B.) During Postpartum.
The indicators used were information given to the patients,
nurses' attention towards patients, nurses' responsiveness to calls, nurses'
reliability to perform services and recognition of the patients' opinion.
As concerns the information given to them, 70% of the
population rated it poor. This implies that they were unsatisfied with the
information which was given to them. 20% rated it good, 10% fair and no body
rated it very good. Their dissatisfaction was due to the fact that little or no
information was given to them at postpartum. From Table 16, 29.7% of
the population had a teaching on at least one subject among whom only 24.3%
were taught on genital care and only 16.2% on breastfeeding despite the fact
that 45.9% of the population were primipara with little or no experience on
this. A few were taught on how to care for the baby's umbilical cord. 13.5%
were taught on baby's care, 29.7% of them were taught on good feeding habits. A
majority of them were those who underwent caesarian sections and were
restricted from solid meals. This is in line with studies which prove that
patients value value postpartum information [7].
From the data collected, 46.7% of the respondents rated the
nurses' ability to respond to calls as good. This implies that a good number of
the nurses attended promptly to the calls of their patients. Though a good
proportion 26.5% said they were unsatisfied with the way the nurses responded
to their calls. This implies that most of the patients were fairly satisfied
with the nurses ability to respond to calls.
Majority of the patients were fairly satisfied with the nurses
reliability to perform services but a large proportion (34.5%) were
dissatisfied with the nurses' reliability. 17.2% were fairly unsatisfied with
the nurses reliability. A minority (9.9%) were satisfied with the reliability
(see Table 20). From this, we could conclude that the respondents were
fairly satisfied with the nurses' reliability.
For nurses involvement of the patients to the care, it was
generally unsatisfactory as 34.6% graded their involvement as poor and 34.6%
graded it as fair . Very few of the patients (26.9%) rated their involvement as
good and a small proportion (3.9%) were satisfied with their involvement. From
a recent undefended thesis , more patients want to participate though the
nurses do not encourage them [38]. This is could certainly account for their
unsatisfaction.
Patient Satisfaction with Intrapartum and Postpartum Nursing
Care: Buea Regional Hospital Annex.
From the data collected and analyzed , a Likert's scale was
developed and the mean value gotten which was approximately 3 and was
considered fair. This implies that most of the respondents were fairly
unsatisfied with the care offered at postpartum.
5.1.5. Patients' Recommendation of the Maternity
service
The patients were asked if they will recommend the maternity
based solely on the nursing care which they had received. The mean value gotten
corresponded to a majority who somewhat agree to recommend the maternity to
their family members and friends. This anchors the fact that the respondents
were generally fairly satisfied with the nursing care provided.
5.1.6. Ways to Improve Patient Satisfaction
In the opinion of the respondents, in order to increase
patient satisfaction with nursing care, nurses should improve on patient
education, mother and child care policy, comfort, care and understanding
measures. This is similar to a research done by Lomoro and collaborators in
2002 on improvement of quality of care where emphasis were laid on health
education on childcare.
5.1.7. Testing of Hypothesis
Testing of hypothesis depends on the data that was collected.
The hypothesis reads «Patients receiving intrapartum and postpartum care
in BRHA are not satisfied with the nursing care they receive.»
From the data collected, it is evident that the participants
were fairly satisfied with the intrapartum nursing care and unsatisfied with
postpartum nursing care. Overall, they were fairly satisfied with nursing care
and thus, the hypothesis is valid.
Patients will be more satisfied if nurses can employ measures to
reinforce postpartum care.
5.2. Conclusion
For most women, intrapartum is usually a time of excitement,
anticipation, anxiety fear and pain while postpartum is a time for
physiological and psychological adjustment for both the mother and her baby.
The nursing care offered to them should be one which is safe, positive and
satisfying to the mother.
From the research, participants were fairly satisfied with the
care offered to them during intrapartum. This is because the nurses were
generally friendly and welcoming, patients were taught breathing exercises,
were supported and provided with a clean environment. Contrarily, participants
received minimal care offered during postpartum and were therefore
dissatisfied. The overall patient perception with the nursing care offered by
this maternity service was fairly satisfactory.
The participants further suggested that in order for their
care to be more satisfactory, nurses should improve on the information they
give their patients, their attitude towards patients and the zeal for their
work.
Nursing care should thus be improved on in order to improve
patients satisfaction.
