DISCUSSION, CONCLUSION AND
RECOMMENDATIONS
5.0. Introduction
From the preceding chapters, we have reviewed literature on
labour and delivery, postpartum, the nurses responsibilities during these
periods and measuring quality of care using patient satisfaction. From the data
collected and analysed, the results will be discussed in this chapter related
to the above sub topics. Discussion therefore is on demographic data, nursing
care offered during intrapartum and postpartum periods, and patients
satisfaction with the care given and ways in which patient satisfaction can be
improved.
5.1. Discussion of results
5.1.1. Choice of study area
Our study area was the Buea Regional hospital Annex, it was
chosen because it is acting as a teaching hospital and is expected that the
care given to the patients here should be standard. Also it acts as a referral
point for health centers patients coming from all over, it is relatively
cheaper thus receives more people than any other health service in the Buea
locality. Assessing patients' satisfaction will help to improve the nursing
care in this great unit of the hospital.
5.1.2. Socio-Demographic Findings
The mean age was 26 with the most represented age group being
20-25. This could possibly be justified by the fact that the most fertile
period in a woman's life is when she is between 22-30 years old. The mean age
for the study population falls between this age group.
Majority of the population (47.1%) had FSLC as their highest
level of education with most of them being low income earners. 34.3% of them
(housewives and applicants) had nothing doing. The study population was made up
of people with low level of education and low social class because the more
educated and better placed people prefer to go to other healthcare providers in
or out of town. Many participants (17.1%) were students.
A greater proportion of the study population constituted
married women while (32.4%) were single. The high rate of sexual activity
during the late teenage and early adolescent ages as well as increased sexual
promiscuity nowadays could possibly account for the high proportion of single
mothers in this study.
54.1% were multipars while 45.9% were primipars. Though most
of them 64.9% had their babies per vagina, a high percentage (35.1%) had their
babies through emergency caesarian section. The fact that the hospital is a
central referral unit could probably account for this.
Most of the patients (54.1%) had spent more than three days in
the hospital. This could be explained by the fact many patients so desired to
voluntarily prolong their stay.
5.1.3. Nursing Care Findings
A) During Intrapartum.
According to the data collected, it could be seen that most of
the women, 83.8% were welcomed in a friendly manner. This implies that the
nurses in this unit generally are soft and have a warm attitude towards their
clients. This addresses the psychological aspect of care since knowledge and
technical ability only are insufficient [33].
Concerning provision of comfort, a majority 63.9% said the
nurse provided them with comfort measures this shows that the nurses here have
some concern and empathy for their patients. With most of them giving words of
comfort, 8.3% were given analgesics and another 8.3% said they had anal touch
which made them feel more comfortable.
Most of the patients received teachings on how to breathe in
and push. Though this is mostly done in the antenatal clinics it is important
to do it in the labour ward as this is an important aspect in the management of
labour [31].
94.4% said the maternity was clean and once again highlights
the importance of environmental hygiene in nursing care.
As for the time spent with patients, 46.4% said nurses spent
time with them during emergencies or when called, 39.3% said nurses spent time
with them during drug administration while only 14.3% said nurses spent time
with them at regular intervals. This demonstrates that the nurses are hardly
always by their patients and so only see them when they have a procedure to
carry out. This is not a positive nursing attitude since constant presence is
very vital [35].
In this study, 59.4% of the respondents said the nurses did
not interpret the meaning of their feelings to them and this could possibly
explain the high levels of patient dissatisfaction. Conlusively, the nursing
care offered during intrapartum is average.
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