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Assessment of the Level of Patient Satisfaction with Obstetric Sonography in Port Harcourt, Rivers State, Nigeria

Joshua Okpara-Ijeruh1, Anthony Chukwuka Ugwu2, Michael Promise Ogolodom3*, Awajimijan Nathaniel Mbaba4, Sokariye Okpara-Ijeruh4 and Nengi Alazigha3

1Radiology Department of Image Diagnostic, Port Harcourt Rivers State, Nigeria

2Department of Radiography and Radiological Sciences, Nnamdi Azikiwe University, Akwa Anambra State

3Rivers State Hospitals Management Board, Port Harcourt, Rivers State, Nigeria

4Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria

*Corresponding Author:
Michael Promise Ogolodom
Rivers State Hospitals Management Board
Port Harcourt, Rivers State, Nigeria
Tel: +2348039697393
E-mail: [email protected]

Received Date: March 22, 2019 Accepted Date: April 17, 2019 Published Date: April 25, 2019

Citation: Ijeruh JO, Ugwu AC, Ogolodom MP, Mbaba AN, Ijeruh SO, et al. (2019) Assessment of the Level of Patient Satisfaction with Obstetric Sonography in Port Harcourt, Rivers State, Nigeria. Crit Care Obst Gyne Vol.5 No.2:9.

Copyright: © 2019 Ijeruh JO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 
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Abstract

Background: The importance of quality of healthcare delivery has drawn global attention and as such, healthcare providers are continuously updating their knowledge to meet the ever-rising challenges of patient’s management. In every setting, good patients care is the pivot on which healthcare policies revolve, therefore, patients care is the primary responsibility of every hospital making patient’s satisfaction a topmost concern. Patient satisfaction is a strong indicator used for evaluation of the quality of health care delivery, and as such needs to be frequently studied for the smooth functioning of the health care system. This study was designed to assess the level of patient’s satisfaction with obstetric ultrasound in Port Harcourt, Rivers State, Nigeria. Materials and methods: The prospective cross-sectional study design was adopted for this study. A convenient sample size of 200 subjects referred for obstetric ultrasound scans was studied using structured questionnaires. The ethical approval and permission to conduct this study were obtained from the Research and Ethics committee of Image Diagnostic Center Port Harcourt, Rivers State, Nigeria. All procedure of this study was adequately explained to the subjects and their consents were properly sought. The information obtained from them were treated with a high level of confidentiality and used for the purpose of this study. This study was conducted in the radiology department of Image Diagnostic Center Port Harcourt, Rivers State between December 2017 and February 2018. Results: Greater numbers of the respondents were within the age group 25 to 34 years of age 60.5% (n=121), followed by 35-44 years of age 34.5% (n=69) and the least were within the age group 16 to 24 years of age 5% (n=10). Out of 200 respondents, 99.5% (n=199) of the respondents were females and the remainder 0.5% (n=1) was male. Majority of the respondent had tertiary education 66.0% (n=130) and the least had primary education 2.5% (n=5). The correlation analysis for educational levels and level of satisfaction showed a statistically significant negative correlation (r=-0.353, P=0.000). With regard to the respondent’s occupation, Civil servants were highest at 24% (n=48), and the least were students 1.5% (n=3). With regard to the instructions by sonographers and courtesy of medical staff, 55% (n=110) were satisfied with the instructions and 7.0% (n=15) were dissatisfied and accounted for the least respondent. There was a positive statistically significant correlation with this variable and the levels of respondent’s satisfaction with (r=0.199, p=0.005). Conclusion: There was a high level of patient satisfaction with obstetric ultrasound in the Radiology department of Image Diagnostic Center, Port Harcourt Nigeria. Christian’s preponderance was noted and Civil servants constitute the highest number of the participants. Greater numbers of the determinants of satisfaction showed statistically significant correlation and relationship with age and education.

