Validity of instruments for measuring the satisfaction of a woman and her partner with care received during labour and childbirth: Systematic review

Background: patient satisfaction as an indicator of quality of care is becoming more and more important. The use of questionnaires is the most common method to evaluate satisfaction with maternity care. Despite the extensive variety of instruments available for this purpose, they vary widely in terms of their content and quality. Objectives: to identify, assess and summarize the most recent and robust instruments available to measure woman and partner satisfaction with the overall package of care during the labour and birth of their baby within a hospital setting. Design: systematic review. Methods: sixteen electronic databases were consulted. The research also included hand searching references of identified articles. Studies were assessed by two independent reviewers. Inclusion criteria were that participants were mothers and their respective partners and that the questionnaire was a multidimensional instrument used for measuring satisfaction with care during the labour and birth of a baby. Furthermore, the psychometric properties related to construction, reliability and validity of the questionnaire had to be reported. Findings: seventeen studies were included. The majority of the questionnaires was developed within Europe and was disparate in terms of sample, items, dimensions and collection time. Most of them were limited to healthy women with low obstetric risk pregnancies. Only one instrument included partners as the subject of study. All questionnaires reported at least one aspect of reliability, content and construct validity. Conclusions: there are a moderate number of instruments capable of measuring maternal satisfaction with the care received during labour and birth within a hospital setting. Our study provides an overview of the most up-to-date, valid and reliable tools available. Further investigations are needed in order to improve existing instruments by performing additional psychometric tests, considering more specific populations and assessing the satisfaction of the partner and mother jointly.