CHAPTER FOUR
PRESENTATION, ANALYSIS AND INTERPRETATION OF FINDINGS
4.0 Introduction
The study looked at s factors associated with the recommendation of lactation amenorrhea: a case study of nurses in mulago national referral hospital. This chapter on addition lays out the analysis and interpretation of study findings as per the formulated objectives in the previous chapter of this report. This was done with the aid of computer packages SPSS and Ms Excel where by data was presented in tables, graphs and charts.
It specifically presents the background information of respondents, the socio-economic factors associated with the recommendation of lactation amenorrhea by nurses to understand the demographic factors associated with the recommendation of lactation amenorrhea among mothers and to understand the intermediate factors associated with the recommendation of lactation amenorrhea among mothers in Mulago National Referral Hospital.
4.1 Background information of the respondents
In order to enrich the quality of the report in analysis, the background information of respondents was taken note of and variables such as; gender, age and marital status were considered in the study as looked at below;
4.1.1 Gender of respondents
The study findings first and foremost, females were more than males as presented in table 1 below.
Table 2 Gender of Respondents
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Male | 11 | 18.6 | 18.6 | 18.6 |
| Female | 48 | 81.4 | 81.4 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data.
From the findings of the study, it was revealed that majority (81.4%) of the respondents were females while the rest (18.6%) were males. This implies that most of the nursing section in Mulago national referralHospital is dominated by women.
4.1.2 Age range of respondents in years
The study also explored the age ranges of respondents and four age ranges were established namely; below 20-29 Yrs, 30-39 Yrs, 40-49 Yrs and 50 Yrs and above years as presented in table 4.2 below.
Table 3 Shows Age bracket of respondents
| Frequency | Percentage | Valid Percent | Cumulative Percent | ||
| Valid | 20-29 Yrs | 24 | 40.7 | 40.7 | 40.7 |
| 30-39 Yrs | 30 | 50.8 | 50.8 | 91.5 | |
| 40-49 Yrs | 4 | 6.8 | 6.8 | 98.3 | |
| 50 Yrs and above | 1 | 1.7 | 1.7 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
Table 2 results showed that 40% of respondents were 20-29 years and these were found to be majorly students doing their practical placement at Mulago National Referral Hospital. It is also showed that 50% of respondents were between 30-39 years and these were also newly enrolled nurses, 6.8% were 40-49 year who were majorly senior nurses while 1.7% was above 50 years. This implies the study collected information from well trained professionals who could respond factually.
4.1.3 Marital status of the respondent
Marital status of respondents was another variable explored and the respondents were; married single and others widowed as looked at below;
Figure 1: Marital status of the respondent
Source Primary data
From the figure 1 above, it was found out that the majority of study respondents were single and this comprised 65.6% of total respondents. The study further established that this group of nurses was basically student nurses doing their practice at the hospital 29.5% were married and these were basically senior nurses while only 3.3% of the nurses were widowed. This implies that most of the nurses were single since a significant number of them were still students.
4.1.4 Religious background of respondents.
The study was also interested in finding out the religious background of respondents and these were categorized into Catholic, Anglican, Muslim, and other religions as presented in the table below;.
Figure 2 Shows religion of respondents
Source Primary data
The results from the figure above show that majority of respondents 47.5% were from other religions like the born again faith, Seventh Day Adventists, orthodox Christians. While on the other hand 29.9% were Anglicans, 18% were Catholics while 3.3 were Muslims. This implies that the study got responses from different religious backgrounds.
4.1.5 Highest level of education a attained by respondents
The study background characteristic of respondents looked at the level of education attained by respondents and this was at the establishing whether education level had a connection with LAM recommendation.
Figure 3 Showing education level of respondents
Source Primary data
From the figure 3 above indicated that most (37.3%) of the respondents were still students doing their practice with in the hospital, (13.6%) were certificate holders, (33.9%) were diploma holders while 15.3% were degree holders. This implies that the study was carried out among literate respondents who could read and understand all the questions asked in the questionnaire.
4.1.5 Period spent in service
It was put to respondents to reveal the period spent working at Mulago National referral hospital and ranges were less than 1 year, 6-10 years and 11 and above years.
