Patient Satisfaction in Perineal Laceration Topics Provided by the “Spesialis Keliling” (Speling) Program: A Cross-Sectional Study
Abstract
Background: Perineal laceration is a prevalent complication of vaginal delivery and may lead to adverse maternal outcomes when postnatal care and education are inadequate. In Indonesia, unequal access to specialist obstetric services remains a challenge. The Spesialis Keliling (Speling) program was introduced to enhance access through community-based outreach. This study aims to assess patient satisfaction and examine associated factors with the Speling program in obstetric and gynecological services.
Methods: An observational cross-sectional study was conducted among women aged ≥18 years who received Speling services, including counseling on birth canal trauma, in Surakarta, Central Java, in 2025. A total of 34 participants were included. Data were collected using a structured questionnaire and analyzed using Chi-square or Fisher’s exact tests.
Results: Overall patient satisfaction was reported by 58.8% of participants. Satisfaction was significantly higher among participants reporting easy access to services, good provider communication, and adequate understanding after counseling (p<0.001 for all). No significant association was found between satisfaction and history of perineal laceration (p=0.295).
Conclusion: The Speling program achieved a favorable level of patient satisfaction. Accessibility, effective communication, and patient understanding emerged as key determinants, underscoring the importance of patient-centered and educational approaches in outreach-based obstetric services.
Keywords
Full Text:
PDFReferences
- Domenighi LHH, Weinmann ARM, Haeffner LSB, Feltrin ML. Perineal Lacerations: A Retrospective Study in a Habitual-Risk Public Maternity. Revista Brasileira de Ginecologia e Obstetricia. 2021;43(8):588–94. doi:10.1055/s-0041-1735227 PubMed PMID: 34547792.
- Karsa SB, Antonius PA, Fitria H, Insani AA, Fadila Z, Dimba M. Perineal Trauma Impact on Postpartum Sexual Function: A Cross-Sectional Study Using Female Sexual Function Index. Jurnal Ilmu Kesehatan.2025. 9(2):341. doi:10.33757/jik.v9i2.1459
- Zhou L, Li J, Zhou Y, Liang Y, Ma Q, Yang L, et al. Pain Management for Postpartum Pain: A Narrative Review. Journal of Pain Research. Dove Medical Press Ltd; 2025. p. 5617–26. doi:10.2147/JPR.S552442
- Rodaki E, Diamanti A, Sarantaki A, Lykeridou A. The Effects of Perineal Tears during Childbirth on Women’s Sex Life. Maedica (Bucur). 2022;17(2):297–305. doi:10.26574/maedica.2022.17.2.297 PubMed PMID: 36032614.
- Kurnia NM, Rahayu AM, Shobah AN. Science Midwifery Factors associated with understanding and perineal wound care behavior of postpartum mothers in Cikeusik district, Pandeglang regency. Science Midwifery [Internet]. Online; 2024. Available from: www.midwifery.iocspublisher.orgJournalhomepage:www.midwifery.iocspublisher.org
- Lelyana N. Outlining Strategies for Increasing Health Accessibility in Rural Areas of Indonesia. West Science Interdisciplinary Studies. 2024.
- Shin HY, Kim KY, Kang P. Concept analysis of community health outreach. BMC Health Serv Res. 2020;20(1). doi:10.1186/s12913-020-05266-7 PubMed PMID: 32404160.
- Gubernur Jawa Tengah. Surat Edaran tentang Dukungan terhadap Program Gubernur Jawa Tengah “Layanan Dokter Spesialis Keliling (Speling).” Semarang; 2025 May.
- Cui J, Du J, Zhang N, Liang Z. National Patient Satisfaction Survey as a Predictor for Quality of Care and Quality Improvement – Experience and Practice. Patient Preference and Adherence . 2025;19:193–206. doi:10.2147/PPA.S496684
- Manzoor F, Wei L, Hussain A, Asif M, Shah SIA. Patient satisfaction with health care services; an application of physician’s behavior as a moderator. Int J Environ Res Public Health. 2019;16(18). doi:10.3390/ijerph16183318 PubMed PMID: 31505840.
- Xesfingi S, Vozikis A. Patient satisfaction with the healthcare system: Assessing the impact of socio-economic and healthcare provision factors. BMC Health Serv Res. 2016;15(16).
- Okeahialam NA, Sultan AH, Thakar R. The prevention of perineal trauma during vaginal birth. American Journal of Obstetrics and Gynecology. Elsevier Inc.; 2024. p. S991–1004. doi:10.1016/j.ajog.2022.06.021 PubMed PMID: 37635056.
- 1Cakwira H, Mukengere M, Lucien B, Aborode AT, Sironge L, Michael MV, et al. The clinical characteristics of perineal tears: A study carried out on 14 pregnant women in a tertiary center: Case series. Annals of Medicine and Surgery. 2022;82. doi:10.1016/j.amsu.2022.104432
- Wahyuni HE, Ismiati, Wahyuni ED. Edukasi Perawatan Luka Perineum untuk Ibu Pascapersalinan di Desa Mantang sebagai Upaya Pencegahan Infeksi dan Percepatan Penyembuhan. SAMBARA: Jurnal Pengabdian Kepada Masyarakat. 2025;3(2):213–20. doi:10.58540/sambarapkm.v3i2.773
- Ferreira DC, Vieira I, Pedro MI, Caldas P, Varela M. Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare (Switzerland). MDPI; 2023. doi:10.3390/healthcare11050639 PubMed PMID: 36900644.
- Chichirez CM, Assistant P. Interpersonal communication in healthcare. J Med Life. 2018;11(2):119–22.
- Abdulai MS, Mumuni E, Abdulai M. Beyond technical skills: How communication shapes patient satisfaction in Ghana’s healthcare system. Dialogues in Health. 2025;7:100254. doi:10.1016/j.dialog.2025.100254
- Bhattad PB, Pacifio L. Empowering Patients: Promoting Patient Education and Health Literacy. Cureus. 2022;14(7).
DOI: https://doi.org/10.20961/placentum.v14i2.117171
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 Placentum: Jurnal Ilmiah Kesehatan dan Aplikasinya

This work is licensed under a Creative Commons Attribution-ShareAlike International 4.0 (CC BY-SA 4.0).
12.png)
b.png)
1.png)







13.png)

8.png)