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FACTORS INFLUENCING UTILIZATION OF PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) SERVICES AMONG PREGNANT WOMEN ATTENDING ANTE-NATAL CLINIC

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FACTORS INFLUENCING UTILIZATION OF PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) SERVICES AMONG PREGNANT WOMEN ATTENDING ANTE-NATAL CLINIC

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ABSTRACT

This study sought to assess the factors influence the utilization of PMTCT services among pregnant women in antenatal clinic in University of Calabar Teaching Healthcare (UCTH), Calabar. The specific Objectives of the Study were: to assess the level of knowledge about PMTCT services, determine the socio-economic factors influencing utilization of PMTCT services and to identify the cultural/religion factors influencing utilization of PMTCT services among pregnant women in UCTH. Three research questions were raised and a hypothesis formulated to guide the study as follows: There is no significant relationship between level of knowledge and utilization of PMTCT services among women. The study was a descriptive research where 85 pregnant women who attended antenatal clinic in UCTH were selected through the purposive sampling technique. Data were collected by administering questionnaire. Data were analyzed using frequency tables and percentages, the findings of the study revealed that: Majority of the respondents have good knowledge about PMTCT services. The socio-economic factors influencing utilization of PMTCT services among pregnant women were: stigmatization and discrimination by healthcare personnel; dependence of women on their husbands to make healthcare decisions; distance to PMTCT facilities; unavailability of PMTCT services and attitude of health personnel (nurses) towards people living with HIV. Cultural/religious beliefs do not hinder utilization of PMTCT services. The hypothesis was tested for significance at 0.05 level and 1 degree of freedom, using the Chi-Square (X2) analysis. The result showed that the calculated value 55.45 is higher than the critical value (3.84). Thus, the null hypothesis was rejected, indicating that there is significant relationship between level of knowledge and utilization of PMTCT services among women. Based on the findings, conclusion was drawn. It was recommended amongst others that: there is need for involvement of the stakeholders in the healthcare system in bridging the gap between knowledge and utilization of PMTCT services among women.

Table of Contents

Title page    –        –        –        –        –        –        –        –        –        –        i

Certification-        –        –        –        –        –        –        –        –        –        ii

Dedication- –        –        –        –        –        –        –        –        –        –        iii

Acknowledgement-        –        –        –        –        –        –        –        –        iv

Abstract      –        –        –        –        –        –        –        –        –        –        v

Table of contents- –        –        –        –        –        –        –        –        –        vi

List of tables-       –        –        –        –        –        –        –        –        –        ix

CHAPTER ONE

INTRODUCTION

1.1            Background of the study-        –        –        –        –        –        –        –        -1

1.2     Statement of problems   –        –        –        –        –        –        –        -2

1.3     Purpose of the study-    –        –        –        –        –        –        –        -3

1.4     Objectives of the study- –        –        –        –        –        –        –        -3

1.5     Research questions-       –        –        –        –        –        –        –        -4

1.6     Hypothesis-          –        –        –        –        –        –        –        –        –        -4

1.7     Scope of the study –       –        –        –        –        –        –        –        -4

1.8       Significance of the study-      –        –        –        –        –        –        -4

1.9     Limitations-          –        –        –        –        –        –        –        –        –        -5

1.10   Operational definition of terms-        –        –        –        –        –        –        -5

CHAPTER TWO

LITERATURE REVIEW    

2.1Theoretically-       –        –        –        –        –        –        –        –        -6

2.1.2 Knowledge about prevention of mother to child transmission (PMTCT)   among pregnant women- –        –        –        –        –        –        –        -10

2.1.3  Factors influencing utilization of PMTCT-          –        –        –        –         12 2.2         Conceptual framework- –        –        –        –        –        –        –        -19

CHAPTER THREE

METHODOLOGY

3.1Research design-          –        –        –        –        –        –        –        –        -22

