Exploring woman –Nurse interaction in a Jordanian antenatal clinic: A qualitative study

Abstract

Background

Effective woman-nurse interaction is critical in providing quality nursing care and would improve the health outcomes and the level of women's satisfaction with health and nursing services.

Aim

To explore how Jordanian nurses and pregnant women perceive their interaction during antenatal visits.

Methods

A descriptive qualitative study was conducted using a purposive sample of twelve pregnant women and twelve nurses. Data were collected through four focus group discussions organized at an antenatal clinic of a large hospital in Jordan. The data were analyzed using Giorgi's four stages of data analysis.

Findings

Approaches to interaction; barriers to interaction; quality of interaction were the main themes emerged from the data. Nurses and pregnant women also provided suggestions for strengthening the womannurse interaction during antenatal visits.

Conclusion

The different aspects of interaction described by the participants of this study may raise awareness and appreciation of the important roles health care providers can play in promoting the health outcomes of pregnant women when effective interaction is built and strengthened. Relevant policies and guidelines on improving appointment systems, and continuing education on communication skills and health education would be needed. More attention is required to adopt appropriate antenatal clinical guidelines and protocols to meet women's needs in Jordan.

Introduction

High quality antenatal care (ANC) reduces maternal and neonatal morbidity and improves health outcomes, particularly in low-income countries. Antenatal women should receive care where they can discuss sensitive issues and disclose problems comfortably with their health provider (Downe et al., 2016). Evidence suggests that parameters for assessing quality of antenatal care should take into account the context of interactions with health care providers (NICE, 2015). In nursing, the woman-nurse interaction is defined as “any process in which a nurse and a client exchange or share information, verbally or nonverbally.

Effective woman-nurse interaction is characterized by effective communication, skills, respect, clarity, and continuity of care. These characteristics would increase pregnant women's satisfaction with ANC services, increase their utilization of these services, and possibly improve health outcomes of pregnant women and their newborns (Emelumadu et al., 2014, Heaman et al., 2015). Woman-nurse interaction affects nurses’ satisfaction with their profession, their roles and improves their accountability for their actions and increases their level of engagement to provide quality of antenatal nursing care (Sword et al., 2012).

With 97.8% of Jordanian pregnant women receiving antenatal care, and 81% attending seven antenatal visits and more, it is imperative that they receive quality antenatal care from the nurses and midwives with whom they interact (Population and Health Survey, 2018). In Jordan, there are 18,454 working nurses and only 2762 midwives (MOH 2014). Because of this severe shortage in midwives, our study participants were nurses only because the majority of midwives in Jordan provide care to women in the labor room while nurses provide care in the ante and postnatal care units. Hence, midwives are not able to practice to the full role and scope of the midwife in all areas (Shaban et al., 2012). However, little is known about the nature and quality of Jordanian woman-nurse interaction during the antenatal visits. Therefore, the aim of this study was to explore Jordanian nurses’ and pregnant women's perception of their interactions during antenatal visits. Findings of this study would increase our understanding and highlight the relationship of nurses and women's ways of interacting and the outcomes of antenatal care.