Table 4 Years of Service
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Les than a yr | 26 | 44.1 | 44.1 | 44.1 |
| 1-5yrs | 7 | 11.9 | 11.9 | 55.9 | |
| 6-10 Yrs | 15 | 25.4 | 25.4 | 81.4 | |
| 11 and above Years | 11 | 18.6 | 18.6 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
From the table 6 above, it is revealed that majority (44.1%) of respondents had worked at Mulago National Referral Hospital for less than a year and these were basically students ,(11.9%) had worked for 1-5 Yrs , and this category of respondents were newly enrolled nurses while 25.4% had worked for 6-10 and 18.6% had worked for 11 and above years at Mulago National referral hospital and this category comprised of senior nurses who were well experienced.
4.2 Factors associated with the recommendation of lactation amenorrhea by nurses in Mulago National referral hospital
According to the interview carried out with two senior nurses, they described Lactation amenorrhea as the temporary postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding.
Table 5 Whether Mothers Education Level influences nurses Recommendation of LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 27 | 45.8 | 45.8 | 45.8 |
| No | 32 | 54.2 | 54.2 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The findings in the table above revealed that majority (54.2%) of respondents disagreed that they don’t consider mothers education level while recommending for LAM while minority (45.8%) suggested that they consider the mothers education. This implies that most nurses don’t pay attention to the mother’s education when recommending LAM.
“Most nurses argued that mothers education level does not determine whether they should breast feed or not therefore they didn’t consider mother education as a determinant factor to recommend LAM”
Table 6 Whether Mothers religion influences nurses Recommendation of LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 5 | 8.5 | 8.5 | 8.5 |
| No | 54 | 91.5 | 91.5 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The results from the study showed that most nurses (91.5%) said that mother’s religion does not influence their decision to recommend LAM while minority 8.5% said it does. This implies that nurses did not consider the mothers religion in order to recommend LAM.
“The reason most nurses were not considering mothers religion was that there is no religion the discourages breast feeding therefore a mothers religious background could not influence their uptake of LAM if recommended by the nurse”.
Table 7 Whether nurses had attended any trainings on LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 56 | 94.9 | 94.9 | 94.9 |
| No | 3 | 5.1 | 5.1 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
It was revealed from the table above that majority of respondents 94.9% suggested that they had attended training regarding the use of LAM while minority 5.1% suggested that they had never been trained in the application of LAM as a family planning measure. This implies that most nurses were well trained and had the necessary knowledge and skills to recommend the use of LAM by many mothers.
Table 8 How nurses benefit from the trainings of recommending LAM to mothers.
| Response | Frequency | Percentage |
| Acquired Knowledge about LAM | 2 | 3.4 |
| Got the skills necessary to recommend LAM to a mother | 4 | 6.8 |
| Changed my attitude towards the method | 12 | 20.3 |
| All the above | 41 | 73.2 |
| Total | 59 | 100 |
Source Primary data
The findings from table 7 above indicate that most 73.2 of the respondents agreed that the training they received benefited them by giving them enough knowledge about LAM, skills and it also changed their attitude about the family planning method. This implies that the training nurses receives helps them to advise mother on how to utilize LAM as a family planning method
Table 9 Frequency nurses have attended LAM training
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Once in 4 Months | 38 | 64.4 | 64.4 | 64.4 |
| Twice in 4 months | 10 | 16.9 | 16.9 | 81.4 | |
| Three times and more in 4 Months | 11 | 18.6 | 18.6 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
According to the findings in the table above, majority 64.4% of the respondents said that they had attended LAM training once in 4 Months, 16.9% had attended LAM training twice in 4 months for while 18.6% had attended three times and more in 4 Months. This implies that majority of the respondents do not regularly attend LAM training the is carried out every month with in the hospital.
Figure 4 Frequency nurses have attended LAM training
Source Primary data
According to the findings in the table above, majority 64.4% of the respondents said that they had attended LAM training once in 4 Months, 16.9% had attended Lam training twice in 4 months for while 18.6% had attended three times and more in 4 Months. This implies that majority of the respondents do not regularly attend LAM training that is carried out every quarter with in the hospital.
Table 10: Whether nurses had recommended LAM basing on the training acquired
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 11 | 18.6 | 18.6 | 18.6 |
| No | 48 | 81.4 | 81.4 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The results in the study show that majority of respondents 81.4% said that they don’t recommend the use of LAM to mothers basing on the training acquired while minority 18.6% said that they follow the training received. This implied that most nurses do not use the training they received while recommending the use of LAM to mothers.
