Anxiety Experience and Preoperative Nursing Care Evaluation Among Postoperative Emergency Caesarian Section Patients in Two Selected Hospitals, Nairobi, Kenya

Emergency caesarean section poses obstetric, anesthetic and surgical risks to the mother and the unborn baby and exacerbates anxiety which is deleterious. Preoperative nursing care rendered during this period greatly influence patient's care perception, a concept underpinned in this study. Patients' pre- and postoperative anxiety levels and demographics informed by literature reviewed were evaluated. Demographics included age, the level of education, mode of hospital bill payment, history of major illness, previous surgeries, current medication, smoking and the condition of the newborn. A descriptive cross-sectional survey was conducted in a private and a public hospital among patients undergoing emergency caesarean section. Sixty participants were purposively and systematically sampled from the postnatal ward admission registers using inclusion criteria. A structured questionnaire was used to assess participants' demographics and care satisfaction. Anxiety levels were evaluated using Form Y-6. Ethical approval was obtained from the respective ethical review boards. Multivariate nonparametric statistical analyses using Statistical Package for Social Sciences (SPSS) version 17 computer software was used to analyze data alongside descriptive statistics. Significant finding observed regarding demographics were on the level of education and mode of hospital hill payment. The highest level of education attained was tertiary 22(73.3%) in private compared to secondary level 14 (46.7%) in the public hospital. The mode of hospital bill payment was through companies' medical schemes 24(80%) in private hospital and through National Health Insurance Fund (NHIF) 22(73.3%) in public. Mann-Whitney U test showed statistically significant differences in only two out of the six anxiety defining statements assessed postoperatively. Participants at the public hospital felt calmer (z=-2.071, p=0.038<0.05) and more relaxed (z=-2.85, p=0.004<0.05) than those at the private hospital. Wilcoxon rank test yielded significant results for only one out of the six care satisfaction defining statements. Participants at the public hospital were more satisfied with the information given by the nurse about what is expected before and after surgery (z=-2.61, p=0.009<0.05) compared to private. This study evidences nurses' ability to render satisfactory care to patients in emergency situations regardless of socio-patients' demographic profile and type of hospital. There is need to initiate and sustain such care surveillance for quality auditing.