Keywords

Patient satisfaction; Obstetric ultrasound; Sonography

Introduction

The importance of quality of healthcare delivery has drawn global attention and as such, healthcare providers are continuously updating their knowledge to meet the ever-rising challenges of patient’s management [1]. In every setting, good patients care is the pivot on which healthcare policies revolve, therefore, patients care is the primary responsibility of every hospital making patient’s satisfaction a topmost concern [1].

Satisfaction is the process of fulfilling a need, desire, appetite, or the feeling gained from such fulfillment [2]. Patient satisfaction has also been defined as the extent of agreement between a patient’s expectations of ideal care and his /her perceptions of the real care he/she receives [3].

Different aspects of patient satisfaction have been studied and identified, ranging from admission to discharge services, as well as medical care and interpersonal communication. Well accepted criteria include responsiveness, communication, attitude, clinical skill, comforting skill, amenities, food services, etc. Interpersonal and technical skills of health care have been reported as two unique dimensions involved in the assessment of hospital care [4]. Patient satisfaction is a strong indicator used for evaluation of the quality of health care delivery, and as such needs to be frequently studied for the smooth functioning of the health care system [5].

Pregnant women are often in both physically and emotionally stressed, worrying about the state of the fetus and duration of labor. Dealing effectively with such clinical situations involves many abilities. Researchers studying patient satisfaction showed that the mode of medical care delivery appears to be more important to patients than the care itself [6].

Ultrasound examination of the fetus otherwise referred to as obstetric sonography became integrated into prenatal care soon after its introduction in the 1950s and has improved over the last four decades in its technology and utilities, thereby greatly improving patient management [7]. Globally, routine obstetric sonography has been identified as one of the procedures through which maternal mortality can be reduced [8].

Obstetric ultrasonography is the application of high frequency and low intensity sound waves on the abdomen and cervix of a pregnant woman to produce images of the fetus. According to Manning [9], it is a technology that has been in use for over 50 years during pregnancies in the United States and around the world. It is generally accepted to be the best and most accurate medical technique to access pregnancy. This is because it does not involve the use of ionizing radiation, and its unique ability to detect pregnancy of about five weeks Gestational Age (GA), as well as the ease at which it differentiates ectopic from intrauterine pregnancy. Based on the available evidence, routine ultrasound in early pregnancy appears to enable better evaluation of gestational age, early detection of multiple pregnancy and detection of clinically unsuspected fetal malformation at a point when early termination of pregnancy is still possible [10].

Larger numbers of the patients undergoing obstetric ultrasound scan are usually apparently healthy and in good state of mind to judge and evaluate services provided to them in imaging departments. In a similar study conducted by Ugwu et al. revealed that within the last few decades, awareness of information about obstetric ultrasound scan among pregnant women has tremendously increased [11]. They equally documented that women’s satisfaction and their ability to cope with anxiety during pregnancy improved majorly with the amount of information giving to them before and during the scan. Kleanthi et al. and Marinho, also reported a great increase in the request for a prenatal ultrasound scan in Nigeria in the last three decades [12,13].

Although there are few research studies on the assessment of patient satisfaction in healthcare delivery in various parts of Nigeria, there is still knowledge gap existing between the findings of the previous studies and the intended aim of this study, as there is no research work that has evaluated the level of patient satisfaction with obstetric ultrasound in a private diagnostic center in Port Harcourt, Rivers State, Nigeria to the best of our knowledge. This study was designed to evaluate the level of patient ’ s satisfaction with obstetric ultrasound in a single private diagnostic center in Port Harcourt, Rivers State, Nigeria.

