How consultation-relational empathy and demographics influence satisfaction with primary antenatal health care:evidence from rural Nigeria

Objectives:This study aims to explore the role of consultation and relational empathy(CARE)and socio-demographic profile as predictors of patients'satisfaction among pregnant women attending antenatal care(ANC)in selected public primary health facilities in rural sub-districts of Saki,Oyo State,Nigeria.Methods:This cross-sectional study recruited a total of 582 pregnant women in four primary health centers.Expectant mothers responded to a questionnaire covering demographic characteristics,clinic visitation,CARE,and patients'satisfaction.All data was analyzed using descriptive,univariate and multivariate statistical tools.P<0.05 level was considered statistically significance.Results:Findings revealed that the participants had a mean age of 23.15±5.23 years.The pattern of patients'satisfaction revealed that 13.40%(78/582)were highly satisfied with the health care received compared to 86.60%(504/582)with moderate to low satisfaction ratings with ANC.Highly satisfied patients placed higher value on technical quality,interpersonal relation,communication,financial aspects,time spent and accessibility convenience(P=0.001).Multiple linear regression model indicated that relational empathy(β=0.28,P<0.001),2nd trimester of pregnancy(β=0.13,P=0.01),age categories of 30-<40 years(β=-0.12,P=0.02),and 40-<50 years(β=-0.11,P=0.04),religious affiliation(β=0.10,P=0.03)predicted satisfaction with ANC.Conclusion:Low patients'satisfaction with antenatal healthcare services resulting from hostile attitudes from health workers has implication for the delivery and acceptability of services offered to eradicate maternal mor-tality globally.Thus,regular training and re-training of health care personnel in frequent contact and interaction with patients will go a long way in reducing untoward work attitude and maternal mortality in rural ANC centers globally.

Development and validation of the Mothers of Preterm Babies Postpartum Depression Scale

Postpartum depression,a common complication in childbearing women,is of great public health concern.Previous screening tools have focused on depressed mood,with less attention paid to postpartum anxiety and suicidal ideation.This study developed and validated a tool to measure postpartum depression among mothers of preterm babies.From the clinical interviews and a pilot survey(n=121)the Mothers of Preterm Babies Postpartum Depression Scale was developed.The Mothers of Preterm Babies Postpartum Depression Scale and the Edinburgh Postnatal Depression Scale questionnaires were completed by 152 mothers who delivered preterm babies at Massey Street Children’s Hospital,Lagos.Data were analyzed with use of confirmatory factor analysis,principal component analysis,and Cronbach’s alpha at the P≤0.05 level of significance.The new scale demonstrated a reliability(α)of 0.91.Construct validity with exploratory factor analysis(Kaiser-Meyer-Olkin measure 0.70)yielded three dimensions of cognitive and emotional difficulty(α=0.92),hopelessness and suicidal ideation(α=0.93),and physiological distress(α=0.71).Confirmatory factor analysis demonstrated a good fit:18 degrees of freedom;goodness of fit index 0.97;adjusted goodness of fit index 0.93;and root mean square error of approximation 0.04.Convergent validity was established with the Edinburgh Postnatal Depression Scale(r=0.66,P=0.00).The new screening tool was demonstrated to have meritorious validity,faster and easier to administer to the obstetric population.