title: The influence of doctor-patient and midwife-patient relationship in quality care perception of italian pregnant women: an exploratory study.
abstract: BACKGROUND
  The study focuses on the perceived nature / technique opposition in pregnancy and delivery emerging from gynaecologist/ midwife/ pregnant woman relationships. We developed a cross-sectional survey to identify, by means of a multidimensional data-driven approach, the main latent concepts structuring the between items correlation correspondent to the different general opinions present in the data set. The obtained results can set the basis to improve patient satisfaction while decreasing healthcare costs.
  
  
  METHODS
  The sample is made of 90 pregnant women within 24-48 hours after natural or operative birth, from three maternity units in Italy. Women filled in a questionnaire about their relationship with gynaecologist and midwife during pregnancy and hospital stay for delivery.
  
  
  RESULTS
  Participation rate approached 100%. The emerging factorial structure gave a proof-of-concept of the hypothesis of 'nature vs. technique' as the main dimension shaping women opinions. The results highlighted the role of midwife as the 'link' between the natural and technical dimension of birth. The quality of welcome and the establishing of an empathic relation between mother and healthcare professional was shown to decrease further request of care in the post-partum period.
  
  
  CONCLUSIONS
  The "fault plane" between nature and technique is a very critical zone for litigation. Women are particularly sensitive to the consideration and attention they receive at their admission in the hospital, as well as to the quality of human relationship with midwife. The perceived quality of welcome scaled with a decreased need of additional care and, more in general, with a more faithful attitude towards health professionals. We hypothesize that increasing the quality of welcome can exert an effect on both welfare costs and litigation. This opens the way (through an extension of this pilot study to wider populations) to relevant ameliorative actions on quality of care at practically null cost.
authors.affiliation: Institute of Philosophy of Scientific and Technological Activity, University Campus Bio-Medico, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Andrissi
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
authors.affiliation: Environment and Health Dept. Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giuliani
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy.
authors.forename: Filiberto Maria
authors.initials: FM
authors.lastname: Severi
authors.affiliation: Division of Gynaecology, Obstetrics and Pathophysiology of Human Reproduction, Department of Surgery, Maternal-Fetal Medicine and Imaging, University of Cagliari, Cagliari, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Angioni
authors.affiliation: Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy.
authors.forename: Herbert
authors.initials: H
authors.lastname: Valensise
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Vannuccini
authors.affiliation: Institute of Philosophy of Scientific and Technological Activity, University Campus Bio-Medico, Rome, Italy.
authors.forename: Nunziata
authors.initials: N
authors.lastname: Comoretto
authors.affiliation: Institute of Philosophy of Scientific and Technological Activity, University Campus Bio-Medico, Rome, Italy.
authors.forename: Vittoradolfo
authors.initials: V
authors.lastname: Tambone
mesh_terms: D005260:Female; D006801:Humans; D007558:Italy; D009721:Nurse Midwives; D009723:Nurse-Patient Relations; D010817:Physician-Patient Relations; D011247:Pregnancy; D011787:Quality of Health Care; D011795:Surveys and Questionnaires