Materials and Methods

A questionnaire prospective cross-sectional study design was adopted for this study. A convenient sample size of 200 subjects referred for obstetric ultrasound scans was selected using volunteer sampling technique. Only pregnant women that visited radiology department of Image Diagnostics for an obstetric ultrasound scan and consented to participate in the study were included in this study, whereas non-pregnant women and also pregnant women who declined interest in the study were excluded. The ethical approval and permission to conduct this study were obtained from the Research and Ethics committee of Image Diagnostic Center Port Harcourt, Rivers State, Nigeria. All procedure of this study was adequately explained to the subjects and their consents were properly sought. The information obtained from them were treated with a high level of confidentiality and used for the purpose of this study. The study was conducted in the radiology department of Image Diagnostic Center Port Harcourt, Rivers State between December 2017 and February 2018.

Procedures and method of data collection

A protocol including the explanation of the contents of the tested semi-structured questionnaire with 4 sections and 20 questions to the consented participants was adopted and replicated for subjects for similarity in the research by the student. Self-administration of the questionnaire method was adopted and this done before the scan proper at the patient’s waiting area. The questionnaire contained both open and closed-ended questions. The closed-ended questions were in scale assessment pattern while their comments in the openended questions were classified into groups. The subjects were advised to fill the questionnaire without bias. The completed questionnaires were retrieved from the subjects before leaving the department. A proforma was also designed to capture all the data for analysis.

Method of data analysis

The statistical analysis was done using statistical package for social science (SPSS) version 22.0 (SPSS INC, Chicago, Illinois, USA). Both descriptive and inferential statistics were performed and p-value of <0.05 was set as the level of statistical significance. Frequency distribution and cross tabulation were computed for categorical variables. The dependent variable was the patient ’ s satisfaction, while some of the independent variables would be waiting for time, age, sex, educational and employment status, etc. of the participants. The rating of patient’s satisfaction using the Likerts’ scale was as follows: (1=Very satisfied, 2=Satisfied, 3=Neutral, 4=Dissatisfied, 5=Very dissatisfied). Ratings of one and two were considered satisfied, three was considered as neutral while, four and five were considered dissatisfied.

Results

Greater numbers of the respondents were within the age group 25-34 years of age 60.5% (n=121), followed by 35-44 years of age 34.5% (n=69) and the least were within the age group 16 to 24 years of age 5% (n=10) (Table 1). Out of 200 respondents, 99.5% (n=199) of the respondents were females and the remainder 0.5% (n=1) was male (Table 1).

Demographics Classification Frequency (%) Correlation p-value Remark
  16-24 10 (5.0%)      
Age (Years) 25-34 121 (60.5%)      
  35-44 69 (34.5 %)      
Gender Male 1 (0.5%)      
  Female 199 (99.5%)      
Religion Christianity 138 (69%) -0.111 0.118 N/S
  Islam 53 (26.5%)      
  Others 9 (4.5%)      
Tribe Igbo 121 (60.5%) 0.29 0 Sig
  Ikwerre 49 (24.5%)      
  Others 30 (15.0%)      
Residence place Urban 128 (64.0%) -0.269 0 Sig
  Rural 72 (36.0%)      
Education Primary 5 (2.5%) -0.353 0 Sig
  Secondary 65 (32.0%)      
  Tertiary 130 (66.0%)      
Occupation Student 3 (1.5%) 0.085 0.23 N/S
  Farmer 6 (2.5%)      
  Trader 22 (11.0%)      
  Artisan 15 (7.5%)      
  Civil Servant 48 (24.0%)      
  Business 46 (23.0%)      
  Company worker 31 (15.5%)      
  Contractor 8 (4%)      
  Pensioner 4 (2%)      
  House wife 11 (5.5%)      
  Others 7 (3.5%)      

Table 1: Frequency distribution of demographics of respondents and correlation analysis.

With regard to respondents religions, Christianity was highest 69% (n=138), followed by Islam 26.5% (n=53) and the least was others 4.5% (n=9) (Table 1). Majority of the respondent had tertiary education 66.0% (n=130) and the least had primary education 2.5% (n=5). The correlation analysis for educational levels and level of satisfaction showed a statistically significant negative correlation (r=-0.353, p=0.000) (Table 1).

