DISCUSSION
The present study evaluated the different effects of practicing Continuous primary nursing care and task-centered nursing care on satisfaction with
nursing care and early postpartum problems for hospitalized pregnant women.
The results demonstrated that compared to the task-centered nursing care group, hospitalized pregnant women in the Continuous primary nursing care group had
significantly increased satisfaction with nursing care and breastfeeding and significantly reduced postpartum health problems.
We believe that the advantages of Continuous primary nursing care are continuous, coherent, patient-centered, holistic nursing and individualized care for pregnant women and new mothers.
It was these advantages that led to higher satisfaction with nursing care for hospitalized pregnant women in the present study.
The higher satisfaction with nursing care promoted good interpersonal relationships and cooperation between the primary nurse and hospitalized pregnant women.
This enhanced cooperation then increased the new mothers’ knowledge and skill in breastfeeding and reduced their postpartum urinary retention and breast discomfort.
These therapeutic effects in turn reduced hospitalized days significantly for the patients in the Continuous primary nursing care group compared to those in the task-centered nursing care group.
Since the concept of primary nursing care was first introduced by Manthey, Ciske, Robertson, and Harris (1970), researchers have found multiple benefits of primary nursing care, including higher quality of nursing care and greater
patients’ satisfaction (Johansson et al., 2002).
We think that patients’ satisfaction with nursing care is related to several factors, including the interaction and interpersonal relationship between patients and nurses, continuous individualized care, and nurses’ competence and communication.
Interpersonal relationships are the most important among these basic factors that contribute to patients’ satisfaction (Can, Akin, Aydiner, Ozdilli, & Durna, 2008). This was really the case in the present study.
We noticed that practicing Continuous primary nursing care significantly enhanced interrelationships between the primary nurse and hospitalized pregnant women continuously, which in turn contributed to hospitalized pregnant women’s satisfaction with nursing care. Practicing Continuous primary nursing care also granted opportunities for the primary nurse to educate hospitalized pregnant women individually and
allowed for much more time for primary nurses to provide high quality nursing care to hospitalized pregnant women and their babies.
Another recent study reported that the higher level of satisfaction was attributed to more time that nurses spent with
patients (Keleher et al., 2009).
The findings in the present study are consistent with a large body of literature
documenting benefits of the primary nursing model (Johansson et al., 2002).
It is important to mention that the difference between the Continuous primary nursing care model and the primary nursing care model is that the Continuous primary nursing care model has gone beyond the primary nursing care model by extending the continuous individualized nursing care by a primary nurse to pregnant women to a period of eight weeks before admission to hospital, the hospitalization period,
and two weeks after discharge from the hospital.
Future research should further compare the therapeutic effects of practicing Continuous primary nursing care and primary nursing care models.
Recent studies have shown that the nurses’ home visitation to new mothers and babies and new mothers’ breastfeeding knowledge can positively influence breastfeeding outcomes (Lewallen et al.,2006).
The present study indicated that by using the Continuous primary nursing care approach, primary nurses enhanced new mothers’ knowledge, compliance, and advanced skills for breastfeeding during their hospitalization and even after their discharge.
These practices contributed to high breastfeeding rates and reduced breast discomfort and disorders in the end.
A recent study showed that postpartum problems can deteriorate new mothers’ quality of life, their future health, and their children’s health (Cheng & Li, 2008).
One of the major postpartum problems is urinary retention, which is common with an occurrence of about 14% (Wang,
2007).
The results of the present study showed that the rate of new mothers’ postpartum urinary retention was 0.87% in the Continuous primary nursing care group, whereas the rate was 6.25% in the task-centered nursing care group.
We believe that the significantly lower rate of new mothers’ postpartum urinary retention in the Continuous primary nursing care group was mainly attributed to the use of a variety of preventive strategies that were performed by the primary nurse. These strategies
included helping patients to stand and walk, assisting them into a warm bath, and practicing traditional Chinese medicine such as acupuncture and acupressure.
The primary nurse in the Continuous primary nursing care group certainly played a key role in providing the continuous assistance to new mothers to practice these preventive strategies.
