Discussion on Satisfaction and Loyalty of Women with Pelvic Treatment in Postpartum Period ^†

Abstract

The satisfaction and loyalty of women in the postpartum period with their pelvic health and related treatment were investigated to provide a reference for the decision-making of operators. The study results showed that women’s age, education level, occupation, postpartum time, and mode of delivery influenced the cognition of and satisfaction with pelvic health recovery. The results also provided a reference for postpartum care centers or related practitioners to offer better choices in pelvic health care to secure the loyalty of women in the postpartum period. Based on these results, women in the postpartum period can improve their quality of life.

1. Introduction

Women experience tremendous physical and mental changes during pregnancy and childbirth. If the loose pelvic floor ligaments and muscles do not recover within three months after delivery, it may cause a change in body shape, lower back pain, walking problems, and even severe pelvic organ prolapse and urinary incontinence. Such symptoms limit women’s physical, psychological, and social functions and affect their quality of life. Most postpartum education focuses on breastfeeding, baby bathing, jaundice precautions, emotional distress, nutrition, and wound care after giving birth [1]. However, postpartum pelvic recovery and pelvic health are crucial for women in the postpartum period. Institutions educate women in the postpartum period about the importance of postpartum pelvic recovery and provide related services to improve women’s postures, promote pelvic health, and regain previous self-confidence and style.

Researchers have also pointed out that dissatisfaction and poor self-image in women in the postpartum period are related to depression or other maternal psychological distress [2]. Therefore, this research was carried out to understand how much women in the postpartum period are satisfied with pelvic health recovery and the relationship between their satisfaction and the effectiveness of treatment. In this research, significant differences in satisfaction with pelvic health recovery and treatment were investigated to suggest how to treat and serve women in the postpartum period.

2. Pelvic Health

The pelvis is a skeletal structure with muscles at the bottom for important functions of support and contraction [3] to hold the organs such as the bladder, intestine, and uterus. The sphincter muscles control the opening and closing of the urethra, vagina, and anus on the pelvic floor. Childbirth is conducted by the proper contraction and relaxation of the pelvic floor muscles [4,5]. Professional techniques are used to maintain the normal function of the pelvis by the muscles, tendons, and membranes. For its functions, the movements of various parts including the air joints and nodules are corporated. In Chinese medicine, the qi of the meridians and viscera is important to allow the smooth flow of qi and blood and coordination between the outside and the inside of the body. By improving the functions of the viscera, tissues, and organs, the physical balance in the pelvis and the mental well-being of women in the postpartum period can be obtained.

3. Satisfaction and Loyalty

3.1. Satisfaction

Cardozo [6] pointed out that satisfaction affected the behavior and willingness of customers to buy and maintain their loyalty to a product or service. Many researchers have different explanations for the definition of customer satisfaction. Boshoff and Gray [7] believed that customer satisfaction could be measured through the evaluation of their experience and reaction after using the product. Joewono and Kubota [8] pointed out that customer satisfaction was the evaluation of products and services based on customers’ experience. According to Baker and Crompton [9], customer satisfaction refers to the psychological and emotional state after an experience. If the expectation before use exceeded that after use, customers were satisfied.

3.2. Loyalty

Customer loyalty refers to the customer’s feelings after using a product or service. For short contacts to develop into loyalty, experience is always required. Therefore, the key to creating customer loyalty is to deliver more and higher customer value. The competition in the industry affects customers’ decisions on whether to continue to use the products and services and relies on the premise that the products are convenient to use. Depending on the decision and comparison, customers choose products or services and decide to maintain a relationship with the service provider [10]. To maintain a long-term relationship, providers must provide education on the advantages of their products and services so that customers can visit or buy the product and service repeatedly. This is called repeated purchase or re-consumption [11]. Providers must offer information and promise to customers for mutual trust. Therefore, Stank et al. [12] defined loyalty as a long-term commitment to repurchase, including the cognition of the provider for repeated purchases.

4. Methods

A questionnaire survey was conducted for women in the postpartum period after receiving pelvic treatment. The responses were analyzed to obtain descriptive statistics and the results of variance, correlation, and regression analyses using SPSS21. The results were investigated to understand the satisfaction with and loyalty to the postpartum treatment. The results of this research provided postpartum care homes or related practitioners with a reference for better care and improvement of their treatments and services. The data were collected from 1 March to 30 April 2022, from 381 subjects who were in the postpartum period. In this research, the following hypotheses were proposed.

Hypothesis 1.

There are significant differences in satisfaction with pelvic treatment and service according to different demographic variables.

Hypothesis 2.