With regard to the respondent’s occupation, Civil servants were highest at 24% (n=48), and the least were students 1.5% (n=3). The correlation analysis for the occupation of the respondents and their level of satisfaction with obstetric sonography showed no statistically significant correlation (r=0.085 p=0.230) (Table 1).

With regard to the duration before card and folder collection, those that spent 30 min to 1 hr were highest 47.5% (n=95) followed <30 min 38.5% (n=77) and the least spent 2 hrs and above 3.0% (n=6). There was no statistically significant correlation between this variable and level of satisfaction with (r=0.032, p=0.652) (Table 2).

Determinants of satisfaction Classification Frequency (%) Correlation p-value Remark
Time duration before card/folder collection <30 min. 77 (38.5%) 0.032 0.652 N/S
  30 min to1 hr 95 (47.5%)      
  1 hr to 2 hrs 22 (11.0%)      
  2 hrs> 6 (3.0%)      
Waiting time before registration Very satisfied 43 (21.5%) 0.24 0.001 Sig
  Satisfied 48 (24.0%)      
  Neutral 56 (28.0%)      
  Dissatisfied 29 (14.5%)      
  Very
Dissatisfied
24 (12.0%)      
Perception on Waiting time (spent before receiving clinical services) Long wait? Yes 98 (49.0%) 0.016 0.818 N/S
  No 102 (51.0%)      
Time with sonographer -----   0.095 0.18 N/S
Waiting time before seeing doctor <30 mins 79 (39.5%) -0.308 0 Sig
  30 min to 1 hr. 84 (42.0%)      
  1 hr to 2 hrs 30 (15.0%)      
  2 hrs> 7 (3.0%)      
Reason for waiting No/few record
clerk(s) on desk
19 (9.5%) 0.156 0.028 Sig
           
  Patients were too many 122 (61.0%)      
  No/few doctors 23 (11.5%)      
  Shunting by other patients 3 (1.5%)      
  Others 33 (16.5%)      

Table 2: Frequency and correlation of time (waiting and receiving care)-determinants of satisfaction.

Waiting time before registration result revealed that those that were neutral about their level of satisfaction were highest 28% (n=56), followed by those that were satisfied 24% (n=48) and the least were those that were very dissatisfied 12% (n=24). There was a statistically significant correlation of this variable with the level of satisfaction of respondent with (r=0.240, p=0.001) (Table 2). With regard to reasons for waiting before the obstetric scans, 61% (n=122) of the respondents which was highest, said there were too many patients and shunting by other patients was the least 1.5% (n=1). There was a statistically significant correlation of this variable with the level of satisfaction of respondents with (r=0.156, p=0.028) (Table 2).

Professionalism, technical experts and service delivery in the facility and staff as a determinant of satisfaction were evaluated in Table 2 and the results are 33% (n=66) of the respondents as highest were satisfied with the registration and 8.5% (n=17) were very dissatisfied. There was a positive statistically significant correlation of this variable with the respondent ’ s satisfaction levels (Table 3).

Determinants of Satisfaction Classification Frequency (%) Correlation p-value Remark
Registration process Very satisfied 25 (12.5%) 0.259 0 Sig
  Satisfied 66 (33.0%)      
  Neutral 54 (27.0%)      
  Dissatisfied 38 (19.0%)      
  Very dissatisfied 17 (8.5%)      
Explanation of procedure Very satisfied 36 (18.0%) -0.032 0.652 N/S
  Satisfied 68 (34.0%)      
  Neutral 73 (36.5%)      
  Dissatisfied 20 (10.0%)      
  Very dissatisfied 3 (1.5%)      
Instructions by the sonographer/ Very satisfied 40 (20%) 0.199 0.005 Sig
Courtesy of medical staff Satisfied 110 (55%)      
  Neutral 24 (12%)      
  Dissatisfied 15 (7.0%)      
  Very dissatisfied 11 (5.5%)      
Technical skills of attending doctor Very satisfied 34 (17.0%) -0.115 0.104 N/S
  Satisfied 69 (34.5%)      
  Neutral 70 (35.0%)      
  Dissatisfied 19 (9.5%)      
  Very dissatisfied 8 (4.0%)      
Opinion/Recommendation
Recommendation of services to other potential clinic users Yes 168 (84.0%) -0.158 0.025 Sig
           
