务态度的满意度均更低,其OR值及95%CI分别为0.31(0.15~0.67)、0.35(0.16~0.77),P<0.01;孕产妇认为获取产前诊断相关信息越难,对医生诊疗技术和服务态度的满意度越低,其OR值及95%CI分别为0.58(0.43~0.77)、0.54(0.39~0.74),P<0.001;医生解释过相关问题、解释得通俗易懂、孕产妇向医生表达过主观诉求、诉求得到解决,均会提高医生诊疗技术、医生服务态度、服务收费的满意度(OR值介于1.42~7.01之间,P<0.05)。结论孕产妇年龄、学历、获取产前诊断相关信息、医生的详细解释说明等均是影响孕产妇满意度的因素,提升产前诊断机构的服务能力及拓展对孕产妇产前诊断的宣传渠道至关重要。

Objective To investigate the situations of capacity building and maternal satisfaction of prenatal diagnosis institutions in Shanghai.Methods A questionnaire survey was conducted among 689pregnant women in Shanghai′s 10prenatal diagnosis institutions between December 2018to March 2020.Multivariate ordered Logistic regression was established to analyze the satisfaction and its influencing factors.Results Participants who considered that the risk of prenatal diagnosis was low accounted for 65.67%,who preferred noninvasive methods such as ultrasound to conducting prenatal diagnosis accounted for 66.24%,and who obtained prenatal diagnosis information through medical staff accounted for 75.11%.The satisfaction with the service charge was lower than the satisfaction with the doctors′diagnosis and treatment techniques,and service attitude(F=1510.50,P<0.001).Multivariate ordered Logistic regression showed that women elder than 35years old were more satisfied with the service charges,and the ORand 95%CI were 1.92(1.26-2.93),P<0.001.Participants with the education level of master′s degree or above were less satisfied with doctors′diagnosis and treatment techniques,and the ORand 95%CI were 0.31(0.15-0.67)and 0.35(0.16-0.77),respectively,P<0.01.Pregnant women considered that the harder access to prenatal diagnosis information,the lower satisfaction with doctors′diagnosis and treatment techniques,and the OR and 95%CI were 0.58(0.43-0.77)and 0.54(0.39-0.74),respectively,P<0.001.Factors that doctor had explained related issues,the explanation was easy to understand,pregnant women had expressed their subjective appeals,and the appeals were solved could improve the satisfaction with doctors′diagnosis and treatment techniques,service attitudes and service charges(OR=1.42-7.01,respectively,P<0.05).Conclusion Maternal age,education level,access to prenatal diagnosis related information and the detailed explanation from doctors are the influencing factors of pregnant women′s satisfaction.It′s extremely important to enhance the service capability of prenatal diagnosis institutions and expand the publicity channels of prenatal diagnosis to pregnant women.