Maternal Perception and Decision-Making Factors towards Exchange Blood Transfusion in the University of Port Harcourt Teaching Hospital, Rivers State
Ikukaiwe Juliet Nkechi *
School of Post Basic Paediatrics Nursing Studies, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Harry Patricia. G.N.
School of Post Basic Paediatrics Nursing Studies, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: The success of life-saving interventions in neonatal emergencies often depends on maternal perception and consent, particularly when procedures such as exchange blood transfusion are required to treat conditions like neonatal sepsis and severe anaemia. This study was designed to examine how maternal perception and decision-making factors influence the willingness of mothers to consent to exchange blood transfusion for their neonates at the University of Port Harcourt Teaching Hospital.
Methods: A cross-sectional survey design was adopted, involving a population of 150 mothers whose babies were admitted into the Special Care Baby Unit of University of Port Harcourt Teaching Hospital. Data were collected using a validated questionnaire, with Cronbach’s alpha coefficients of 0.81, 0.84, and 0.86 for perception, decision-making, and willingness scales, respectively. Data obtained were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression.
Results: The findings showed that perception-related misconceptions such as fear of death (χ² = 21.06, p < .001), belief that EBT is harmful (χ² = 20.01, p < .001), and spiritual interpretations (χ² = 9.57, p = .008) significantly reduced maternal willingness to consent. Regression analysis revealed that mothers who believed EBT could kill the baby were 22.81 times less likely to give consent (OR = 22.81, p < .001), while fear of fatal outcomes (OR = 17.64, p = .001) and metaphysical beliefs (OR = 10.83, p = .003) were also strong deterrents. Decision-making factors such as religious opposition (χ² = 22.77, p < .001), cultural beliefs (χ² = 17.96, p < .001), and lack of information (χ² = 39.04, p < .001) significantly influenced maternal consent. Mothers who had cost-related for concerns EBT procedure were 10.75 times more likely to approve (OR = 10.75, p < .017). Additionally, education level had a strong effect: mothers with tertiary education were 17.61 times more likely to consent than those with primary education (OR = 17.61, p < .001).
Conclusion: Maternal willingness is shaped by a complex interaction of cognitive, cultural, spiritual, and experiential factors. We recommend that healthcare providers should intensify efforts on antenatal health education, increase engagement with religious and community leaders to create awareness through campaigns, establish peer-support platforms for the mothers, subsidizing EBT costs, and training healthcare providers on culturally sensitive communication strategies.
Keywords: Maternal perception, decision-making, exchange blood transfusion, UPTH, Rivers State