  No 32 (16.0%)      
Suggestions of respondents on improvement More equipment/infrastructure 49 (24.5%) 0.213 0.003 Sig
           
  Employ more doctors 85 (42.5%)      
  Employ more nurses 25 (12.5%)      
  Employ more record staff 24 (12.0%)      
  Improve courtesy of medical staff 9 (4.5%)      
           
  Missing response 8 (4%)      

Table 3: Professionalism/technical expertise/service delivery of the facility and staff as a determinant of satisfaction.

With regard to the instructions by sonographers and courtesy of medical staff, 55% (n=110) were satisfied with the instructions and 7.0% (n=15) were dissatisfied and accounted for the least respondents. There was a positive statistically significant correlation with this variable and the levels of respondent’s satisfaction with (r=0.199, p=0.005) (Table 3).

The technical skills of the attending doctor were also evaluated with respect to the level of satisfaction by the respondents, and the results showed that 35% (n=70) of the respondents were neutral and 4% (n=8) were very dissatisfied with the technical skills of the attending doctor.

There was no statistically significant correlation of this variable with the respondent ’ s level of satisfaction with (r=-0.115, p=0.104) (Table 3). Majority of the respondents 42.5% (n=85) suggested the employment of more doctors in the facility and the least 4% (n=8) does not response to this section of the question.

Greater numbers of the respondents 53% (n=106) were satisfied with the cleanliness of the waiting area and the least 3% (n=6) were very dissatisfied with the cleanliness of the waiting area. There was a statistically significant correlation of cleanliness of the waiting area with the level of satisfactions of the respondents with (r=0.355, p=0.00) (Table 4).

Determinants of Satisfaction Classification Frequency (%) Correlation p-value Remark
Cleanliness of waiting area Very satisfied 19 (9.5%) 0.355 0 Sig
  Satisfied 106 (53.0%)      
  Neutral 50 (25.0%)      
  Dissatisfied 19 (9.5%)      
  Very dissatisfied 6 (3.0%)      
Condition of consulting room (comfort, privacy etc) Very satisfied 41 (20.5%) 0.026 0.712 N/S
  Satisfied 74 (37.0%)      
  Neutral 51 (25.5%)      
  Dissatisfied 12 (6.0%)      
  Very dissatisfied 22 (11%)      

Table 4: Frequency and correlation of work environment as determinants of satisfaction.

From Table 5, there were statistically significant associations between courtesy (F=5.962, p=0.000), technical skills (11.588, p=0.00) and the age of the respondents.

    Sum of squares df Mean square F p-value
Time Between groups 2.301 2 1.15 2.034 0.134
  Within groups 110.835 196 0.565    
Courtesy Between groups 13.46 2 6.73 5.962 0.003
  Within groups 221.224 196 1.129    
Registration Between groups 44.443 2 22.222 15.209 0
  Within groups 281.98 193 1.461    
Processes Between groups 32.857 2 16.428 14.036 0
  Within groups 229.415 196 1.17    
Cleanliness Between groups 22.272 2 11.136 15.737 0
  Within groups 138.693 196 0.708    
Time Before Doctor Between groups 12.833 2 6.417 10.657 0
  Within groups 118.011 196 0.602    
Technical Skills Between groups 21.776 2 10.888 11.858 0
  Within groups 179.973 196 0.918    
Explanations Between groups 5.676 2 2.838 3.215 0.042
  Within groups 173.018 196 0.883    
Consulting Room Between groups 2.907 2 1.453 1 0.37
  Within groups 284.842 196 1.453    
Perception Between groups 0.705 2 0.353 1.41 0.247
  Within groups 49.013 196 0.25    
Reasons Between groups 10.868 2 5.434 3.82 0.024
  Within groups 270.292 190 1.423    
Recommendation Between groups 0.819 2 0.41 3.085 0.048
  Within groups 26.035 196 0.133    
Suggestion Between groups 34.581 2 17.291 12.493 0
  Within groups 260.193 188 1.384    

Table 5: ANOVA distribution of determinants of satisfaction with age of respondents (significant=p<0.05, non-significant=p>0.05).

