KNOWLEDGE AND ATTITUDE ON POSTPARTUM DEPRESSION AMONG WOMEN OF REPRODUCTIVE AGE IN EWEKORO LOCAL GOVERNMENT AREA OGUN STATE

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ABSTRACT

Postpartum depression (PPD) is a significant mental health issue affecting women during the perinatal period, posing risks to maternal and child well-being. This study aim to assess knowledge and attitudes regarding postpartum depression among women of reproductive age in Ewekoro Local Government Area, Abeokuta. A cross-sectional study involving 150 women was conducted using convenience sampling. Structured questionnaires assessed demographics, PPD knowledge, and attitudes. Data collection occurred at homes, markets, and women's groups. Descriptive and inferential statistics analyzed the data. This study found that 71.3% of respondents had heard of PPD. However, only 40% identified adequate preventive strategies. Misconceptions surrounding societal stigma and severity were prevalent. Significant associations existed between PPD knowledge and education level, marital status, and previous PPD experience. This study highlights the need for targeted educational interventions to enhance PPD understanding among women in this region. Integrating mental health education into reproductive health services and community-based programs can mitigate PPD risk. Healthcare providers should prioritize PPD screening, education, and support. Future research should investigate effective PPD prevention strategies and cultural influences on PPD management. The study's findings have implications for promoting maternal mental health and well-being in Nigeria. Policy makers and healthcare administrators should develop programs addressing PPD awareness and education. Ultimately, improving knowledge and attitudes toward PPD will reduce the stigma associated with this condition and promote better health outcomes for women and their families. By addressing PPD, we can enhance maternal and child well-being in Nigeria.

Keywords: Postpartum, Depression, Knowledge, Attitude, Reproductive Age, Women.





 

TABLE OF CONTENTS

Title page                                                                                                                                i

Declaration                                                                                                                              ii

Certification                                                                                                                            iii

Dedication                                                                                                                              iv

Acknowledgement                                                                                                                  v

Table of Contents                                                                                                                   vi

List of Figures                                                                                                                         ix

List of Tables                                                                                                                          x

List of Abbreviations                                                                                                              xi

Abstract                                                                                                                                  xii

CHAPTER ONE: INTRODUCTION

1.1 Background of the study                                                                                                  1

1.2 Statement of the problem                                                                                                 2

1.3 Objective of the study                                                                                                      3

1.4 Research questions                                                                                                            4

1.5 Statement of Hypothesis                                                                                                  4

1.6 Significance of the study                                                                                                  4

1.7 Scope of the study                                                                                                                        5

1.8 Operational Definition of terms                                                                                        5

CHAPTER TWO: LITERATURE REVIEW

2.0 Introduction                                                                                                                      7

2.1 Conceptual Literature reviews                                                                                          7

2.1.1 Concept of postpartum depression                                                                                7

2.1.2 History of postpartum depression                                                                                  9

2.1.3 Risk Factors of postpartum depression                                                                          10

2.1.4 Causes of postpartum depression                                                                                  12

2.1.5 Signs and Symptoms                                                                                                     13

2.1.6 Diagnosis                                                                                                                       14

2.1.7 Prevention of PPD                                                                                                         16

2.1.8 Management                                                                                                                  17

2.1.9 Complications                                                                                                                23

2.2 Theoretical Review                                                                                                           24

2.3 Empirical Review                                                                                                              27

CHAPTER THREE: METHODOLOGY

3.0 Introduction                                                                                                                      30

3.1 Research Design                                                                                                               30

3.2 Research Setting                                                                                                               30

3.3 Targeted population                                                                                                          31

3.4 Sample size and Sample technique                                                                                   31

3.5 Instrument of data collection                                                                                            32

3.6 Validity of Instrument                                                                                                      32

3.7 Reliability of Instrument                                                                                                   32

3.8 Method of Data collection                                                                                                32

3.9 Method of Data Analysis                                                                                                 33