3.2      Research setting- –        –        –        –        –        –        –        –        -22

3.3     Research population-    –        –        –        –        –        –        –        -23

3.3.1  Target population-        –        –        –        –        –        –        –        –        -23

3.3.2   Accessible population- –        –        –        –        –        –        –        -23

3.4.1   Sample Size-       –        –        –        –        –        –        –        –        -23

3.4.2    Sampling technique-    –        –        –        –        –        –        –        -23

3.5     Instruments for data collection-        –        –        –        –        –        –        -24

3.6.1 Validity of the instrument-      –        –        –        –        –        –        -24

3.6.2  Reliability of the instrument-  –        –        –        –        –        –        -24

3.7   Method of Data Collection-     –        –        –        –        –        –        -25

3.8   Method of data analysis- –        –        –        –        –        –        –        -25

3.9   Ethical considerations-    –        –        –        –        –        –        –        -25

CHAPTER FOUR

DATA ANALYSIS AND RESULTS

4.1     Socio-Demographic Variables-         –        –        –        –        –        –        -26

4.2 Results for Research Questions- –        –        –        –        –        –        -28

4.3 Result of Research Hypothesis-  –        –        –        –        –        –        -34

CHAPTER FIVE

DISCUSSION OF FINDING

5.1     Discussion of Findings-          –        –        –        –        –        –        –        -36

5.1.1 The knowledge of pregnant women in UCTH about prevention and control of HIV/AIDS.-          –        –        –        –        –        –        –        –        –        -36

5.1.2  Socio-economic factors influencing utilization of PMTCT services among pregnant women.-      –        —       –        –        –        –        –        –        -37

5.1.3  Cultural/religion factors influencing utilization of PMTCT services among

pregnant women in UCTH.-    –        –        –        –        –        –        -38

5.1.4  Relationship between level of knowledge and utilization of PMTCT services among women-       –        –        –        –        –        –        –        -39

5.2                      Summary-   –        –        –        –        –        –        –        –        –        -39

5.3 Conclusion-    –        –        –        –        –        –        –        –        –        -41

5.4 Recommendations-  –        –        –        –        –        –        –        –        -41

REFERENCES

APPENDIX i (QUESTIONNAIRE)

APPENDIX ii (LETTER OF INTRODUCTION)

LIST OF TABLES

Table 1: Socio-Demographic Data

Table 2: Level of knowledge about PMTCT services among pregnant women in          UCTH

Table 3: Socio-economic factors influencing utilization of PMTCT service in     UCTH

Table 4: Cultural/ religious factors influencing utilization of PMTCT service in UCTH

Table 5: chi-square (X2 ) Analysis of the relationship between level of      knowledge and utilization of  PMTCT service

CHAPTER ONE

INTRODUCTION

1.2            Background of the study

The greatest challenge to human kind in the 21st century is the epidemic of Acquired immune Deficiency Syndrome (AIDS).Human Immune Deficiency Virus (HIV) is the causative organism of AIDS which was first discovered in the year 1981. Despite years of campaigns, advocacy, control programmes and awareness exercises taken to curb HIV/AIDS spread, there is still a worrisome rate of increase of the infection. According to UNAIDS (2006), about 33.3 million people are estimated to live with Human immune Deficiency virus globally; 22.5 million of this population are from the sub-Saharan Africa.

Over 55% of these people living with HIV are women of reproductive age who become pregnant. HIV infection in women of reproductive age increase the epidemic of peri-natal HIV (UNAIDS, 2006). About 2.5million children live with HIV globally and 1.8million are from sub-Saharan Africa. Worldwide, over 1700 children become infected with HIV daily (UNAIDS 2006).

In Nigeria, about 69,400 children became infected with HIV through mother-to-child transmission in 2011. This has led to a rise in the total number of children living with HIV in the country to an unprecedented 440,000 (UNAIDS, 2012).

Majumali, (2011), opined that, Virtually all HIV infection in children occurs following mother to child transmission during the antenatal period (pregnancy), intranatal period (labour/delivery) and the post-natal period. Mother-to-child transmission of HIV is about 5-10% during pregnancy, 10-20% during labour and 10-15% during breastfeeding.

There is an estimation of about 20-45% chances of a baby born to an HIV positive mother to become infected without effective interventions to prevention of mother-to-child transmission. With effective interventions, such as use of antiretroviral drugs both for mother formula feeding etc., the risk of mother to child transmission has been shown to reduce by 5%. Primary preventive measures (prevention of new infections in parents, avoiding new pregnancies in HIV infected women) and secondary preventive measures (preventing transmission of HIV from an infected mother to her infant) are the three approaches in reducing mother to child transmission (MTCT) promoted by the World Health  Organisation (WHO), (McIntyres $ Gray 2004).New approaches in preventing MTCT to <2% includes use of combined anti-retroviral prophylaxis, elective caesarean section and by avoiding prolonged breastfeeding or  mixed feeding.

In Nigeria, despite these preventives measures of mother to child transmission, research has shown poor utilization of these services. Thus, the need for this study.