The descriptive statistics of determinants of satisfaction with age of the respondents were evaluated in and the results showed that the mean and standard deviation of time, courtesy, registration and cleanliness within age group 25-34 years of age were 1.71 ± 0.625, 2.11 ± 0.947, 2.32 ± 1.313 and 2.21 ± 0.733) respectively (Table 6).

Determinant variables Age grp (yrs) N Mean Std. dev Std. error 95% Confidence interval for mean Minimum Maximum
            Lower Upper    
Time 16-24 10 2.1 0.876 0.277 1.47 2.73 1 3
  25-34 121 1.71 0.625 0.057 1.6 1.82 1 3
  34-44 68 1.88 0.923 0.112 1.66 2.11 1 4
Courtesy 16-24 10 2.4 0.966 0.306 1.71 3.09 1 3
  25-34 121 2.11 0.947 0.086 1.94 2.28 1 5
  34-44 68 2.66 1.253 0.152 2.36 2.97 1 5
Registration 16-24 10 3.3 0.483 0.153 2.95 3.65 3 4
  25-34 118 2.32 1.313 0.121 2.08 2.56 1 5
  34-44 68 3.29 1.08 0.131 3.03 3.56 1 5
Processes 16-24 10 3.1 0.876 0.277 2.47 3.73 2 4
  25-34 121 2.45 1.049 0.095 2.27 2.64 1 5
  34-44 68 3.31 1.162 0.141 3.03 3.59 1 5
Cleanliness 16-24 10 2 0 0 2 2 2 2
  25-34 121 2.21 0.733 0.067 2.08 2.35 1 4
  34-44 68 2.9 1.053 0.128 2.64 3.15 1 5
Time before doctor 16-24 10 2.3 0.483 0.153 1.95 2.65 2 3
  25-34 121 1.98 0.841 0.076 1.82 2.13 1 4
  34-44 68 1.49 0.68 0.082 1.32 1.65 1 3
Technical skills 16-24 10 1.6 0.516 0.163 1.23 1.97 1 2
  25-34 121 2.74 0.89 0.081 2.58 2.9 1 5
  34-44 68 2.19 1.11 0.135 1.92 2.46 1 5
Explanations 16-24 10 1.9 0.876 0.277 1.27 2.53 1 3
  25-34 121 2.55 0.856 0.078 2.39 2.7 1 5
  34-44 68 2.29 1.08 0.131 2.03 2.56 1 4
Consulting room 16-24 10 2 0.816 0.258 1.42 2.58 1 3
  25-34 121 2.55 1.231 0.112 2.33 2.78 1 5
  34-44 68 2.47 1.203 0.146 2.18 2.76 1 5
Perception 16-24 10 1.7 0.483 0.153 1.35 2.05 1 2
  25-34 121 1.47 0.501 0.046 1.38 1.56 1 2
  34-44 68 1.56 0.5 0.061 1.44 1.68 1 2
Reasons 16-24 10 2 0 0 2 2 2 2
  25-34 121 2.46 1.096 0.1 2.27 2.66 1 5
  34-44 62 2.89 1.438 0.183 2.52 3.25 1 5
Recommendation 16-24 10 1.4 0.516 0.163 1.03 1.77 1 2
  25-34 121 1.17 0.38 0.035 1.11 1.24 1 2
  34-44 68 1.1 0.306 0.037 1.03 1.18 1 2
Suggestion 16-24 10 2.9 2.183 0.69 1.34 4.46 1 6
  25-34 113 1.96 0.88 0.083 1.79 2.12 1 4
  34-44 68 2.81 1.396 0.169 2.47 3.15 1 6

Table 6: Descriptive statistics of determinants of satisfaction with age of respondents.