3.10 Ethical consideration                                                                                                      33

CHAPTER FOUR: RESULTS OF FINDINGS

4.1 Socio-demographic Characteristics of the Respondent                                                    32

4.2 Respondents' Knowledge on Postpartum Depression                                                      38

4.3 Respondents' Attitude towards Postpartum Depression                                                  42

CHAPTER FIVE: DISCUSSION OF FINDINGS

5.1   Discussion of findings                                                                                                    46

5.2 Implication of finding to nursing                                                                                      46

5.3 limitation of the study                                                                                                      47

5.4 Summary                                                                                                                           47

5.5 Conclusion                                                                                                                        48

5.6 Recommendation                                                                                                              48

5.7 Suggestions for further studies                                                                                         49

Reference                                                                                                                                51

Appendix I&II                                                                                                                                    55

                                                                      

 

 

 

 

LIST OF FIGURE

Figure 2.1: The theory of planned behavior as applied to knowledge and attitude on postpartum depression among women of reproductive age.

 

 

 

 

LIST OF TABLES

Table 1: DSM IV Criteria for Major Depression Disorder                                                     37

Table 2: Socio-demographic Characteristics of the Respondent                                            40

Table 3: Respondents' Knowledge on Postpartum Depression                                              45

Table 4: Respondents' Attitude towards Postpartum Depression                                          57

 

 

 

 

 

 

LIST OF ABBREVIATIONS

APA          American psychiatric Association

APC          All Progressive Congress

BDI            Beck Depression Inventory

DSM         Diagnostic and Stational Manuel of Mental Disorders

ECT          Electro Convulsive Therapy

EPDS       Edinburgh Postnatal Depression Scale

HO            Hypothesis

ICD           International Classification of Disease

KPDRS     Kessler Psychological Distress Rating scale

KAP         Knowledge, Attitude and Practice

LGA          Local Government Area

MAOLs     Monoamine Oxidase Inhibitors

NIMH.      National Institute of Mental Health

PO             Per Oral

PPD          Postpartum Depression

RDC          Research Diagnostic criteria

SSRls       Selective Serotonin Reuptake inhibitors

TPB         Theory of Planned Behavior

WHO        World Health Organization

 





CHAPTER ONE

INTRODUCTION

1.1 Background to the study

Effective communication in healthcare is fundamental to ensuring optimal patient outcomes, with nurses playing a critical role in this interaction. Nurses, who spend a significant portion of their time interacting with patients, are often the first point of contact in the healthcare setting. Their interpersonal communication skills not only determine the quality of the patient-nurse relationship but also influence patient satisfaction and recovery outcomes. According to research, interpersonal communication between healthcare providers and patients is vital for building trust, improving adherence to medical instructions, and enhancing patient satisfaction (Fleischer et al., 2009). Nurses' communication skills also facilitate patient education, enabling patients to better understand their health conditions and treatment plans.

Quality of care, an essential aspect of healthcare delivery, is directly influenced by effective communication. Studies have shown that when nurses engage in clear, empathetic, and consistent communication, patients tend to report higher levels of satisfaction and better clinical outcomes (Bailey, 2017). In particular, the quality of care provided by nurses in federal healthcare institutions, such as Federal Medical Center (FMC) Abeokuta, depends largely on their ability to establish rapport, manage patient concerns, and convey critical health information accurately.

Relationship is a common and complex word that has varieties of meaning. It exists between two or more parties. The manner an individual relates to people determines their level of relationship. Nurse-patient relationship is very vital for patient‟s recovery both physically and emotionally (Palesa et al., 2011). A good and compassionate nurse works for the well-being and improvement of his or her patient. According to Hildegard (2023) interpersonal relationship model theory, nurse-client interaction is geared towards enhancing the client‟s well-being, and the client may be an individual, a family, a group or a community (Doss, Depascal and Hadley, 2011). Irrespective of the competent medical care given to patient, he or she will not get satisfied if it fails to meet his psychological and emotional needs. The nurse-patient relationship depends on interaction of thoughts, feelings and action of each other. Patient will experience better health when all their needs are fully considered in the relationship ( Arungwa, 2014).

