背景：孕产期是女性一生中的重要阶段，涵盖了产前、产时、产后延续性保健服务，这些服务的质量和效果，直接影响到母婴的健康和安全，特别是90后当代女性对孕产期保健服务质量和效果有更高的要求，因此研究孕产期保健服务满意度显得更为重要，也能够为我国改善优生优育全程服务相关政策提供参考。目的：通过构建孕产期保健服务满意度评价指标体系，了解当代女性孕产期保健服务满意度评价现状，找出亟待改进的服务环节，提出改善的措施和对策。方法：分析孕产期保健服务内容和流程，结合文献研究进行指标初拟，邀请27位专家，通过德尔菲法进行指标确定，通过层次分析法进行指标赋权，构建了孕产期保健服务满意度评价指标体系；进行满意度评价问卷调查，收集了254份有效问卷，了解孕产期保健服务的满意度现状；为提升满意度，进行需求调查，收集了216份有效问卷，探索了提升孕产期保健服务满意度的技术创新对策。结果：（1）基于SERVQUAL模型，构建了孕产期保健服务满意度评价指标体系，共5个一级指标、12个二级指标和30个三级指标；一级指标中“保证性”权重最高，“响应性”权重最低。（2）孕产期保健服务总体满意率为65.75%，分娩方式、医院类型和受教育程度对总体满意度得分有显著性差异；一级指标中“有形性”满意度得分最高，“移情性”满意度得分最低。（3）IPA分析结果显示，一级指标“移情性”处于改进区；二级指标“诊疗效果”、“个性化服务”和“随访服务”处于改进区；三级指标有6个服务项目处于改进区，需要优先改善。（4）经过多维度分析，认为数字疗法作为创新工具，提升孕产期保健服务满意度是可行的。结论：孕产期保健服务总体满意度处于中等偏上，仍有提升空间，特别是在满意度较低的心理保健、产后康复等关键服务上，应通过针对性的创新对策和实践措施，实现孕产期保健服务质量和满意度的提升。建议：针对性提升服务质量，适度降低剖宫产率；注重女性心理健康，加强孕产期心理保健；加强产前产后随访，做好孕产期暖心陪伴；重视产后康复服务，满足产妇个性化需求；探索以数字疗法赋能孕产期保健服务，完善数字疗法相关政策。
Background Pregnant and puer-peral period are important stages in a woman‘s life, covering prenatal, postpartum and continuous healthcare services. The quality and effectiveness of these services directly affect the health and safety of mothers and infants. In particular, contemporary women born in the 1990s have higher requirements for the quality and effectiveness of maternal healthcare services, so it is important to study the satisfaction of maternal healthcare services. It can also provide reference for China‘s policy to improve the whole course of maternal healthcare service.Objective This study aims to establish satisfaction evaluation index system of maternal healthcare services, and to evaluate the status quo of satisfaction with maternal healthcare services. Finally, a series of countermeasures are put forward to improve satisfaction.Methods Based on the analysis of the content and process of maternal healthcare services and literature research, the indicators were preliminarily screened. 27 experts were invited to determine the indicators by Delphi method and empower the indicators by Analytic Hierarchy Process to construct the evaluation index system of satisfaction of maternal healthcare services. A survey on the satisfaction of contemporary women with pregnancy experience was conducted, and 254 valid questionnaires were collected to understand the satisfaction status of maternal healthcare services. In order to improve the satisfaction, the needs of contemporary women who have had pregnancy experience were investigated, and 216 valid questionnaires were collected. The feasibility of Digital Therapeutics to improve the satisfaction of maternal healthcare service was analyzed.Results (1) Based on SERVQUAL model, the evaluation index system of maternal health care service satisfaction was established, including 5 primary indexes, 12 secondary indexes and 30 tertiary indexes. Among the first-level indicators, "assurance" has the highest weight and "responsiveness" has the lowest weight. (2) The overall satisfaction rate of maternal healthcare service was 65.75%, and the method of delivery, the type of hospital and the level of education had significant differences on the overall satisfaction score. The tangibility dimension has the highest satisfaction score, and the empathy dimension has the lowest satisfaction score. (3) The results of IPA analysis show that the first-level indicator "empathy" is in the improvement area, the second-level indicator "diagnosis and treatment effect", "personalized service" and "follow-up service" are in the improvement area, and the third-level indicator has 6 items in the improvement area, and these services need to be improved first. (4) Through multi-dimensional analysis, it is considered that it is feasible for Digital Therapeutics as innovative technological means to improve the satisfaction of maternal healthcare services is feasible.Conclusions The overall satisfaction of maternal healthcare services is above the medium level, and there is still room for improvement. Especially in key services such as mental healthcare and postpartum rehabilitation with low satisfaction, targeted innovative countermeasures and practical suggestions should be adopted to improve the quality and satisfaction of maternal healthcare services.Recommendations Improve the quality of service and moderately reduce the rate of cesarean section; Strength the maternal healthcare on psychology; Strengthen prenatal and postpartum follow-up, provide warm companionship during pregnancy; Strengthen postpartum rehabilitation services; Explore the use of Digital Therapeutics to help maternal healthcare services, and improve policies related to Digital Therapeutics.