1.2     Statement of problems

Mother to child transmission of HIV has a lot of impact on the health of the mother and infant including the economy of the country. MTCT increases the prevalence of HIV in infants thereby resulting in increased infant and maternal morbidity and mortality.

Despite the introduction of improved preventive services of MTCT of HIV over the years, HIV infections via MTCT (vertically/ perinatal transmission) is still on the increase in Nigeria. In 2011, about 440,000 infants were infected with HIV (UNAIDS, 2012).

During the researcher’s clinical experience in the antenatal clinic UCTH, it was observed that despite availability of this prevention of MTCT services, very few women utilized the services. For this reason, this pertinent question formed the birth rock of this study: What then are the factors that influence the utilization of prevention of mother to child transmission services?

1.3     Purpose of the study

The purpose of the study is to ascertain the factors influencing the utilization of PMTCT services among pregnant women in antenatal clinic in UCTH.

1.4     Objectives of the study

The specific objectives of the study are:

1.     To assess the level of knowledge about PMTCT services among pregnant women in UCTH.

2.     To determine the socio-economic factors influencing utilization of PMTCT services among pregnant women in UCTH.

3.     To ascertain the cultural/religion factors influencing utilization of PMTCT services among pregnant women in UCTH.

1.5     Research questions

1.     What is the level of knowledge about PMTCT services among pregnant women in UCTH?

2.     To what extent do socio-economic factors influencing utilization of PMTCT services among pregnant women in UCTH?

3.     What are the cultural/religion factors influencing utilization of PMTCT services among pregnant women in UCTH?

1.6     Hypothesis

There is no significant relationship between level of knowledge and utilization of PMTCT services among women.

1.7     Scope of the study

The study is delimited to pregnant women that attended antenatal clinic in University of Calabar Teaching Hospital.

1.8       Significance of the study

It is very important that factors influencing the utilization of PMTCT services in a resource poor setting should be studied. It is important in the context of cross river state where health resources are unevenly distributed between rural and urban areas including distribution of health care providers.

Practically: The findings of this study will be handy for cancelling purposes in ensuring increased utilization of PMTCT services.

Research: The result of this study will increase the existing knowledge on utilization of PMTCT services and will also serve as research as a resource material for further research work.

Nurse/midwife: The findings of this study will help to improve the attitude of Nurses in delivery of PMTCT services to ensure its utilization by pregnant women thereby decreasing the rate of MTCT.

Government: The findings of this study will help improve policies on findings and distribution of PMTCT services in both rural and urban areas to ensure its utilization.

1.9     Limitations

Major limitation was encountered during this study because the Teaching Hospital was on strike and many patients were not (accessed) reached. Also some respondents refused to divulge their information for confidential purposes.

1.10   Operational definition of terms

Factors: are variables that influence utilization of PMTCT services

Utilization: refers to the process of using PMTCT services

PMTCT services: are  services that aims at offering preventive measures towards mother to child transmission.

Ante natal: refers a period from conception to the onset of labour

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Nursing Science Research Sample In Nigeria

ATTITUDE OF NURSES TOWARDS RELAPSE PREVENTION AMONG PSYCHIATRIC PATIENTS

ATTITUDE OF NURSES TOWARDS RELAPSE PREVENTION AMONG PSYCHIATRIC PATIENTS IN FEDERAL NEUROPSYCHIATRIC HOSPITAL BARNAWA, KADUNA  .

