Abstract

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 that is safe, positive, and satisfying to the mother.

This study seeks to determine the level of mothers’ satisfaction with intrapartum and postpartum nursing care rendered at the Buea Regional Hospital. It was a descriptive study targeting mothers receiving intrapartum and postpartum nursing care at the Buea Regional Hospital.

It included mothers who gave through vaginal delivery or cesarean section and had been in the ward for at least 48 hours and excluded mothers who started feeling too much labour pains at the time of data collection.

A convenience sampling technique was used for this study with a sample size of 123 participants including women of all age groups.  Data was collected using well-structured questionnaires which were self-administered.

The study revealed that the mothers were satisfied (71.8%) with the nursing care offered during the intrapartum period while during the postpartum period that is after delivery, (87.5%) were unsatisfied with the care they received at the Buea Regional Hospital and based on this, only (47.5%) of the respondents agreed to recommend the maternity services to their family members and friends.

This, therefore, shows some level of dissatisfaction. To conclude, nurses should improve on the care offered during labour and delivery (intrapartum) and strive to provide adequate and standard care to postpartum mothers. It is therefore recommended that the hospital should implement regular checks on nursing care given to patients so that the nurses will have a sense of duty consciousness.

CHAPTER ONE

INTRODUCTION

1.0 Background

The World Health Organization (W.H.O) defines Health as not the mere absence of a disease or infirmity but a state of complete physical, mental and social wellbeing of an individual and it should be a universal human right (W.H.O, 1996).

Better health care outcomes will therefore include social aspects of pregnancy and childbirth (Bitew, et al., 2015). For a good outcome, every woman should be satisfied with the care and support she received during pregnancy, delivery, and postpartum periods and also feel that she and her baby have been the center of care (Kavitha, et al., 2014).

For many women, labour and childbirth are a time of excitement and anticipation alongside uncertainty, anxiety, fear, and pain. Clearly, the support and care they receive during this period are critical (Lumadi, et al., 2011).

Nurses have an important role to help the woman during childbirth. The postpartum period is significant for two important things: It is a time for physiological adjustments for both the mother and her baby and a period for important social and psychological adjustments (W.H.O, 2015).

Nursing care here should be flexible and organized in collaboration with the woman to address her individual needs (Bazant, et al., 2009). Evaluation is one of the most critical phases of the nursing process because it supports the basis of the usefulness and effectiveness of nursing practice. Nursing practice is both patient-driven and patient-centered.

Accordingly, patient satisfaction has been strongly advocated for by nursing professionals worldwide to be an important indicator of quality nursing care during delivery (Kavitha, et al., 2014).

The purpose of measuring satisfaction with this aspect of care is to understand the mothers’ experience of labour and childbirth and assess postpartum care in order to obtain information about the quality of nursing care and identify problem areas (Ebu, et al., 2015).

In accordance with international professional standards and guidelines, contemporary maternity care providers strive to create a childbirth experience that is safe for both the mother and her baby which is positive and satisfying for the childbearing woman (Newhouse, et al., 2005).

A lot of research has been done on identifying the factors that promote a positive experience. Beneficial outcomes of a positive childbirth experience include self-esteem, efficient and enhanced maternal attachment, and compliance (Janet, 1999).

Research has demonstrated that a positive childbirth experience helps a woman develop a positive attitude towards motherhood, which helps facilitate transition into the maternal role (Bryatin, 2006).

This positive experience can also establish rich and successful family relations, encourage self-esteem, improve self-confidence and ensure the positive development of the woman (Peterson, et al., 2007).

We need to accept that labour is a time for unique sensitivity to environmental factors. Events and the interactions occurring during labour have powerful psychological effects therefore, for the benefit of both the parturient woman and her child, a positive childbirth experience is desirable (Janet, 1999).

Studies also confirmed that the intraparietal nurse would be the deciding factor on whether the woman has a positive or negative experience during childbirth (Guzzetta, 1998). Postpartum women experience physical discomfort and psychological changes following delivery of their infants (Demas, et al., 2017).

Several scientific studies have been carried out on postpartum care and it was found that parents valued the postpartum information they were taught (Delvaux, et al., 2007). Also, mothers’ satisfaction with postpartum care is dependent on their perceptions of the nurse’s ability to place them at ease (Peterson, et al., 2007).

Information sharing, calmness, demonstration of confidence and the anticipation of unstated needs are Nursing care qualities that contributed to the satisfactory experience (Sayed, et al., 2018 and demas, et al., 2017).

These findings illustrated qualitative inquiry for understanding patient satisfaction with care. The 2009 birth rate estimate in Cameroon, stood out at 31.4/1000 persons. The latest survey indicated that 62% of such childbirths were assisted by a skilled birth attendant (W.H.O, 2004).

This indicates that health practitioners are receiving more than half of the total births and hence a need for improved quality of nursing care. It is known that nursing and midwifery services are the backbone of the healthcare system in almost all countries in the world (Melese, 2014).

They represent between 60-70% of the health personnel (W.H.O, 2007). It is therefore important that we assess the quality of nursing care offered in order to improve on it. Patient satisfaction is an important indicator.

For many years, nurses have dictated what is «good» for their patients and how much of it is «good» because the patient is usually entitled to receiving care. To evaluate and improve the quality of care provided, it is of vital importance to investigate the quality of care in the context of healthcare.

Patient satisfaction is a significant indicator of the quality of care. It is against this background that this study sought to assess patients’ satisfaction with intrapartum and postpartum nursing care at the Buea Regional Hospital.

1.1 Problem Statement

During childbirth, a woman’s functional ability is limited and she is unable to control her body’s natural physiologic process (Kifle, et al., 2017). The intrapartum and postpartum mothers therefore rely on the clinical assistance of the nurses and the clinical staff. It is generally said that the primary reason why patients are admitted to health facilities is to receive care that cannot be obtained elsewhere.

The major role of the nurse is to care (Yohannes, et al., 2017 and Assefa, et al., 2011). But in our society and in most hospitals, nurses focus on other tasks leaving out the great aspect of care (Lumley, et al., 1993).

This is revealed in their attitude towards patients, co-workers, and even in the performance of their tasks. Although special care needs to be given to the woman during and after the delivery periods with the available resources, manpower, and time, nurses rather tend to give these mothers the care they deem worth giving and not necessarily what is required of them to meet their needs. Sub-standard care is bound to be offered (Gashaye, et al., 2019).

Usually, the patients’ needs are not fully met and this makes some of the patients perceive care as negative. We, therefore, want to assess the level of satisfaction of maternity patients to intrapartum and postpartum nursing care as very little research has been done on this in the Buea Regional Hospital.

1.2 Research Hypothesis

Patients receiving intrapartum and postpartum care in the Buea Regional Hospital are not satisfied with the quality of nursing care they receive.

1.3 Research Objectives

1.3.1 General Objective

To assess the quality of nursing care offered during intrapartum and postpartum periods using mothers’ satisfaction as an indicator.

1.3.2 Specific Objectives

1. To assess the quality of nursing care offered during intrapartum and postpartum periods in the Buea Regional Hospital.
2. To assess mothers’ level of satisfaction with the quality of care offered in the Buea Regional Hospital.
3. To identify ways of improving mothers’ satisfaction at the Buea Regional Hospital.