Knowledge On Discharge Information Among Patients With Hypertensive Disorders In Pregnancy At Muhimbili National Hospital

Abstract

Background: Adequate knowledge on the discharge information is one of the key elements in improving the quality of care and health outcomes. Hypertensive disorders in pregnancy (HDP) are one of the leading causes of the persistently high maternal mortality ratio in Tanzania. Assessment of the knowledge on discharge information given to patients with hypertensive disorders in pregnancy will help analyze the practice, recognize gaps and pave areas for improvement which will subsequently improve the quality of maternal health. Methodology: An analytical cross-sectional study was carried out at Muhimbili National Hospital from September to November 2020. Exit face-to-face interviews were conducted among 422 women with Hypertensive disorders in pregnancy who were conveniently recruited during discharge. We used a Swahili translated structured questionnaire adopted from World Health Organization (WHO), California Medical Quality Care Collaborative tool kit (CMQCC), and previous studies. The questionnaire consisted of 30 questions divided into 5 parts: Social demographic and obstetric characteristics, postpartum danger signs, diagnosis, medication, and follow-up plan. A composite score was used to group the knowledge level. One with at least a half or more of the maximum score in each domain were defined as adequate knowledge. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) version 23.0. Descriptive statistics such as frequency and means were used to summarize and describe obtained data. A chi-square test was used to determine association between the social demographic and obstetric factors with knowledge on discharge information. Logistic regression was used to determine which factors strongly affect the knowledge on discharge information. The results were expressed as the Odds Ratio (OR), with statistically significant level at p<0.05 and 95% Confidence Interval (CI). Results: Seventy-three percent of women with HDP had adequate knowledge on the discharge information. In each domain, 79% of women had adequate knowledge on postpartum danger signs, 77% in diagnosis, 87% in prescribed medications and 92% in follow up plan. Women who were married, employed, with higher level of education, booked ANC at an early vi gestational age of less than four months and had more than four ANC visits were more likely to have adequate knowledge on discharge information. Conclusion: Most women with hypertensive disorders in pregnancy had an adequate knowledge on their discharge information. As observed from our study, most women were in the younger age group and primiparous, greater emphasis and a more tailored education must be given to these women due to high rate of recurrence of this condition in subsequent pregnancies.