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ABSTRACT
The problem of every hospital when the targeted objective is not achieved is that there is something wring either with health care givers, the patients or the general public. In order to improve the standard of health of the patients and keep them progressively fit. The reason why such lapse are present here to be sought and the remedy met in order to achieve the set objective of the hospital.
This study is based on the Attitude of nurses towards Relapse prevention among psychiatric patients in Federal neuropsychiatric hospital Barnawa Kaduna. The aim and objective of this study are all directed towards bringing out lasting solutions to curtail this menace. It also intends to actively involve the management of the hospital especially on employing new and scientific approach to holistic patient care. The instruments used for data collection were from interview and Questionnaire which were represented in tabular form, bar chart, pie chart and percentages. Nurses were used for the study .the data collected were analyzed. The result showed that many factor contribute to the effect of relapse.
All these can be prevented through adequate Education, Family oriented therapies, good social support, compliance and keep the follow-up appointment.
CHAPTER ONE
1.1 Background of Study
Psychiatric illness has fascinated and confounded healers, scientist and philosopher for centuries, it symptoms have been attributed to possession by demons considered to be punishment by the gods for the evil done or accepted as evidence of the inhumanity of its sufferers victims. Thus explanation resulted in enduring stigma for those whose were diagnosed with such disorders. Even today, much of the sigma persist although it has less to do with demonic possession than with society’s unwillingness to shoulder the tremendous cost associated with mental illness.
Relapse is one of the most severe problem of mental health care givers. It is common in about 1.3% of the already treated cases of mental illness or more than two million people (U.S. Department of Health and Human Services [USDHHS] 1999). Its economic cost is envious. Direct cost of relapse treatment expenses of most psychiatric illness were estimated 2.5% of the total treatment of first hand mental illness care budget in 1998 (American Psychiatric Association [APA] 2000).
The last year for which these data were available (USDHHS, 1999). In 1997, this accountant for $23.6 billion of mental health care dollar spent. The indirect cost such as lost of wages, premature death and incarceration were estimated to be $46 billion in the first half of 1998 (APA, 2000).
Further unemployment among permanent disability is 10% (APA 1998). The cost relapse in terms of individuals and family suffering are probably inestimable.
Despite the current trend in modern treatment, there is still an alarming rate of relapse and the reoccurrence of psychiatric illness globally. Individual who ought to be productive and responsible in life are wasting away on daily basis.
Today patients are required to stay for a short period of time in the hospital admission and discharge to home environment to help reduce dependency on the hospital care and reducing relapse. Also this helps to reduce stigmatization and prevent complications (Feyinsayo, A. 2009). This study will attempt an overview of Nurse and also to show how proper utilization of psychiatric Nursing service will go a long way in reducing and eradicating the ever growing cases of relapse among psychiatric patients in Federal Neuropsychiatric Hospital Barnawa, Kaduna.

Nursing Science Research Sample In Nigeria

KNOWLEDGE AND PRACTICE OF CONTRACEPTIVES AMONG FEMALE STUDENTS IN DELTA STATE UNIVERSITY, ABRAKA

KNOWLEDGE AND PRACTICE OF CONTRACEPTIVES AMONG FEMALE STUDENTS IN DELTA STATE UNIVERSITY, ABRAKA

 

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CHAPTER ONE

1.1 Background of study ………………………………………….………….…         1

1.2 Purpose/Aim of the study…………………………………………………….         3

1.3 Statement of research problem ………………………………………….….            3

1.4 Significance of the study ………………………………………..…………..           4

1.5 Objective of the study ………………………………………………….…….           4

1.6 Specific objective……………………………………………………..……..           4

1.7 Research question……………………………………………………………            4

1.8 Hypothesis…………………………………………………………………..             5

1.9 Limitation of the study………………………………………………………             5

1.10 Delimitation/Scope of study …………………………………….………….            6

1.11 Definition of terms ……………………………………………………….…             6

 

CHAPTER TWO

2.0       Review of literature   .           .           .           .           .           .           .           10

2.1       Introduction    .           .           .           .           .           .           .           .           10

2.3       Contraception uses     .           .           .           .           .           .           .           14

2.4       Contraceptive pills: Important for youth       .           .           .           .           19

2.5       Common barriers and concerns         .           .           .           .           .           24

2.8       Theoretical framework           .           .           .           .           .           .

2.2.1 Contraceptive and prevention of Unwanted pregnancy…………………………………10

2.2.2   Adolescent’s limited awareness and knowledge…………………………………17

2.3   Conceptual Framework ………………………………………………                30

2.4    Summary of literature review…………………………………………………………..30

2.5      Theoretical Framework …………………………………………………………………………..30

2.7       Applicability of the Theoretical Framework to the Study.

CHAPTER THREE

Methodology ………………………………………………………………..                 35

Research design …………………………………………………………….                35

Setting of the study …………………………………………………………                35

Sample  population/sample size ……………………….……………………                  35

Validity/ Reliability ………………………………..…………………….…                  36

Method of data collection ……………………………..…………………….                   36

Method of data analysis …………………………………………………….