Women in the postpartum period have different loyalty to the treatment and service depending on different demographic variables.

Hypothesis 3.

Satisfaction with pelvic treatment and service of women in the postpartum period has a positive impact on their loyalty.

5. Result and Discussion

5.1. Reliability of Questionnaire Survey

The four dimensions of satisfaction and loyalty are shown in

Table 1. Reliability test results of questionnaire survey.

Dimension of Satisfaction and Loyalty	Cronbach’s α	Number of Questions
Space and environment	0.952	6
Service attitude	0.935	5
Professionalism	0.95	5
Cost	0.95	4
Loyalty	0.921	6

. The Cronbach α values were 0.952, 0.935, 0.950, 0.950, and 0.921 for each dimension. The results indicated satisfactory reliability of the questionnaire survey.

5.2. Survey Result

Table 2. Results of descriptive analysis of background data.

Variable	Item	Number of Respondents	Ratio (%)
Age	Under 25 years old (inclusive)	18	4.7
	26–30 years old	65	17.1
	31–35 years old	154	40.4
	36–40 years old	72	18.9
	41 years old (inclusive) and above	72	18.9
Education	High school/vocational (inclusive) or below	73	19.2
	University/college	247	64.8
	Graduate school (inclusive) or above	61	16.0
Occupation	None (student/housekeeping)	113	29.7
	service industry	100	26.2
	Military education	17	4.5
	Business	29	7.6
	Technology industry	19	5.0
	Manufacturing industry	32	8.4
	Others	71	18.6
Years after delivery	Within 1 year	184	48.3
	1–3 years	79	20.7
	4 years	118	31.0
Mode of delivery	Spontaneous delivery	236	61.9
	Caesarean section	119	31.2
	Both	26	6.8

presents the descriptive statistics of the questionnaire survey results. Respondents aged 31−35 accounted for 40.4% of the total number of respondents. Those who were 36−40 years old and over 41 years old accounted for 37.8%. Those who were younger than 30 years old accounted for 21.8%. For the education level, 80.8% of respondents graduated from universities or higher. In total, 29.7% were students or unemployed while the remaining 70.3% had occupations. A total of 48.3% gave birth 1 year before the survey, 20.7% delivered their babies 1–3 years before the survey, and 31% did so 4 years before it. A total of 38.0% had experienced a Caesarean section.

Table 3. Descriptive statistical results of each dimension.

Dimension	Sum of Scores (Number of Questions)	Average Score
Space and environment	27.86 (6)	4.64
Service attitude	24.09 (5)	4.82
Professionalism	24.11 (5)	4.82
Cost	18.56 (4)	4.64
Loyalty	27.63 (6)	4.61

shows the sum and the average of scores for the questions in each dimension. The average score of each item was above 4, which showed that the respondents were satisfied with the dimensions and had loyalty to them.

5.3. Variance Analysis

There was no significant difference between the groups of different ages for the four dimensions at the significance level of 0.05. The education level of the respondents showed a significant impact on satisfaction with the space and environment of the institutions for treatment and services. However, it did not influence the service attitude, professionalism, cost, and loyalty of the institutions at a significance level of 0.05. The occupations of respondents also did not impact their satisfaction with and loyalty to the institutions. The mode of delivery influenced the satisfaction with professionalism significantly but did not impact the space and environment, service attitude, cost, and loyalty. The results of multiple regression analysis of the four dimensions (

Table 4. Multiple regression analysis results of four dimensions of satisfaction and loyalty.

Dimension	Coefficient	Standard Errors	t Value (p Value)
Space and environment	1.371	1.001	1.369 (0.172)
Service attitude	−0.127	0.034	−3.740 (0.000)
Professionalism	−0.444	0.122	−3.638 (0.000)
Cost	0.768	0.123	6.241 (0.000)
Loyalty	1.183	0.054	21.982 (0.000)
	0.80
			F value (p value) 381.781 (0.000)

) present that the adjusted R-squared (coefficient of determination) reached 0.80. This indicated a significant relationship between the four dimensions. In particular, a significant relationship between cost and loyalty was observed in the results of the multiple regression analysis.

6. Conclusions

The satisfaction and loyalty of women in the postpartum period were explored in this study. The results provide the required information for institutions of pelvic treatment and maternal services including beauty spas, beauty parlors, hospitals, and maternal care centers. It also can be used to establish a mother–infant-friendly institution with better treatments and services. Women in the postpartum period showed satisfaction and loyalty, the degrees of which differed with education levels and the delivery method they experienced. Those who were at different ages showed significant differences in loyalty, and so did their different occupations. The preliminary research results need to be complemented with future research.