According to Happ et al., (2006), everyone has personal needs such as feeling accepted, love, care, understanding, respects, identity, privacy, power, control and affection. Nurses should use their professional skills to detect patients problems be it religious, cultural, parental, emotional or otherwise and this can only be done through a good nurse-patient relationship. Helping relationships are created through the nurse‟s application of scientific knowledge, understanding of human behaviours and communication and also commitment to the caring. In such relationship, the nurse assumes the role of professional help and comes to know the client as an individual who has unique health needs, human responses and a pattern of living. In good nurse-patient relationship, clients are helped to clarify needs and goals, solve problems, cope with situational or maturational cases that arise, clarify and strengthen values, reduce stress and anxiety and gain insight and self-understanding (Foster and Hawkins, 2015). Nurses occupy a very significant or strategic position. She stays with the patient more than any other professionals (i.e 24 hours). They form the highest population of hospital workers (Campbell and Davis, 2011). Patients see nurse’s interaction with others and draw conclusions about the hospital based on their observation. Nurse’s attitude towards their work, co-workers and the organization affects patient and family judgment of all the things they do not see behind the scenes. (Barlett et al, 2018). Without a positive nurse-patient relationship, there cannot be patient and family satisfaction and there cannot be an environment that supports anxiety-reduction and healing.

In Nigeria, the role of nurses is especially crucial given the unique challenges posed by a high patient-to-nurse ratio, limited resources, and diverse patient demographics (Ogunbanjo, 2015). In such settings, the importance of interpersonal communication skills among nurses is heightened, as it directly correlates with the quality of care delivered and patient perceptions of healthcare services.

1.2 Statement of the Problem

Despite the recognized importance of effective communication in healthcare, challenges persist in achieving optimal communication between nurses and patients in many healthcare settings. Specifically, at FMC Abeokuta, anecdotal reports and patient feedback suggest that there are gaps in the interpersonal communication skills of some nurses, which may negatively impact the perceived quality of care. In a context where patients rely heavily on clear communication to navigate their treatment plans and recovery, these gaps could lead to misunderstandings, decreased patient satisfaction, and even adverse health outcomes (Adeleke & Fatoye, 2018).

Research indicates that poor communication between nurses and patients is a key contributor to dissatisfaction in healthcare services (Bramhall, 2014). Therefore, understanding how nurses' communication skills at FMC Abeokuta influence the quality of care provided is essential for identifying potential areas of improvement. This study seeks to address the gap in knowledge concerning the relationship between nurses' interpersonal communication skills and the quality of care, with a specific focus on the experiences of patients at FMC Abeokuta.


1.3 Objective of the Study

The general purpose of the study is to investigate the impact of nurses' interpersonal communication skills and quality of care on patient in federal medical center, FMC Abeokuta.

The objectives of the study were:

i. To determine the nature of nurse-patient relationship in federal medical center, FMC Abeokuta. 

ii. To find out the impact of the present relationship of nurses on the patient carein federal medical center, FMC Abeokuta

iii. To identify barriers against effective nurse-patients relationship in federal medical center, FMC Abeokuta.


1.4 Research Questions

1. What the nature of nurse-patient relationship in federal medical center, FMC Abeokuta?

2. What is the impact of the present relationship of nurses on the patient care in federal medical center, FMC Abeokuta?

3. What are the barriers against effective nurse-patients relationship in federal medical center, FMC Abeokuta?


1.5 Research Hypothesis

H0: There is no significant relationship between the nurse-patient relationship and patient satisfaction at Federal Medical Center, Abeokuta.

H1: There is a significant positive relationship between the quality of the nurse-patient relationship and patient satisfaction at Federal Medical Center, Abeokuta.


