An evaluation of strategies to improve the quality and content of hospital-based postnatal care in a metropolitan Australian hospital

Publication Type:
Journal Article
Journal Of Clinical Nursing, 2009, 18 (13), pp. 1850 - 1861
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Aim and objective. This study aimed to design, implement and evaluate strategies to improve the quality and content of hospital-based postnatal care. Background. Following birth, women report physical health problems, difficulties with breastfeeding, a lack of parenting self-efficacy and there is high occurrence of postnatal distress and depression. Despite these significant needs, women are frequently dissatisfied with the advice and support they receive from hospital-based postnatal care. Design. A pre/post test design compared the effect of multifaceted strategies on perceptions of quality and content of postnatal care, knowledge and experience of postnatal problems, parenting self-efficacy and breastfeeding outcomes. The key strategy, `one-to-one time, focused on providing women an uninterrupted period of time each day when a midwife would be available to discuss womens concerns about their health and that of their baby. Method. A convenience sample of 146 women at baseline and 148 women postintervention completed a postal self-report questionnaire between 24 weeks postpartum. Results. There were no significant differences between baseline and postintervention groups in perceived quality of care, breastfeeding outcomes and maternal self-efficacy. Women experiencing health issues, including insufficient milk supply, backache, abnormal bleeding and urinary incontinence, were more likely to report that they received good or excellent care and advice in the postintervention group. Strategies to increase rest appeared effective with women less likely to report excessive tiredness postintervention.
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