[Survey of 319 women satisfaction using abortion in centers of Pays de la Loire in France].
BACKGROUND
Perinatal network the "Security birth" Pays de la Loire (RSN), in collaboration with the regional network "Sexual health" (RRSS) organized a satisfaction survey in 2014 among women who had an induced abortion in the centers in Pays de la Loire. The objective of the study is to evaluate the satisfaction of women who resort to abortion centers, study the factors and propose actions for improvement.


METHODS
A questionnaire, developed with professionals, was offered to women after the end of the abortion act. The scales of satisfaction were based on Likert scales to 4 degrees. They were collected for the period of contact centers, for the abortion itself, and overall. Data were collected on the civil status, the care pathway to get to the abortion center, features centers and professionals met, acts anesthesia and end of abortion, wait times and overall satisfaction of women. The women with rather poor satisfaction were compared with other women by univariate analysis with odds ratios (OR) and multivariate with adjusted odds ratios (ORa).


RESULTS
Of the 18 centers, 13 participated and 319 responses were analyzed. The abortions were performed on average 8±SA 2. Among the methods, 40.1 % were drug, and 59.9 % with anesthesia (14.0 % with general anesthesia [AG] and 45.9 % under local anesthesia [AL]). The first contacts on average to 5.7 SA were mostly general practitioners (38 %), then the abortion centers directly (22 %), and planning centers (16 %). The information was considered clear (94 %), the appropriate orientation (97 %), with respect to the application (98 %). The first meeting at the center was done 7 days after the call (6.7 SA), and met women overall. The abortion was performed 16 days after the first call center (8.0 SA) with satisfaction by field 78 % (waiting time) to 98 % (confidentiality, privacy…). The overall satisfaction rate was 89.0 % and 8.2 % were not satisfied. Factors related to the non-satisfaction in multivariate analysis were the least easy access to the center (ORa=0.31 [.11 to 0.86; p=0.02]), pain perceived≥4 (ORa=3 50 [1.32 to 9.28], p=0.02), the lack of explanation (ORa=0.23 [0.05 to 0.97]; p=0.04), and the accompanying inability (ORa=0.27 [0.10 to 0.70], p=0.007). Finally, 12.6 % of women reported for improvement with clear remarks.


CONCLUSIONS
This is the first regional survey on the satisfaction of women resorting to abortion. Delays from the first contact are satisfactory and show no organizational problem. The various dimensions of satisfaction showed a high satisfaction rate in the 13 participating centers. The least satisfactory factors are related to organizational problems (waiting circuits especially trips to the operating room and maternity) and problems related to the care itself (not enough explanations, reduced ability to reassure and support Savory absence, lack of choice of the method of anesthesia, pain experienced). Five areas for improvement have been proposed to the care-givers of the centers.
Réseau « Sécurité naissance » des Pays de la Loire, 2, rue de la Loire, 44200 Nantes, France. Electronic address: branger44@gmail.com.
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Branger
Commission « Centres IVG » du Réseau « Sécurité naissance » des Pays de la Loire, clinique Jules-Verne, 2-4, route de Paris, 44300 Nantes, France.
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David
Réseau régional « Santé sexuelle » des Pays de la Loire, 90, rue Gambetta, 44000 Nantes, France.
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Bonnet
Réseau « Sécurité naissance » des Pays de la Loire, 2, rue de la Loire, 44200 Nantes, France.
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Coutin
Réseau « Sécurité naissance » des Pays de la Loire, 2, rue de la Loire, 44200 Nantes, France.
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Collin
D000028:Abortion, Induced / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D000328:Adult; D005602:France; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D055815:Young Adult
Induced abortion; Interruption volontaire de grossesse; Satisfaction