1.6 Significance of the Study

This study on the impact of nurses' interpersonal communication skills and the quality of care on patient outcomes at the Federal Medical Center (FMC) Abeokuta holds significant value for various stakeholders in the healthcare sector.

Firstly, for healthcare practitioners, particularly nurses, the findings of this study can provide insights into how their communication behaviors directly affect patient outcomes. By understanding the critical role interpersonal communication plays in patient satisfaction and recovery, nurses can enhance their communication skills to improve patient-nurse interactions, leading to better healthcare experiences and outcomes. Furthermore, the study may highlight areas where nurses need additional training or support, fostering professional growth and improved care standards.

For healthcare administrators at FMC Abeokuta and similar institutions, this research could offer valuable evidence-based data to guide policy-making and staff training initiatives. By addressing communication deficiencies and enhancing the quality of care provided, hospital management can achieve higher patient satisfaction rates, reduce medical errors caused by miscommunication, and improve overall healthcare service delivery. Implementing targeted communication training programs for nurses could potentially reduce patient complaints and improve clinical outcomes, contributing to the hospital’s reputation and success.

For patients, the study is important because it directly addresses their needs and concerns about the quality of communication they receive in healthcare settings. Improved nurse-patient communication leads to better understanding of health conditions, increased adherence to treatment plans, and enhanced trust in healthcare providers. Consequently, the study will contribute to improving patients’ overall experiences, ensuring that they receive compassionate, clear, and supportive care, which can significantly influence their recovery and well-being.

Finally, from an academic and research perspective, this study will add to the body of literature on nurse-patient communication, especially in the Nigerian healthcare context, where studies on interpersonal communication in hospitals are limited. The research findings could serve as a reference for future studies, as well as for educational institutions that train nurses. The study will also contribute to a better understanding of how healthcare systems in developing countries can improve patient outcomes through effective communication strategies, bridging gaps between healthcare providers and patients.

In sum, this study has the potential to influence improvements in nursing practices, healthcare management, patient experiences, and academic research, ultimately contributing to enhanced healthcare delivery at FMC Abeokuta and beyond.


1.7 Scope of the Study

This study covers the impact of nurses' interpersonal communication skills and quality of care on patient. Geographically, the study will focus on nurses in federal medical center, FMC Abeokuta.


1.8 Operational Definitions of Term

·       Interpersonal Communication Skills: These refer to the abilities of nurses to effectively exchange information, emotions, and understanding with patients. It involves verbal and non-verbal communication techniques such as active listening, empathy, clarity, and patient-centered communication. In the context of this study, it highlights the communication behaviors of nurses in their interactions with patients.

·       Quality of Care: This term refers to the degree to which healthcare services provided to patients improve desired health outcomes. Quality care means providing services that are safe, effective, patient-centered, timely, efficient, and equitable. In this study, it focuses on the standard of healthcare services delivered by nurses, particularly as influenced by their communication skills.

·       Patient Outcomes: These are the results experienced by patients as a result of healthcare interventions, which may include their satisfaction with care, recovery, well-being, and overall health status. In this research, patient outcomes are viewed in relation to how nurses' communication and the quality of care affect patients' perceptions and health.

·       Federal Medical Center (FMC) Abeokuta: FMC Abeokuta is a government-owned tertiary healthcare institution located in Ogun State, Nigeria. It provides a wide range of medical services, including primary, secondary, and tertiary care, and serves as the context for this study on nurses' communication and the quality of care.

·       Nurse-Patient Relationship: This term describes the professional relationship between nurses and patients, characterized by trust, respect, and empathy. It involves the dynamic interactions that occur during care delivery, where effective communication is crucial in establishing rapport and fostering cooperation.

·       Patient Satisfaction: This refers to the degree to which patients feel that their healthcare needs and expectations are being met. It is a key indicator of the quality of care, influenced by various factors such as communication, responsiveness, and the overall patient experience.

 

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