Journal de la grossesse et de la santé infantile

Abstrait

Healthcare Decision-making: Targeting Women as Leaders of Change for Population Health

Michele McCarroll, Karen Frantz, Tiffany Kenny, Jennifer Doyle, David Gothard and Vivian E

This pilot study was a prospective survey of n = 500 postpartum mothers and n = 36 obstetricians (OBs) to assess characteristics, opinions, and experiences of healthcare. A convenient sample of women on the postpartum floors and OBs were invited to participate in a survey. The survey was distributed from 2013 to 2014 investigating general opinions from women about healthcare decision-making, healthcare experiences during a healthcare stay after delivery, and overall quality of life using the Patient Reported Outcomes Measurement Information System. The majority of women indicated that they made the healthcare decisions for themselves, n = 278 (57.3%) versus n = 191 (39.3%) indicated her and her spouse/partner together made healthcare decisions for her. Interestingly, only 39.3% (n = 69) of women reported that their spouse/partner were the only ones involved in their healthcare decisions whereas women reported to be more jointly involved in healthcare decisions of their spouse’s/partner’s health, n = 313 (66.6%). PROMIS® scores had a significant relationship (p = 0.022) in the global mental domain to age and insurance type with accessing the same facility for future healthcare. Further analysis revealed a significant (p = 0.013) relationship as PROMIS® global mental scores go down, the increased willingness to return to the same birthing facility for future healthcare goes up. Two specific PROMIS® global mental questions were identified as having a significant (p = 0.008) or trending towards significant (p = 0.08) negative value for Kendall’s tau indicating that the lower the score on the PROMIS® global mental question, the more likely they are to visit the same birthing facility in the future for other healthcare procedures. A substantial amount of women are responsible for their family’s health. Future studies should have a longitudinal design to assess the true lifetime impact of the birth experience for a woman on healthcare decision-making for her family.