Hispanic Women's Perceptions of Patient‐Centeredness During Prenatal Care: A Mixed‐Method Studya

Abstract

Assessing the quality of prenatal care received by Hispanic women is particularly important, given the rapidly growing Hispanic population in the United States. The purpose of this study was threefold: to assess the prevalence of Hispanic mothers who perceived their prenatal care to be patient-centered, to determine whether Hispanic mothers were less likely to perceive their prenatal care to be patient-centered than non-Hispanic mothers, and to better understand Hispanic women's perceptions of the patient-centeredness of their prenatal care. Semistructured interviews were conducted with a proportionate, stratified random sample of 359 women initiating prenatal care in their first trimester and 68 women initiating prenatal care in their third trimester who delivered at 10 Palm Beach County, Florida, maternity hospitals between May and December 2003. Interviews assessed three aspects of patient-centered prenatal care using quantitative and qualitative methods. Hispanic mothers were less likely than non-Hispanic mothers to perceive that doctors and nurses treated them with respect during their prenatal care appointments (adjusted OR, 0.29; 95% CI, 0.10-0.86), and to perceive that office staff treated them with respect during their prenatal care appointments (adjusted OR, 0.29; 95% CI, 0.12-0.73). Hispanic mothers were more likely to experience language or communication problems than non-Hispanic mothers (adjusted OR, 3.30; 95% CI, 1.40-7.76). Qualitative analyses found that lack of patient-centered care limited Hispanic mothers' ability to understand information given during prenatal visits, ability to ask questions about their prenatal care, and desire to return for subsequent appointments. Hispanic women could benefit from prenatal care that is more culturally and linguistically competent as well as care that is responsive to the group's cultural norms. One recommendation is the use of group prenatal care, which encourages groups of women with similar gestational ages to articulate and discuss cultural norms and attitudes about pregnancy during structured prenatal care sessions.