The association between patients\' perceptions and adherence to management protocols and the occurrence of maternal delay in near-miss preeclampsia cases at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Objective: To analyse the relationship between patient perception, treatment adherence, and maternal referral delay (Types I–IV) in near-miss preeclampsia cases according to the WHO near-miss criteria at Dr. Soetomo General Hospital. Methodology: This study included 40 near-miss preeclampsia patients at the hospital. Data were collected through demographic information, medical record reviews, and questionnaires. Statistical analyses, including chi-square tests, were used to examine relationships between variables. Results: Most patients were 20-39 years old (85%), married (90%), had a high school education (45%), and had given birth multiple times (67,5%). Significant associations were found between patient perceptions and treatment adherence (p=0.028) as well as between patient perceptions and maternal referral delay (p=0.012). The most common type of delay was Type I (decision to seek help, 60%), followed by Type IV (influenced by the community, 55%), Type II (reaching the health facility, 52,5%), and Type III (receiving adequate care, 50%). Conclusion: Patient perceptions significantly influence treatment adherence and maternal referral delays in near-miss preeclampsia cases, particularly affecting decision-making and health-seeking behavior.