title: A systematic review of the relationship factor between women and health professionals within the multivariant analysis of maternal satisfaction.
abstract: BACKGROUND
  personalised support provided to women by health professionals is one of the prime factors attaining women's satisfaction during pregnancy and childbirth. However the multifactorial nature of 'satisfaction' makes difficult to assess it. Statistical multivariate analysis may be an effective technique to obtain in depth quantitative evidence of the importance of this factor and its interaction with the other factors involved. This technique allows us to estimate the importance of overall satisfaction in its context and suggest actions for healthcare services.
  
  
  METHODS
  systematic review of studies that quantitatively measure the personal relationship between women and healthcare professionals (gynecologists, obstetricians, nurse, midwifes, etc.) regarding maternity care satisfaction. The literature search focused on studies carried out between 1970 and 2014 that used multivariate analyses and included the woman-caregiver relationship as a factor of their analysis.
  
  
  RESULTS
  twenty-four studies which applied various multivariate analysis tools to different periods of maternity care (antenatal, perinatal, post partum) were selected. The studies included discrete scale scores and questionnaires from women with low-risk pregnancies. The "personal relationship" factor appeared under various names: care received, personalised treatment, professional support, amongst others. The most common multivariate techniques used to assess the percentage of variance explained and the odds ratio of each factor were principal component analysis and logistic regression.
  
  
  CONCLUSIONS
  the data, variables and factor analysis suggest that continuous, personalised care provided by the usual midwife and delivered within a family or a specialised setting, generates the highest level of satisfaction. In addition, these factors foster the woman's psychological and physiological recovery, often surpassing clinical action (e.g. medicalization and hospital organization) and/or physiological determinants (e.g. pain, pathologies, etc.).
authors.affiliation: Department of Humanities, Universitat Internacional de Catalunya, Barcelona, Spain. Electronic address: imacpherson@gmail.com.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Macpherson
authors.affiliation: Department of Humanities, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: María V
authors.initials: MV
authors.lastname: Roqué-Sánchez
authors.affiliation: Department of Nursing, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Finola O
authors.initials: FO
authors.lastname: Legget Bn
authors.affiliation: Department of Nursing, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Fuertes
authors.affiliation: Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, University of Barcelona, Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Segarra
mesh_terms: D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards; D009035:Mothers / Q000523:psychology*; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards; D011247:Pregnancy; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires
keywords: Childbirth; Maternity care; Multivariate analysis; Relationship; Satisfaction