5.3. Recommendations
v' Nurses in this unit should have refresher courses for the
care of their intrapartum and postpartum patients so that they will be able to
increase their knowledge on proper care of these patients.
v' The hospital should implement regular checks on the nursing
care given to patients that the nurses will have a sense of duty
consciousness.
v' Studies on patient satisfaction should be done in the other
units of the hospital so that a global change is done to improve care in this
hospital.
v' Government should recruit qualified staff to ensure quality
care is given to patients.
For further research
1. Factors responsible for the low quality of nursing care
offered during postpartum.
1. W.H.O. Basic Document. 1992. 39th edition.
2. Mollas Donaldson. Measuring the Quality of
Healthcare. 1999. National Academy Press Washington D.C.
3. Page L.A. The new midwifery science and
sensitivity practice. 2000. Churchill Livingston Imprint of Elvier Ltd.
4. Shields Donna. Nursing Care in Labor and
Patient Satisfaction, a descriptive study. Journal of Advanced
Nursing, 1999. 3(6) 535-50.
5. Guzzetta Cathie E. Essential Readings in
Holistic Nursing. 1998. Aspen publishers.
6. Lisa P. Patient compliance and satisfaction
with nursing care during delivery and recovery. Journal of Advanced
Nursing, 2002. 16(2) 60-66.
7. Lin C. Patient satisfaction with nursing
care as an outcome variable dilemma for Nursing evaluation researchers.
Journal of Professional Nursing, 1996. 12(4) 207-216.
8. Newhouse R., Poe S. Measuring Patient
Safety. 2005. Jones & Barlette Publishers, London.
9. Janet C. Perception of childbirth experience
and its relationship to early postpartum parenting. Journal of Advanced
Nursing, 1999. 8 (10) 1257-1264.
10. Bryatin J. Women's perception of Nursing
support during labor. Journal of Obstetrics & Gynaecology and Neonatal
Nursing, 2006. 23(8) 638-44.
11. Peterson W.E., Sward W., Charles C.
Adolescents' perception of inpatient postpartum Nursing Care, a
qualitative health research. 2007.
12.
www.indexmude.com
13. W.H.O. Department of making pregnancy safe. 2004.
39th edition.
14. Woodward C.A. Strategies for Assisting
Health workers to modify and improve skills. 2000. Oxford university press, New
York USA.
15. W.H.O. Developing World has acute shortage of health
workers. 2007.
16. Perla T. Patient compliance and
satisfaction with care during delivery and recovery. Journal of Nursing
Care Quality, 2003. 10(8) 56-60.
17. Philips Celeste. Family centered Maternity
care. 2003. Jones & Barlette Publishers, London.
18. American Academy of Pediatrics and the American
College of Obstetricians and Gynecologists: Guidelines for Perinatal
Care, 5th ed. 2002. Washington, DC, AAP and ACOG.
19. American College of Obstetricians and Gynecologists
Committee Opinion No. 267: Exercise during pregnancy and the
postpartum period. 2002. 99:171. ACOG.
20. Bernal AL: Overview of current research in
parturition. 2000. 86:213.
21. Kilpatrick SJ, Laros RK. Characteristics of
normal labor. 1989. 74:85, [PMID: 2733947]
22. Cohen W, Friedman EA (eds). Management of
Labor. 1983. Baltimore, University Park Press.
23. Mayerhofer K, Bodner-Adler B, Bodner K, et al.
Traditional care of the perineum during birth: A prospective,
randomized, multicenter study of 1,076 women. Journal of Reproductive
Medicine, 2002. 47:477, [PMID: 12092017].
24. Berman Mimi Cohen C. Obstetrics and
Gynaecology, 2nd ed. 1997. Lippincot Williams & Wilkins Company
Ltd. publishers U.S.A.
25. Simpson K.R., Creehan P.A. Perinatal
Nursing, 3rd ed. 2008. Lippincot Williams & Wilkins Company Ltd.
publishers U.S.A.
26. Delaune, Suc C., Lander P.K. Fundamentals
of Nursing Standards and Practice. 1998. Delmar publishers, U.S.A.
27. Hobfol S. E. Stress, Social support and
Woman. 1986. Hemisphere publishing corporation.
28. UNICEF/OMS/FNUAP. Guidelines for Monitoring
the Availability and Use of Obstetric Services. 1997. UNICEF: New York.
29. FNUAP et AMDD. Reducing Maternal Deaths:
Selecting Priorities, Tracking Progress, Distance Learning Courses on
Population Issues. 2002. Turin: UN System Staff College.