There was a statistically significant relationship between the highest level of education of the respondent with sex (MD=0.8346, p=0.002), and there was no statistically significant between pre-registration waiting time and tertiary and secondary levels of education of the respondents (MD=0.72031, p=0.439) and (MD=0.67692, p=0.496) (Table 7).

Variable Education (I) Education (J) Mean difference (I-J) p-value
Age Primary Secondary 0.49231 0.108
  Tertiary 0.83846* 0.002
Sex Primary Secondary 0.01538 0.886
  Tertiary 0 1
Religion Primary Secondary -0.0615 0.97
  Tertiary 0.10 0.92
Tribe Primary Secondary 0.27692 0.693
  Tertiary 0.56154 0.212
Place of residence Primary Secondary -0.3539 0.517
  Tertiary -0.4692 0.302
Occupation Primary Secondary 0.53846 0.842
  Tertiary -0.5692 0.819
Time Primary Secondary 0.36923 0.541
  Tertiary 0.14615 0.905
Courtesy of medical staff Primary Secondary 1.50769* 0.008
  Tertiary 1.52308* 0.006
Pre-registration waiting time Primary Secondary 0.67692 0.496
  Tertiary 0.72031 0.439
Registration processes Primary Secondary 0.83077 0.262
  Tertiary 0.53846 0.556
Cleanliness Of record area Primary Secondary 0.16923 0.914
  Tertiary 0.16923 0.911
Time with doctor Primary Secondary 0 1
  Tertiary -0.3462 0.608
Technical skills Primary Secondary 1.49231* 0.004
  Tertiary 1.26923* 0.015
Explanations on investigation Primary Secondary 0.21538 0.877
  Tertiary 0.15385 0.933
Time with sonographer Primary Secondary -0.3539 0.741
  Tertiary -0.1846 0.919
Condition of consulting room Primary Secondary -0.1846 0.94
  Tertiary 0.24615 0.893
Perception on time spent Primary Secondary -0.0462 0.978
  Tertiary 0.16154 0.753
Possible reasons Primary Secondary -0.8308 0.296
  Tertiary -0.4231 0.719
Recommendations Primary Secondary 0.36923 0.069
  Tertiary 0.18462 0.494
Suggestion Primary Secondary 0.75385 0.389
  Tertiary 0.99508 0.184

Table 7: Multiplecomparisons on education and age with respect to satisfaction.

The overall correlations of all the indices of patient ’ s satisfaction were illustrated by scatter plots diagrams (Figure 1).

obstetrics-determinants

Figure 1: Scatter plot showing correlation of the determinants variables with satisfaction.

Discussion

The importance of quality of healthcare delivery has drawn global attention and as such, healthcare providers are continuously updating their knowledge to meet the ever-rising challenges of patient’s management [1]. In every setting, good patients care is the pivot on which healthcare policies revolve, therefore, patients care is the primary responsibility of every hospital making patient’s satisfaction a topmost concern [1].

This study provides information on the level of patient ’ s satisfaction with obstetric sonography in Port Harcourt, Rivers State Nigeria. The relationships between age, educational status of the respondents and their levels of satisfaction were also evaluated in this study.

In this study, majority of the respondents were Christians. This is not in agreement with a similar study conducted by Ugwu et al. which assessed the views and expectations of pregnant women concerning prenatal sonogram as well as their level of awareness of its purpose, limitations, and safety in a predominately Moslem society [11]. In their study, greater numbers of the participants were Moslems. This discrepancy could be attributed to the geographic variations of our studies.

