Pregnant Women Clinical Trial
Official title:
The Effectiveness of Adopting Humanized Service Program on Transvaginal Ultrasound About Women's Service Quality and Satisfaction.
Owing to its image resolutions and its convenience in diagnosis, both better than abdominal ultrasound, transvaginal ultrasound is nowadays widely applied in diagnosing practice in obstetrics and gynecology. As a result, female examinees who undergo these check-up procedures have to expose their private parts, instead of their abdomens like the old days. According to the literature, women who receive transvaginal ultrasound check-ups normally have anxiety reactions, and worry about pain and discomfort. In clinical practice, when giving advice to the examinees to go through this check-up, more than often the diagnosis itself is its sole purpose, and little psychological assistance is offered. Traditional clinical space and disposal process tend to be designed to serve the purposes of conforming to the customs of medical staff and to the integrity of human resources and facilities in the hospital managers' minds, and less frequently tend to take the needs of patients into consideration. Consequently these patients are forced to enter strange medical environments and accommodate to the existent medical systems, with physical and psychological discomforts, to suffer from even more uncomfortable and anxiety-causing check-ups. Current medical service is required to not only provide a clean environment, but also give attention to creating an artistic space to increase healthy factors to the environment. The literature points out that a comfortable and artistic space can eliminate environmental strangeness, and help patients to soothe their pressures caused by their own and by the environment.
This women-centered study designs a "humanized service program", to give women care and
respect, and protect women's privacy and their rights to know; the space design is
women-concerned, warm and homelike-layout; its furnishings are well-designed in order to
facilitate access for women to use, and give every effort to maintain women's safety,
comfort and self-esteem. The main purpose of this space is to provide the women who receive
transvaginal ultrasound "the human-based check-up service program", in order to see how it
affects the physical and psychological experiences of these women, its service quality and
service satisfaction.
This study adopts a quasi-experimental research method and takes the ultrasound examination
rooms of the obstetrics and gynecology department of a medical center in northern Taiwan as
the sites of collecting case data. The studied targets are the women who came to the
obstetrics and gynecology clinic as outpatients and were required to undergo transvaginal
ultrasound. The women in the control-group were offered with "the routine service", and the
experimental group, the "humanized service program". The study results compare differences
between the control group and the experimental group with regard to their respective basic
information concerning their physical and psychological experiences, their opinions on its
service quality and service satisfaction, discuss about the effectiveness of this program,
and explore the inter-relationships among the physical and psychological experiences,
service quality and service satisfaction. The research tools include the humanized service
programs and the research questionnaires. The research questionnaires include a basic
information scale, a physical and psychological experiences scale, a service quality scale
and a service satisfaction scale. Scales of humanized service programs and basic information
adopt expert validity for validity evaluation; the physical and psychological experiences
scale, the service quality scale and the service satisfaction scale adopt expert validity
and internal consistency reliability and construct validity for reliability and validity
evaluation. The results show that its reliability and validity both fall within acceptable
ranges.
Chi-square test analysis reveals that the cases in the two groups have homogeneity. From the
descriptive statistics, it can be learned that the 9 most common existing feelings the women
had who received transvaginal ultrasound are the following: sense of tension over the whole
body, feeling nervous, feeling awkward , feeling shy, feeling embarrassed, worrying about
discomfort, worrying about pain, fear of infection and lower abdominal fullness feeling. The
outpatients in the two groups perceived the service quality dimensions as such: the highest
dimension is the Empathy, and the lowest is the Tangibles. The highest dimension of the two
groups concerning the check-up service satisfaction is the Staff's Attitude, and the lowest
is the environment and the Waiting Time for Check-Up. Independent-samples T test analysis
shows that the points of the cases in the experimental group are significantly higher than
the ones of the control group in these three aspects: physical and psychological experience,
service quality and service satisfaction. This study results demonstrates that the
human-based check-up service program is effective for physical and psychological
experiences, service qualities and satisfaction. It lessens the physical and psychological
negative feelings of the women when they underwent transvaginal ultrasound, and at the same
time improves the transvaginal ultrasound service quality and satisfaction. Structural
Equation Modeling (SEM) analysis of the relationships among the three, physical and
psychological experience, service quality and service satisfaction, shows that there is a
significant positive correlation between service quality and physical and psychological
experiences, also between service quality and service satisfaction. Moreover, the service
quality produces an indirect effect on service satisfaction through the physical and
psychological experience. There is also a significant positive correlation between physical
and mental feelings and service satisfaction; this indicates that increase in service
quality may affect the physical and psychological experience of women to tend to be
positive, and enlarge service satisfaction; when women have more positive physical and
mental feelings, it will also increase their satisfaction with the services.
The physical and psychological experience scale designed in this study can be applied to
other assessments of women's physical and psychological feelings under the situations of
necessary perineal area exposures, such as Pap smear, colposcopy and so on. "The humanized
service program" can offer the transvaginal ultrasound examinees better service; besides, it
can be used in various female-based obstetrics and gynecology-related check-ups. Within
other medical divisions, this concept can also be applied in order to provide more superior
medical service and care.
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Observational Model: Case Control, Time Perspective: Prospective
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