4.3 The demographic factors associated with the recommendation of lactation amenorrhea by nurses
Table 11 Whether nurses had considered the mothers age when recommending LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 6 | 10.2 | 10.2 | 10.2 |
| No | 53 | 89.8 | 89.8 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The study revealed that majority of respondents (89.8%) suggested that they don’t consider the mothers age while recommending them for LAM while minority 10.2% said that they do consider the mothers age. This implied that the mothers’ age does not matter when nurses are recommending LAM to mothers. This further shows the poor practices nurses had towards recommending LAM as a family planning method to mothers,
However according to 10.2% who were basically senior nurses, revealed that mother’s age greatly matters when recommending the use of LAM. This according to them was that age is the strongest predictor of ovarian reserve. Reproductive success diminishes exponentially with advancing maternal age therefore nurses should consider maternal age when recommending the use of LAM.
Table 12 Whether nurses had considered the mothers marital status when recommending LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 4 | 6.8 | 6.8 | 6.8 |
| No | 55 | 93.2 | 93.2 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The results in the table above showed majority of respondents (93.2%) suggested that they don’t consider the mothers marital status while recommending them for LAM while minority 6.8% suggested that they do consider marital status. This implies that most nurses were not considering mothers marital status when recommending LAM.
However according to the interviews with some senior nurses, they revealed that marital status has to be considered while recommending LAM. This was because there is a possibility for married mothers to have regular sexual intercourse than the ones who are not married. There for its considered poor practice if consider marital status is not put in consideration when nurses are recommending LAM.
Table 13: Whether nurses had considered the mothers parity when recommending LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 10 | 16.9 | 16.9 | 16.9 |
| No | 49 | 83.1 | 83.1 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The results of the study revealed that majority of respondents 83.1% don’t consider the mothers parity when recommending LAM while minority 16.9% said they consider parity. This implies that nurses don’t take into account the mothers’ parity when recommending LAM to the mothers.
However while in an interview with a small number of nurses, they suggested that “mothers parity should be considered by nurses while recommending the use of LAM to mothers. Where by this method should be emphasized to those mothers with many un spaced children”
4.4 The intermediate factors associated with the recommendation of lactation amenorrhea by nurses.
Table 14 Whether nurses had considered the mothers culture when recommending LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 5 | 8.5 | 8.5 | 8.5 |
| No | 54 | 91.5 | 91.5 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The results of the study showed that majority of respondents 91.5% showed that nurses do not consider mothers’ culture when recommending the two used LAM while minority 8.5% suggested that they don’t consider the culture. This implies that most nurses did not pay attention to mothers’ culture when recommending LAM to mothers.
According to the interviews carried out with some senior nurses, they agreed that culture is sometimes very influential in determining the uptake of LAM by mothers with recommendation from nurses.
Table 15: Whether mothers report side effects associated with LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 35 | 59.3 | 59.3 | 59.3 |
| No | 24 | 40.7 | 40.7 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The results in the figure above show that majority of respondents 59.3% agreed that mothers have reported side effects associated with LAM whereas minority 40.7% disagreed that mothers had never reported to them any side effects as result of using LAM as a family planning method. This implied that most mother who use LAM get side effects.
However in an interview with some nurse, they suggested that method does not cause any side effects to the mother or the baby and mothers have never reported to them any side effects as a result of LAM.
Table 16 Whether nurses had considered the mothers job when recommending LAM
| Frequency | Percent | Valid Percent | Cumulative Percent | ||
| Valid | Yes | 12 | 20.3 | 20.3 | 20.3 |
| No | 47 | 79.7 | 79.7 | 100.0 | |
| Total | 59 | 100.0 | 100.0 | ||
Source Primary data
The results of the study revealed that majority 79.7% of respondents don’t consider the mothers job when recommending LAM while 20.3% said that they consider the mothers job. This implies that most nurses did not take in account the occupation of mothers when recommending LAM.
It was revealed in the interview by some nurses that a mothers occupation has to be considered while recommending LAM. Some mothers have very demanding jobs that they can’t keep up with exclusive breast feeding while some jobs can allow for exclusive breast feeding. Therefore LAM should be recommended to those mothers who can afford to exclusively breast feed and those who can’t should try other methods.
Figure 6: Whether nurses had recommended LAM a mother in the past three months
Source Primary data
It was also revealed that most of the respondents 84.7% said that they had never recommended LAM to a mother I the past three months while minority 15.3% said they had ever recommended. This implies that nurses in Mulago National Referral Hospital rarely recommend the use of LAM to mother.
