Patient satisfaction with intrapartum and postpartum nursing care
par Ngwingmechi MBEINKONG Chwinui
University of Buea, Cameroon - Bachelor in Nursing Sciences (BNS) 2009
MINISTRY OF HIGHER EDUCATION REPUBLIC OF CAMEROON
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THE UNIVERSITY OF BUEA PEACE-WORK-FATHERLAND
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FACULTY OF HEALTH SCIENCES
PATIENT SATISFACTION WITH INTRAPARTUM
AND POSTPARTUM NURSING CARE :
THE CASE OF BUEA REGIONAL HOSPITAL
A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF
CHWINUI NGWINGMECHI MBEINKONG
Supervisor: Dr. NDE FON Peter
BUEA, July 2010.
This is to certify that the Research work «Patient Satisfaction with Intrapartum and Postpartum Nursing Care» carried out in the Buea Regional Hospital Annex was done by CHWINUI NGWINGMECHI MBEINKONG and meets the criteria for the award of a Bachelor Degree in Nursing Science.
Dr. Nde Fon Peter Chief Ndeso Atanga
Supervisor Head of Department
Pr. Peter Martins NDUMBE
This piece of work is dedicated to all Nurses who have the God-given
Assignment of caring for the Sick.
This research work would definitely not have been brought to light without the restless efforts of several personalities. I will like to appreciate all of you who built a step in one way or the other for me to climb to the top of this mountain: Special thanks to my Lord and Saviour Jesus Christ who gave me salvation and a reason to live.
A million thanks to my supervisor Dr. Nde Fon Peter for the sleepless nights in directing and correcting this piece of work.
Many thanks go to my lecturers Chief Ndeso Atanga, Dr. Mrs Mary Bih suh, Dr Palle John and Mr Sab Clement for all their guidance.
Innermost gratitude goes to my family: to my lovely parents
Mr and Mrs Ghogomu MBEINKONG for their unfailing love and tender care. To my caring sisters Yehyeh, Nuigo, Keinui and my dear brother Halle for their love.
Sincere thanks go to my lovely niece Pearl Ciana for the love she gave me through out my stay in Yaounde.
Heartfelt thanks to my special friend Edwin for all his assistance.
I must recognize the love and support of my friends Alvina, Calvin, Betrand, Kelvina and Lesley for their support and to all my classmates who made UB a place to be during my 4 years of study.
To the staff of the Buea Regional Hospital Annex Maternity, for all your collaboration, I say THANK YOU.
LIST OF ABBREVIATIONS
A/L Advanced Level
AAP American Academy of Paediatrics
ACOG American College of Obstetricians and Gynaecologists AIDS Acquired Immune Deficiency Syndrome
AMTSL Active Management of Third Stage of Labour
BRHA Buea Regional Hospital Annex.
C/S Caesarean Section
DIVC Disseminated Intravascular Coagulation
EFW Estimated Foetal Weight
FH Fundal Height
FSH Follicle Stimulating Hormone
FSLC First School Leaving Certificate
HIV Human Immunodeficiency Virus
O/L Ordinary Level
WHO World Health Organization
LIST OF TABLES
Table 1: The Bishop Scoring System 21
Table 2: Distribution according to Age 37
Table 3: Distribution according to Levels of Education 38
Table 4: Distribution according to Profession 39
Table 5: Distribution according to Marital Status 40
Table 6: Distribution according to Number of days spent at Maternity 40
Table 7: Distribution according to Parity 41
Table 8: Mode of Delivery 41
Table 9: Distribution according to Nurses' Attitude on Admission 42
Table 10: Distribution according to Nursing Comfort Measures 42
Table 11: Distribution according to Breathing Techniques Taught 43
Table 12: Distribution according to Environmental Hygiene 43
Table 13: Distribution according to Time spent with patients 43
Table 14: Distribution according to Interpretation of Patients' feelings 44
Table 15: Distribution according to Monitoring Vital signs 44
Table 16: Distribution according to Patient Education 45
Table 17: Distribution according to Examination of Baby 46
Table 18: Distribution according to Examination of Mother 46
Table 19: Rating during Intrapartum (using the Likert's Scale) 47
