RELATIONAL COMMUNICATION BEHAVIOUR IN GROUP PRENATAL CARE CLINICS IN IBADAN, NIGERIA

Abstract

Relational communication behaviour in group prenatal care explores the relational interaction between caregivers and pregnant women. Existing studies on group prenatal care in Nigeria have focused on evolving antenatal practices, with little attention paid to the implication of systemic issues for relational communication in the Nigeria group care programme. Therefore, this study was designed to investigate the dynamics of systemic issues in the prenatal care clinics in Ibadan, Nigeria. This was with a view to determining the influence of systemic issues on how pregnant women, nursing mothers and care providers perceived the care quality. Attribution, Systems and Communication Accommodation theories were used as the framework, while the mixed methods design was employed. Eight group prenatal clinics were purposively selected (Jericho Nursing Home, Jericho Specialist, Ring Road Specialist, Maternal and Child Health Apata, Our Lady of Apostles Oluyoro, St. Peters Aremo, Moniya General and Adeoyo Teaching Hospitals). Group prenatal care questionnaire was administered to 355 available pregnant women from June to October, 2018 across the selected hospitals. In-depth interviews were conducted with eight group care nurses, while four sessions of focus group discussion with eight respondents per group, were held across four randomly selected hospitals. Through a 20-item observational checklist, pregnant women and nurses’ verbal and non-verbal behaviours were observed for five months across the sampled hospitals. Quantitative data were analysed using ANOVA at 0.05 level of significance, while qualitative data were content-analysed. Pregnant women at Adeoyo Hospital reported a statistically significant difference [F(3;256) =7.48] in nurses’ rapport, listening [F(3;256)=8.84], informing [F(3;256)=10.38] and feedback skills F(3;254)=2.87]. Conversely, there was no significant difference in nurses’ confirming/disconfirming behaviours at Adeoyo. The Chief Medical Director (CMD) of St. Peters Hospital Aremo noted the hospital’ s location within a cemetery made pregnant women avoid it. Nursing mothers at St. Peters Aremo disagreed with the CMD’ s claims, stressing that their manageable group size contributed to the good relational care. The absence of a feedback checking mechanism in seven of the eight hospitals explains why interviewed caregivers could not determine how feedback modified the conduct of prenatal care. Differences in the administration of prenatal care across the hospitals were based on group size, care provider and situational factors. Rapport building, listening, confirming (acknowledgement and supportive responses), disconfirming (side-talk, conversational dominance and one-sided laughter) and feedback skills were the index of relational communication behaviours. The unmanageable sizes of groups of pregnant women at three hospitals accounted for their inattentiveness and side talk. Providers’ conversational dominance was, however, common across the hospitals. Nursing mothers at two of the hospitals attested to the disconfirming behaviours of nurses. Prevalent systemic issues weakened existing relational communication between care receivers and the nurses in prenatal care clinics in Ibadan, Nigeria.