Ethical consideration …………………………………………………………………….. 37

CHAPTER FOUR:  ANALYSIS DATA   

4.1   Results analysis          –           –           –           –           –           –           –                            38

4.2    Testing of Hypothesis      –       –    –      –        –         –         –           –         –            –   –    45

CHAPTER FIVE: DISCUSSION AND CONCLUSION

5.1    Introduction    –           –           –           –           –           –           –           –           –           –     49

5.2    Discussions of findings          –           –           –           –          –           –           –           –     49

5.3   Summary and Conclusion            –     –           –           –           –           –            –        –      49

5.4    Recommendations-    –                       –           –          –           –           –           –         –     50

5.5    Implication to Nursing           –           –           –           –           –           –           –           –     52

5.6    Suggestion for further study –            –           –           –           –           –             –         –          –     53

References  –           –           –           –           –           –           –           –           –               –     –     55

 

 

 

 

 

ABSTRACT

 

Access to contraceptive has become increasingly crucial for adolescents because many are sexually active at earlier ages than in the past. This will further compound overall levels of maternal mortality in Nigeria tertiary institutions.This research was specifically designed to determine the knowledge and utilization of  contraceptives among female students in Delta State University, Abraka. A total of 107 questionnaires were distributed and 97 were retrieved. majority of respondents were within the age bracket of 20-24 years of 35.1%. 79.4 % of the respondents were single. More than half (95%) of the respondents knew about  contraceptives.reason for the lack of detailed knowledge on this subject may be linked to the sources of information; majority of the students got to know about contraception from their friends/peers (39.2%). The study disclosed that there is a high number of females students who practiced sexual intercourse which may result into unintended pregnancy. Also revealed that there is a low trend of use of modern contraceptives for inadequate knowledge. It is therefore recommended that the use of contraceptives amongst undergraduate female students that are attributed to esteem and habit of students should be reviewed for preferred methods and legally backed practice and use of contraceptives by undergraduates.

 

 

Key words;   Knowledge, contraceptives, Attitudes and female.

Word count:204

 

 

 

 

 

 

 

 

 

 

CHAPTER ONE

INTRODUCTION

UNAIDS (2007) estimated that 33.2 million women had HIV infection worldwide. In many regions of the world more women than men are at risk of HIV infection with not less 50% of all new daily infections in sub-Saharan Africa being in women. Children account for 12% of all new infections and globally 2.5 million children less than 15years of age were living with HIV in 2007, about 1,200 children under the age of 15years became infected with HIV daily (UNAID/WHO, 2007), without appropriate care and treatment, more than 50% of newly infected children will die before the second birthday.

 

In 2008, around 430,000 children under 15years become infected with HIV, mainly through mothers –to child transmission (MTCT), infection occurred in Africa where AIDS is beginning to reverse decades of steady progress in child survival. In high income countries MTCT has been virtually eliminated thanks to effective HIV counseling and testing, access to antiretroviral therapy ART, Safe delivery practices, and the widespread availability and safe use of breast-milk substitutes.  If these interventions were used worldwide, they could save the lives of thousands of children each year.

 

Owing to the transmissibility of HIV from mother to child, the feeding of HIV-exposed infants remains a significant challenge in controlling the spread of HIV/AIDS. The dilemma concerning feeding infants of HIV-positive mothers is how to balance the risk of HIV transmission through breastfeeding with the risk of death from causes other than HIV such as pneumonia, diarrhoeal diseases and malnutrition among formula-fed infants (WHO, 2010). Exclusive breastfeeding (EBF) plays a critical role in the overall health of infants. It is estimated that 3% of all under-5 mortalities in low-income countries could be prevented through optimal breastfeeding during the crucial first year of life (WHO, 2013). Optimal breastfeeding is considered to be EBF for the first 6 months of life, followed by continued breastfeeding combined with safe and nutritionally adequate complementary feeding up to 24 months of age (WHO, 2009).EBF is regarded as a global health goal given its strong association with reduced morbidity and mortality, particularly in low-income countries where safe water and sanitation are often lacking.

The HIV/AIDS epidemic is one of the major factors challenging women’s health with 20 million women living with the virus and more than 2 million pregnancies occurring in HIV sero-positive women annually. Thus, HIV infection has become a major problem complicating the management of pregnancy. In Africa, HIV prevalence varies considerably, with most countries in Southern Africa having more than one in five pregnant women infected, and in a few sub-Saharan countries, median HIV prevalence in antenatal clinics in 2003 exceeded 10% (McIntyre,2005). As at 2005 the prevalence in Nigeria was 4. 4%, and by the end of 2006, it was estimated that there are 2. 99 million Nigerians living with HIV, with 305, 080 adult new infections and 74, 520 in children, largely (up to 90%) acquired through mother-to-child transmission (MTCT). Between 25 and 44% of mother-to-child transmission (MTCT) of HIV occurs through breastfeeding (FMOH, 2007)

