title: Patient perception of involvement in medical care during labor and delivery.
abstract: BACKGROUND
  Patients who feel involved in their treatment have better outcomes than those who do not.
  
  
  OBJECTIVE
  To identify determinants of perceived patient involvement in obstetric care.
  
  
  METHODS
  A retrospective study was undertaken in 1,452 (83%) of 1,750 women sampled in November 1995 from maternity wards of 14 general hospitals in Israel. A postal and telephone survey using a self-administered questionnaire included the following variables: hospital (identity number), patients' age, self-reported complications, previous deliveries, education, ethnicity, and number of obstetric interventions performed and/or considered. The main outcome measured was the reported involvement in decisions for obstetric interventions.
  
  
  RESULTS
  Reported full involvement varied from 72% for epidural analgesia to 13% for forceps/vacuum extraction. Factor analysis identified two dimensions of perceived involvement: one for "routine" interventions (enema, monitoring, IV line and episiotomy), which are performed in Israel mostly by midwives, and another for "special" interventions (forceps/vacuum extraction, epidural or other analgesia, and cesarian section) performed by physicians. Logistic regression identified hospitals, younger age, number of interventions, and Arab ethnicity as correlates of a perceived non-involvement in decisions for "special" interventions.
  
  
  CONCLUSIONS
  Clinical setting, age and ethnicity affected patient perception of involvement in decisions for obstetric interventions.
authors: JDC-Brookdale Institute, Health Policy Research Program, Jerusalem, Israel. AyeletB@jdc.org.il
authors: A
authors: A
authors: Berg
authors: D
authors: D
authors: Yuval
authors: M
authors: M
authors: Ivancovsky
authors: S
authors: S
authors: Zalcberg
authors: A
authors: A
authors: Dubani
authors: J
authors: J
authors: Benbassat
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D010358:Patient Participation; D011247:Pregnancy; D011795:Surveys and Questionnaires