Different determinants of satisfaction were investigated in this study and the result showed that the overall level of patient satisfaction with obstetric scan in this study was very high above 60%. Although some of the respondents remained neutral to some of the questions on the level of their satisfaction. This high level of patient’s satisfaction recorded in this study was basically due to the high level of professionalism, technical expertise, and service delivery in the facility. This finding is in keeping with related studies conducted by Ugwu et al. [6], Udoh et al. [14], and Zira [15]. Ugwu et al. in their study reported average satisfaction ratings above 50% for all the determinants of satisfaction with exception of perceptions of the time between arrival and departure [6]. In their study, they also recommended that good staff-patient interaction and proper organizational behavior would improve satisfaction rating. In Udoh et al. study conducted to compare the quality of services between government and missionary hospital in Southeastern Nigeria among 700 pregnant mothers who had obstetric sonography at least twice in both missionary and government hospitals reported moderately satisfaction with the services rendered in Missionary hospital but moderately dissatisfaction with the services in the government hospital [14].

The differences in some aspect of Udoh et al. finding could be attributed to the differences in the scope of our studies and the sample sizes studied [14]. Moderately dissatisfaction of services rendered in Government hospital could be ascribed to the high level of the nonchalant attitude of staff in government hospitals when compared to private diagnostic centers/hospitals like the case of this study. In Zira study which evaluated pregnant women’s perception of care and satisfaction during and after obstetrics ultrasound in Bauchi State Nigeria, reported a high level of patients satisfaction of 97.2% (n=68) [15].

Although evidence also finds that the use of ultrasound technology is related with mothers feeling or security and satisfaction with care; healthcare organizations are callous to promote these feelings of patient satisfaction especially when clinical risk is considered low. Contrary to the finding of this study and some reviewed literature, Rici et al. evaluated the impact of ultrasound use on satisfaction during pregnancy among women in Northeast Nigeria and their findings suggested that ultrasound scan use is not an important driver of satisfaction with pregnancy-related care [16]. They attributed this to the fact that efforts to improve patient satisfaction during pregnancy using ultrasound may increase resource use and cost, but do little to improve patients overall experience [16].

The age group of respondents was between 16 to 44 years with a mean and standard deviation of 32.50 ± 3.90 years. The age parameters documented in this study were similar to that of other related previous studies conducted by Ugwu et al. in a study they evaluated the awareness of information, expectations, and experiences of pregnant women coming for obstetric sonography in Anambra State of Nigeria [17]. They recruited, 110 pregnant women with a mean age of 30.5 ± 145 years and Zira who reported age group of respondents in his study to be between 15 to 44 years [15]. In this study, the majority of the indices used as determinants of satisfaction were statistically significantly correlated with a socio-demographic variable such as age. This is inconsistent with the finding of a similar study conducted by Zira in Bauchi State Nigeria [15]. He reported that there was no statistically significant relationship between the patients socio-demographic and their level of satisfaction. The discrepancies in our results could be attributed to the geographical variations and the sample size studied.

With regard to the assessment of the relationship between the educational levels of the respondents and their level of satisfaction with obstetric scans in Port Harcourt, majority of the determinants of satisfaction showed statistically significant correlation with the respondent’s educational level. This is also in keeping with the findings of a related study conducted by Ugwu et al [11]. In Ugwu et al. study, they reported the small percentage of the respondent with no formal form of Western or Islamic educational background (24.7%), which according to them, the educational background of the respondents could have a great influence on their perceptions of satisfaction during obstetric scans [11].

The major limitation encountered in this study was the neutrality of some of the respondents to some questions on their levels of satisfaction.

Conclusion

There was a high level of patient satisfaction with obstetric ultrasound in the Radiology department of Image Diagnostic Center, Port Harcourt Nigeria. Christian’s preponderance was noted and Civil servants constitute the highest number of the participants.

Greater numbers of the determinants of satisfaction showed statistically significant correlation and relationship with age and educational levels of the respondents respectively.

References

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