Determination of Patients’ Perception on the Quality of Nursing Care Among Postabortal Care Clients Attended to at Kenyatta National Hospital

Abstract

Abortions are serious public health problems with worldwide distribution. It affects all reproductive age groups. Despite this wide distribution, many patients don’t seek for appropriate abortion care services for many reasons. This creates a big gap between actual abortion care needs of the population and the demand for postabortal care. Part of the reason for shortcomings in seeking for abortion services could have been either negative perception of quality of nursing services from the patient perspective, related to negative attitude of the nursing staff towards post abortal care. The postabortal care clients might fear criminalization of the abortion issue and also being notified to the police for arrest by the nursing staff. Objectives: The broad objective was to determine the patients’ perception on the quality of nursing care among postabortal care clients attended to at Kenyatta national hospital. Specific objectives were derived from the theoretical framework i.e. patients’ perception, demographic factors, social-cultural factors, economic factors and health factors. Methodology: This study was done in acute gynaecological ward at Kenyatta national hospital. It was able determine patients’ perception on the quality of nursing care among postabortal care clients attended to at Kenyatta national hospital. This was a descriptive cross sectional quantitative and qualitative study and data was collected by administering structured questionnaires under the research assistants’ supervision. The questionnaires were written in English, for patients who had challenge in English the research assistants were able to translate it into Kiswahili using simple terms. Focused group discussion (FGD) and Key informant interview (KII) guides were used. Collected data was cleaned by going through all the filled questionnaires and collected information from Focused group

discussion (FGD) and Key informant interview (KII) for completeness and proper documentation. Fischer’s formula was used to determine sample size from a total population of 80 patients per month, according to KNH health information system 2016/2017; 66 postabortal care clients who were interviewed in the ward after evacuation. Simple random sampling method was used to select the first postabortal care client. The data was then analyzed using statistical package for social sciences (SPSS) and the results presented in descriptive statistics such as frequency tables, bar charts and bar graphs. Inferential statistic was also presented in the form of significance tests and chi squire. Verbatim reporting in qualitative findings was presented and other qualitative data were put into themes for further analysis. Ethical consideration and study limitations were addressed. Results: the mean age for postabortal care client was 28 years. Most of the clients (78.8%) had secondary education and above. On comparing attitude and perception for postabortal care clients’ attended to at KNH, the p-value was 0.03 which was statistically significant. (n=42;63.6%) of post-abortal care clients were advised on the safety of post-abortal care management. Were as (n=22;33.3%) reported that they were not advised on the safety of postabortal care management. (n=32;48.5) were not aware of the availability of post-abortal care services at the time when abortion started. Majority, that is (n=20;56.6%) of the patients undergoing post-abortal care experienced pain during the care provided at Kenyatta National Hospital. (n=53;80.3%) of the post-abortal care clients reported that they were given counselling or health education during the care process, were as (n=13;19.7% were not given counselling or health education during the post-abortal care

process. (n=33;50%) have had a previous history of at least one case of previous incidence of an abortion. Recommendations: the study suggested that awareness for post-abortal care clients’ needs to be addressed. Nurses and midwives should also look for ways of sensitizing the community. The community should be sensitized on safe abortion management at hospitals like KNH for clients experiencing abortion. All postabortal care clients at Kenyatta National Hospital needs to undergo post-abortal care counselling, these will help in minimizing the number of unwanted pregnancies which in most cases leads to unsafe abortion. Pain needs to be taken care of, because it may discourage clients from seeking health care advice at KNH once they experience abortion.