Table 20: Rating during Postpartum(using the Likert's Scale) 48
Table 21: Patients' Recommendation of the Maternity 49
Table 22: Patients' Opinion on how satisfaction can be improved. 50
LIST OF FIGURES
Figure 1: Spontaneous Symphysiotmy 18
Figure 2: Estimated Foetal Weight 20
Figure 3: Intramuscular administration of Oxytocin 24
Figure 4: Deliverance of the placenta 25
Figure 5: Examining the placenta 25
Figure 6: Sketch diagram of BRHA 32
Figure 7: Organigram of BRHA 33
Figure 8: Distribution according to Age 47
Figure 9: Distribution according to Levels of Education 48
Figure 10: Distribution according to Professional 49
Figure 11: Distribution according to Marital Status 50
Figure 12: Distribution according to Number of days spent at Maternity 51
Figure 13: Distribution according to Gravidity 52
Figure 14: Distribution according to Mode of Delivery 52
Figure 15: Distribution according to Patient Education 56
Figure 16: Rating during Intrapartum 58
Figure 17: Rating during Postpartum 59
Figure 18: Patients' Recommendation of the Maternity 60
Figure 19: Data Entry Form 64
TABLE OF CONTENTS
LIST OF ABBREVIATIONS iv
LIST OF TABLES v
LIST OF FIGURES vi
TABLE OF CONTENTS vii
CHAPTER 1: INTRODUCTION AND OBJECTIVES
1.0. Introduction 2
1.1. Background 3
1.2. Problem statement 4
1.3. Objectives of the study 5
1.4. Research questions 5
1.5. Hypothesis 5
1.6. Purpose of study 5
1.7. Justification 6
1.8. Limitations of the study 6
1.9. Operational definition of terms 7
CHAPTER 2: LITERATURE REVIEW
2.0. AN OVERVIEW OF LABOUR, DELIVERY AND POSTPARTUM 9
2.1. NURSING CARE AND RESPONSIBILITIES 19
2.2. PATIENTS' PERCEPTION ON NURSING CARE 29
Patient Satisfaction with Intrapartum and Postpartum Nursing Care: Buea Regional Hospital Annex.
CHAPTER 3: METHODOLOGY
3.1. Study design 32
3.2. Study period: 32
3.3. Study site 32
3.4. Study population 34
3.5. Sampling method 34
3.6. Sample size 34
3.7. Data collection procedure 34
3.8. Ethical considerations 35
3.9. Budget 35
CHAPTER 4: PRESENTATION AND ANALYSIS OF RESULTS
4.1 Socio-Demographic Data 37
4.2. Intrapartum Nursing Care Assessment 42
4.3. Postpartum Nursing Care Assessment 44
4.4. Assessment of Patient Satisfaction 47
4.4.1. Rating during Intrapartum (using the Likert's Scale) 47
4.4.2. Rating during Postpartum(using the Likert's Scale) 47
4.5. Patients' Recommendation of the Maternity 49
4.6. Patients' Opinion on how satisfaction can be improved. 50
CHAPTER 5: DISCUSSION, CONCLUSION AND RECOMMENDATIONS
5.0. Introduction 52
5.1. Discussion of results 52
5.2. Conclusion 58
5.3. Recommendations 59
This research project «Patient Satisfaction with Intrapartum and Postpartum nursing care the case of Buea Regional Hospital Annex» was conceived due to the fact that nursing care is hardly evaluated and so rarely improved on. This research aims at evaluating nursing care by assessing patient satisfaction with nursing care offered.
It is a descriptive study targeting patients in the postpartum ward who either had a normal delivery or an emergency caesarian section in the BRHA maternity. Data was collected using a structured questionnaire which was self-administered to a convenient sample of 37 participants.
The study revealed that the nursing care offered during intrapartum was average but was poor during postpartum. Majority of the ratings for patients' satisfaction during intrapartum (42.3%) were good implying that the patients were fairly satisfied; while a majority of the ratings during postpartum (37.6%) were poor implying that they were unsatisfied with the care. A majority (52.8%) of the population somewhat agreed to recommend the maternity services based solely on the nursing care they received. This therefore means that the participants were fairly satisfied with the care offered in this maternity.
Nurses therefore must improve on the care offered during labour and delivery (intrapartum) and strive to provide adequate and standard care to the postpartum mothers.