Maternal Satisfaction With Universal Postnatal Nurse Home Visiting Services and Its Covariates: A Cross-Sectional Survey of 22,040 Mothers With Young Children in Seoul, Korea

Abstract

Background: Universal postnatal nurse home visitation services were introduced in Seoul, Korea in 2013 and are now being expanded nationally with government funding. This study examined maternal satisfaction with these services and identified factors associated with satisfaction among mothers of young children. Methods: A cross-sectional online survey was conducted with 22,040 mothers who participated in universal home visitation services between 2017 and 2019 in Seoul, Korea, approximately one month after service delivery. Maternal satisfaction was measured using a modified version of the Parent Satisfaction Questionnaire-18. The study estimated least square means of maternal satisfaction scores and prevalence ratios (PRs) of scoring 33 or higher (fidelity indicator) according to covariates. Results: The average satisfaction score was 36.27 (standard deviation: 4.32) out of 40. About 80.7% scored 33 or higher, and only 0.2% scored below 16. Among the four dimensions, "communication" had the highest score (9.34/10), whereas "general satisfaction" had the lowest (8.77). Satisfaction was lower among mothers aged 23 or younger (P = 0.002), from culturally diverse backgrounds (P < 0.001), with high Edinburgh Postnatal Depression Scale scores (P < 0.001), experiencing suicidal ideation (P < 0.001), or with childhood abuse experience (P = 0.019). These groups also had lower PRs of scoring 33 or higher. Mothers with two or more home visits had higher satisfaction scores (P < 0.001) and were more likely to score 33 or higher (PR, 1.05; 95% confidence interval [CI], 1.03-1.07; P < 0.001). Participation in a mothers' group program was also linked to higher satisfaction (P < 0.001) and increased PRs of scoring 33 or higher (PR, 1.06; 95% CI, 1.02-1.09; P < 0.001). These relationships remained consistent after adjusting for other covariates. Conclusion: Mothers with young children who received universal postnatal nurse home visits reported high satisfaction. Increasing visit frequency and expanding mothers' group program opportunities could further improve satisfaction.