The promotion of breastfeeding is a key component of infant health polices globally because of its obvious health benefits. It is widely practiced not only in Nigeria, but most of Africa, as it is socially and culturally acceptable and natural. However, in the present context of HIV epidemic, this has become a public health dilemma as the overwhelming source of HIV infection in young children is through MTCT (FMOH, 2007). There is also the dilemma of infant feeding decisions by HIV sero-positive mothers, because most breast milk transmission of HIV- 1 occurs in the first four months of life, a time when replacement feeding carries the greatest risk of increasing infectious disease morbidity and the benefits of the breastfeeding are highest. In developing countries, decisions regarding the best mode of infant feeding can be difficult due to social, economic and practical constraints. The relative risks of morbidity and mortality associated with replacement feeding vary according to many factors: the environment, individual circumstances of the mother and her family including her education and economic status (WHO, 2004). The WHO/UNAIDS strategic response to prevention of HIV infection in infants centered on four ‘pillars’: primary prevention of infection generally in women, prevention of transmission from HIV infected women to their infants and provision of treatment, care and support to HIV infected women and their families (WHO, 2004) . Thus, the option most likely to be chosen by HIV infected women who do not wish to risk breastfeeding their infants is replacement feeding with formula or other foods. However, WHO recommended that HIV infected women avoid breastfeeding when replacement feeding is acceptable, feasible, affordable, sustainable and safe (AFASS) (Throne C., Semenenko I., Pilipenko T., Malyuta, 2009). Most women in sub-Saharan Africa have their human immunodeficiency virus (HIV) status diagnosed during pregnancy because of testing available through programmes for the prevention of mother-to-child transmission (PMTCT) of HIV. The programme commenced in Nigeria in 2001, and has since undergone several scale-up of both in scope and coverage mainly in secondary and tertiary health facilities. Despite all these, participation/enrollment has been very low. It is in the light of this, that an assessment of feeding practices and determinants of feeding practices among HIV sero-positive mothers was carried out in one each of secondary and tertiary health facilities in Abuja, the capital of Nigeria, with a view of identifying relevant and appropriate interventions for resolving some of the problems faced by these mothers

PURPOSE /AIM OF STUDY

The study is carried out to explore the knowledge and practice of safe infant feeding amongst mothers living with HIV attending postnatal clinic of Central Hospital Sapele, Delta State.

 STATEMENT OF PROBLEM

The 2010 HIV Sero-prevalence sentinel survey conducted among women attending antenatal clinics in Nigeria. Shows that HIV/AIDS is still on the increase among pregnant women, HIV/AIDS still remain one of the leading causes of morbidity and mortality in Sub-Saharan Africa.

According to the study reports by the former Minister of Health Nigeria Professor Onyebuchi Chukwu, the epidemic has affected all parts of the

Nursing Science Research Sample In Nigeria

PERCEPTION OF POST-NATAL MOTHER ABOUT MIDWIVES ATTITUDE DURING LABOUR AT CENTRAL HOSPITAL SAPELE, DELTA STATE

PERCEPTION OF POST-NATAL MOTHER ABOUT MIDWIVES ATTITUDE DURING LABOUR AT CENTRAL HOSPITAL SAPELE, DELTA STATE

 

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CHAPTER ONE

Introduction…………………………………………………………………………..1

Purpose/Aim of the study…………………………………………………………………………………3

Statement of Problem………………………………………………………………….3

Research questions…………………………………………………………..…………3

Broad objectives of the Study……………………………………………..………….3

Scope of the study ………………………………………………………………………………………….4

Significance of the Study…………………………………..………………………….4

Operational definition of Terms…………………………..……………………………………5

CHAPTER TWO

Literature Review…………………………………………………………………….7

CHAPTER THREE

Methodology………………………………………………………………….……..32

Research design……………………………………………………………………..32

Research setting……………………………………………………………………..32

Research population…………………………………..………………………………32

Sampling techniques …………………………………..……………………………..33

Instrument of data collection…………………………..……………………………..33

Validity of the instrument……………………………………………………………………………….33

Method of data collection…………………………………..………………………..33

Method of Data analysis……………………………………..………………………34

Ethical consideration………………………………………….……………………..34

Limitation of study……………………………………………………………………………………….34

CHAPTER FOUR

Data Analysis…………………………………………………………………………36

CHAPTER FIVE

Discussion of findings……………………………………………….………………55

Implication of study to nursing…………………………………….…………………60

Summary…………………………………………………………………………….60

Conclusion…………………………………………………………………………..61

Recommendation…………………………………………………………………….61

Suggestion for further studies……………………………….………….………..….62

References…………………………………………………………………………   63

LIST OF TABLES

Table 1: Demographic data

Table 2:      Percentage distribution showing the Relationship

between the Midwives and Respondents            –           –                       36

