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Outcome measurement in surveys of women’s experiences of maternity care. Josephine Green Mother and Infant Research Unit (MIRU) Department of Health Sciences, University of York, UK. Great Expectations 2 antenatal q’res, 1 postnatal, 6 maternity units, N=825. 1987.
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Outcome measurement in surveys of women’s experiences of maternity care Josephine Green Mother and Infant Research Unit (MIRU) Department of Health Sciences, University of York, UK
Great Expectations 2 antenatal q’res, 1 postnatal, 6 maternity units, N=825 1987 Cambridge Prenatal Screening Study 3 antenatal q’res, 1 postnatal, 9 maternity units, N=1824 1991 2000 Greater Expectations? Re-study of Great Ex. 8 maternity units, N=1432 Follow up of women from Greater Ex 3 years later, N=738 (Baston PhD thesis) 2003 Dutch ‘replication’ of G’r Ex follow up. 8 primary care midwifery practices, N=1310 2004 2008 Joint analysis of data from KUB in Sweden and Greater Ex
ESMEE • European Survey of Maternity Expectations & Experiences • Nine participating countries in Northern and Central Europe • Funding applications to the European Collaborative Research Partnership (2009, 2010) MOTHER & INFANT RESEARCH UNIT
Choosing outcomes: principles • Know what the question is that you want to answer • Relate the outcomes you measure to your model (assumptions) about how things work • Measure at the right time • ‘Validated’ doesn’t necessarily make it valid for your circumstances • E.g. not valid for this population • Measuring the wrong thing • How/when administered
Satisfaction • Specific is better than global • May be better to avoid the word satisfaction altogether • Any expression of dissatisfaction is significant (van Teijlingen et al 2003) • Continuum from ‘Satisfied’ to ‘Very Satisfied’ Collins & O’Cathain (2003) • “Did the right thing happen?”
Interpersonal interactions • Do you feel that you were treated as an individual? • yes, always • yes, by most of the staff • only by a few of the staff • no, not at all • Do you feel that you were treated with respect?
Other ways of asking (1) • Adjective checklists Green et al 1990
Other ways of asking (2) • The Cambridge Worry Scale (Green et al 2003) • Potential worries determined by qualitative work with the target group • Now been used in a number of countries (incl. Greece right now) • Andrew Symon’s Mother Generated Index (2002, 2003 onwards)
A comparison of Swedish and English primiparae’s experiences of birth Josephine Green & Helen Baston Mother & Infant Research Unit, Department of Health Sciences, University of York, UK Erica Schytt & Ulla Waldenström Center for Clinical Research Dalarna, Sweden & Department of Woman and Child Health, KarolinskaInstitutet, Stockholm, Sweden Schytt et al (2008) Journal of Reproductive & Infant Psychology, 26(4), 277-294 MOTHER & INFANT RESEARCH UNIT
Background • Plans for an international comparative study of women’s experiences of childbirth (ESMEE) • To what extent can we answer comparative questions through secondary analysis of existing data? • Special issue of Journal of Reproductive & Infant Psychology “Cross-national comparisons of psychosocial aspects of childbirth” (November 2008) MOTHER & INFANT RESEARCH UNIT