30. W.H.O. Standard classification of hypertensive disorders in
Pregnancy. 2003.
31. Littleson V. Lynna, Engebretson Joan C.
Maternity Nursing Care. 2009. Plengane Learning Publishing
Corporation, Canada.
32. Rosdah C. B. , Kowalsi M. Textbook of basic
Nursing, 9th ed. 2008. Lippincot Williams & Wilkins Company Ltd.
publishers U.S.A.
33. Dujardin B, De Schampheleire I, Sene H, et al:
Value of the alert and action lines on the partogram. 1992. Lancet
339:1336, [PMID: 1350000]
34. Williams A.M. Quality measurement.
Journal of Advanced Nursing, 1998. 27(4) 808-816.
35. Corbett C.A., Callister. Nursing support
during labor. Clinical Nursing research. 2000. 9(1) 70-83.
36. Bryatin J. Womens' perception of Nursing
support during labor. Journal of Obstetrics & Gynaecology and Neonatal
Nursing, 2006. 23(8) 638-44.
37. Merlyn D. Harris. Handbook of Home Health
care administration. 2005. 4th ed. Jones & Barlette Publishers
International Barbhouse, London.
I am Chwinui Mbeinkong, a final year nursing student of
the department of nursing in the University of Buea. I am carrying out a
research on patient satisfaction with nursing care offered during and after
labour and delivery. The information required from you is strictly for academic
purposes. I will be very grateful if you make an effort to answer each question
honestly. All information will be treated with confidentiality. Thanks for your
cooperation
Please put a tick ( ? ) where necessary or fill the
blanks where appropriate.
Section A. Socio-demographic Data
1) Age:
2) Educational level: FSLC O/L A/L Degree
others
3) Marital status:
4) Profession:
6) How many days have you been in the hospital? 1 2
3 or more
8) How many times have you been pregnant?
....................................
9) Mode of delivery: Normal vaginal Caesarean
section
Section B. Nursing care
? During Labour and Delivery
1) How did the nurse treat you on admission?
A) Friendly and welcoming B)not very welcoming C)
unwelcoming
2) Nurse provides comfort and support during pain and
discomfort? YES NO
If yes what did she do?
4) Were you taught how to breathe and how to push? YES
NO
6) Were you provided a clean environment? Yes NO
8) Did the nurse spend time with you in the labour
ward? YES NO
If yes, how often?
At regular intervals On emergency During examination
10) Did the nurse help you to interpret the meaning of your
feeling and showed concern?
YES NO
Dear Respondent,
7) Were your vital signs checked immediately after
delivery? YES NO
If yes, how often?
Regularly, every 5mins. Every 30mins. Once daily twice
daily.
? After Labour and Delivery
APPENDIX 1: DATA ENTRY FORM
1) Information: how clear and complete
were the nurse's information about what you were going through?
2) Concern and caring by the nurses:
Courtesy and respect, friendliness and kindness?
3) Skills and competence of the nurse: How
well were things were done?
4) Restful atmosphere provided by the nurses:
Amount of peace and quietness?
5) Coordination of care: team work between
the nurses and other staff?
II. After Delivery
6) Information given: Concerning breast
care, perineal care, breast feeding?
7) Attention of nurses to your condition:
how often did the nurses checked on you?
8) Nurse's responsiveness to calls: How
quick were they to respond to your calls?
9) Reliability to perform promised services
10) Recognition of your opinion: how much
you were involved (participated) in decision making?
Section C. Patient Satisfaction
Please rate some things about the nursing care offered
during your hospital stay in terms of whether they were very good ,good, fair
or poor.
I. During labour and delivery Very
Good Good Fair Poor
8) Which of the following topics did the nurse teach you
on?
Genital care
How to breast feed
How to care for baby's cord How to bathe/care for baby
Feeding Hygiene Others
10) Did the nurse come around to examine (physical assess)
the baby? YES NO
If yes, how often?
At least once every shift once a day more than twice a day
12) Which of the following checks did the nurse do?
Amount of bleeding Breast examination Genitals
Conjunctiva
Height of uterus Others
Based on the nursing care I Strongly Some what Some what
Strongly
Will recommend this maternity agree agree disagree
disagree
To my family and friends
Section D. Possible ways of improving patient
satisfaction patients
In your opinion, perspective what should the nurses do in order
to improve the quality of care and make you more satisfied.
THANK YOU!!!
APPENDIX 2: CONSENT FORM
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