Table 3:      Percentage distribution showing how women were receiveduring Labour         –                   –                            –           –           –           —–                                          39

Table 4:      Percentage distribution according to the response on whether the midwives were with them throughout labour                                                                     40

Table 5:      Percentage distribution according to those that were given any information during labour to re-enforce what    they already knew about labour       –         41

Table 6: Percentage distribution showing how the midwives attended to the Respondents needs in labour –                                                                                        42

Table 7: Percentage distribution showing the respondents Respowhat the midwives did when they needed their husband                                                  43

Table 8: Percentage distribution showing the attitude of midwives to
them when they were in pains – – – – –                          44
Table 9: Percentage distribution showing respondents view
if midwives were friendly and empathetic
while discharging their duties – – – – –                         45
Table 9: Percentage distribution showing how the friendly
attitude of midwives helped women to cope with labour.46-
Table 10: Percentage distribution according to whether
midwives answered them when they called for help – –     47
Table 11: Percentage distribution showing the respondents
impression of midwives attitude during labour – – –         48
Table 12: Percentage distribution showing the respondents description
of midwives attitude towards them – – – –                        49
Table 13: Percentage distribution showing how best the respondents
think midwives can improve their services – –                 50

ABSTRACT

The main purpose of this research work is to ascertain perception of postnatal mothers about midwives attitude during labour at Central Hospital Sapele, Delta State. This study is of great importance because the attitude of midwives to women during labour will affect them either positively or negatively invariably affecting the outcome of labour and also influence their decision to patronize the health facility or not during their subsequent pregnancies. The objectives of this study include the following; to find out the level of relationship that exists between the client and midwife during labour, to find out if midwives are kind and empathetic while discharging their duties and to know how mothers perceived the attitude of midwives during labour. The significance of this study is to provide information to improve the attitude of midwives towards women in labour. It will also make midwives to rise up to their responsibilities of caring for the woman in labour. The non-experimental survey research was used and a convenient method of non-probability sampling technique was used to select samples for study, questionnaire was used for data collection. (120) questionnaires were distributed, same retrieved. The data collected were analyzed using frequency table and all information obtained were recorded. The findings revealed that postnatal mothers have good perception about midwives attitude during labour. In conclusion, the researcher suggested that similar studies should be conducted in remote villages where there is high rate of maternal mortality so as to discover the reason why women do not patronize the hospital for delivery.

 CHAPTER ONE

INTRODUCTION

Background of the study

World Health Organization (2007) estimated that over half a million women in developing countries die each year from causes related to pregnancy and childbirth, leaving at least one million children motherless and so one feasible way of reducing this mortality rate is to improve the quality of maternal services.In Nigeria with a population of 140 million people with women of child bearing age constituting about 31 million, only about 40% of the deliveries are attended to by trained midwives (Midwives Serves Scheme, 2009).

Every pregnant woman looks forward to the day she will deliver. Women throughout the ages have depended upon a skilled person usually woman to be with them during labour.In the practice of safe delivery therefore, the midwife is expected to be courteous, patient and attend to client’s/patient’s need immediately when taking delivery. McCrea, Wright and Murphy-Black (2008) examined the influence of midwives’ approaches on the care given to women for pain relief during labour and their findings revealed that the midwives approach had a positive influence on the women’s experience of labour pain.

Myles (2009), defined labour as the expulsion of the foetus, placenta and membranes through the birth canal. Labour is a very stressful life experience of women and so the attitude of midwives during labour will either affect them positively or negatively. The emotions of the woman in labour greatly influence her reaction to discomfort and pains and are the contributing factor in determining the amount of physical and mental exhaustion she will experience, hence the whole process of childbearing should be handled with sensitivity and compassion. The midwife needs to appreciate what the woman is thinking and suffering from so as to give adequate care to her therefore communication between the client in labour and the midwife is of utmost importance because explanation of what is happening during labour will go a long way in relieving client’s stress during labour.