DISCUSSIONThe present study evaluated the different effects of practicing Continuous primary nursing care and task-centered nursing care on satisfaction withnursing care and early postpartum problems for hospitalized pregnant women. The results demonstrated that compared to the task-centered nursing care group, hospitalized pregnant women in the Continuous primary nursing care group had significantly increased satisfaction with nursing care and breastfeeding and significantly reduced postpartum health problems. We believe that the advantages of Continuous primary nursing care are continuous, coherent, patient-centered, holistic nursing and individualized care for pregnant women and new mothers. It was these advantages that led to higher satisfaction with nursing care for hospitalized pregnant women in the present study. The higher satisfaction with nursing care promoted good interpersonal relationships and cooperation between the primary nurse and hospitalized pregnant women. This enhanced cooperation then increased the new mothers’ knowledge and skill in breastfeeding and reduced their postpartum urinary retention and breast discomfort. These therapeutic effects in turn reduced hospitalized days significantly for the patients in the Continuous primary nursing care group compared to those in the task-centered nursing care group.Since the concept of primary nursing care was first introduced by Manthey, Ciske, Robertson, and Harris (1970), researchers have found multiple benefits of primary nursing care, including higher quality of nursing care and greaterpatients’ satisfaction (Johansson et al., 2002).We think that patients’ satisfaction with nursing care is related to several factors, including the interaction and interpersonal relationship between patients and nurses, continuous individualized care, and nurses’ competence and communication.Interpersonal relationships are the most important among these basic factors that contribute to patients’ satisfaction (Can, Akin, Aydiner, Ozdilli, & Durna, 2008). This was really the case in the present study.We noticed that practicing Continuous primary nursing care significantly enhanced interrelationships between the primary nurse and hospitalized pregnant women continuously, which in turn contributed to hospitalized pregnant women’s satisfaction with nursing care. Practicing Continuous primary nursing care also granted opportunities for the primary nurse to educate hospitalized pregnant women individually andallowed for much more time for primary nurses to provide high quality nursing care to hospitalized pregnant women and their babies. Another recent study reported that the higher level of satisfaction was attributed to more time that nurses spent withpatients (Keleher et al., 2009). The findings in the present study are consistent with a large body of literaturedocumenting benefits of the primary nursing model (Johansson et al., 2002). It is important to mention that the difference between the Continuous primary nursing care model and the primary nursing care model is that the Continuous primary nursing care model has gone beyond the primary nursing care model by extending the continuous individualized nursing care by a primary nurse to pregnant women to a period of eight weeks before admission to hospital, the hospitalization period,and two weeks after discharge from the hospital.Future research should further compare the therapeutic effects of practicing Continuous primary nursing care and primary nursing care models.Recent studies have shown that the nurses’ home visitation to new mothers and babies and new mothers’ breastfeeding knowledge can positively influence breastfeeding outcomes (Lewallen et al.,2006). The present study indicated that by using the Continuous primary nursing care approach, primary nurses enhanced new mothers’ knowledge, compliance, and advanced skills for breastfeeding during their hospitalization and even after their discharge. These practices contributed to high breastfeeding rates and reduced breast discomfort and disorders in the end.A recent study showed that postpartum problems can deteriorate new mothers’ quality of life, their future health, and their children’s health (Cheng & Li, 2008). One of the major postpartum problems is urinary retention, which is common with an occurrence of about 14% (Wang,2007). The results of the present study showed that the rate of new mothers’ postpartum urinary retention was 0.87% in the Continuous primary nursing care group, whereas the rate was 6.25% in the task-centered nursing care group.We believe that the significantly lower rate of new mothers’ postpartum urinary retention in the Continuous primary nursing care group was mainly attributed to the use of a variety of preventive strategies that were performed by the primary nurse. These strategiesincluded helping patients to stand and walk, assisting them into a warm bath, and practicing traditional Chinese medicine such as acupuncture and acupressure. The primary nurse in the Continuous primary nursing care group certainly played a key role in providing the continuous assistance to new mothers to practice these preventive strategies.
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