Statistics worldwide show that about 130 million women gives birth in the hospital attended to by trained midwives each year (Valarie, 2007), also (Lucia, 2010) states that midwives negative attitude to women in labour influence their decision about where to give birth. Women are most likely to labour best where they feel, safe and private, with midwives who they feel safe with and not a midwife whose attitude will affect them negatively.

A midwife according to (ICM) international definition is a person who having been admitted to a midwifery education programme duly recognized in the country where it is located and have successfully completed the prescribed course of study in midwifery and has acquired the requisite qualification to be registered and legally licensed to practice.Nigerian is spending the stipulated number of years in training recommended by the NMCN’. The midwife must be able to give the necessary supervision, care and advice to women during pregnancy, labour and the post-partum period, to competently conduct deliveries independently and to care for the newborn infant.

Purpose/aim of the study

The study was carried out to explore the perception of postnatal mothers about midwives attitude during labour at Central Hospital, Sapele Delta State.

Statement of the problem

Childbirth is said to be a universally celebrated event, an occasion for dancing, gifts, yet for many women in labour each day in Sub-Sahara Africa particularly in Nigeria, it is not so because of midwives attitude

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Nursing Science Research Sample In Nigeria

ATTITUDE OF NURSES TOWARDS RELAPSE PREVENTION AMONG PSYCHIATRIC PATIENTS

ATTITUDE OF NURSES TOWARDS RELAPSE PREVENTION AMONG PSYCHIATRIC PATIENTS IN FEDERAL NEUROPSYCHIATRIC HOSPITAL BARNAWA, KADUNA  .

 

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ABSTRACT
The problem of every hospital when the targeted objective is not achieved is that there is something wring either with health care givers, the patients or the general public. In order to improve the standard of health of the patients and keep them progressively fit. The reason why such lapse are present here to be sought and the remedy met in order to achieve the set objective of the hospital.
This study is based on the Attitude of nurses towards Relapse prevention among psychiatric patients in Federal neuropsychiatric hospital Barnawa Kaduna. The aim and objective of this study are all directed towards bringing out lasting solutions to curtail this menace. It also intends to actively involve the management of the hospital especially on employing new and scientific approach to holistic patient care. The instruments used for data collection were from interview and Questionnaire which were represented in tabular form, bar chart, pie chart and percentages. Nurses were used for the study .the data collected were analyzed. The result showed that many factor contribute to the effect of relapse.
All these can be prevented through adequate Education, Family oriented therapies, good social support, compliance and keep the follow-up appointment.

 

CHAPTER ONE
1.1 Background of Study
Psychiatric illness has fascinated and confounded healers, scientist and philosopher for centuries, it symptoms have been attributed to possession by demons considered to be punishment by the gods for the evil done or accepted as evidence of the inhumanity of its sufferers victims. Thus explanation resulted in enduring stigma for those whose were diagnosed with such disorders. Even today, much of the sigma persist although it has less to do with demonic possession than with society’s unwillingness to shoulder the tremendous cost associated with mental illness.

Relapse is one of the most severe problem of mental health care givers. It is common in about 1.3% of the already treated cases of mental illness or more than two million people (U.S. Department of Health and Human Services [USDHHS] 1999). Its economic cost is envious. Direct cost of relapse treatment expenses of most psychiatric illness were estimated 2.5% of the total treatment of first hand mental illness care budget in 1998 (American Psychiatric Association [APA] 2000).

The last year for which these data were available (USDHHS, 1999). In 1997, this accountant for $23.6 billion of mental health care dollar spent. The indirect cost such as lost of wages, premature death and incarceration were estimated to be $46 billion in the first half of 1998 (APA, 2000).

Further unemployment among permanent disability is 10% (APA 1998). The cost relapse in terms of individuals and family suffering are probably inestimable.

Despite the current trend in modern treatment, there is still an alarming rate of relapse and the reoccurrence of psychiatric illness globally. Individual who ought to be productive and responsible in life are wasting away on daily basis.

Today patients are required to stay for a short period of time in the hospital admission and discharge to home environment to help reduce dependency on the hospital care and reducing relapse. Also this helps to reduce stigmatization and prevent complications (Feyinsayo, A. 2009). This study will attempt an overview of Nurse and also to show how proper utilization of psychiatric Nursing service will go a long way in reducing and eradicating the ever growing cases of relapse among psychiatric patients in Federal Neuropsychiatric Hospital Barnawa, Kaduna.

 

 

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