# Families' Perception of Cognitive and Emotional Support From Healthcare Professionals Across the Maternal and Newborn Care Continuum

## TL;DR

This study shows that families in Ghana feel healthcare professionals provide inadequate emotional and cognitive support during maternal and newborn care, especially for high-risk pregnancies and sick newborns.

## Contribution

The study reveals that emotional support is significantly lower than cognitive support and highlights the need for improved communication and inclusion of all family members in care.

## Key findings

- Families rated overall support from healthcare professionals as deficient, with emotional support lower than cognitive support.
- Older family members and males felt excluded from care decisions and information.
- Families requested integration of alternative medicine and spirituality into care plans.

## Abstract

During the perinatal period, women and newborns require high‐quality supportive care. While cognitive and emotional care support is central to family systems care, few quantitative studies have explored this in sub‐Saharan Africa.

We investigated families' perspectives on the support provided by healthcare professionals during maternal and newborn care, examining the impact of family demographics on their perceived support and identifying unmet support needs.

This cross‐sectional survey was conducted in the Hohoe Municipality, Ghana. Participants included high‐risk pregnant, birthing and postnatal women, mothers with small/sick newborns and their family members. Family support was assessed using the Icelandic Family Perceived Support Questionnaire (5‐point Likert; scores: cognitive 5–25, emotional 9–45, overall 14–70). Descriptive and inferential statistics were conducted with STATA. Analysis of open‐ended text elements was done in two cycles, employing open coding and thematic categorisation via NVIVO software.

Participants (N = 442) perceived their overall support from healthcare professionals, covering antenatal, labour, neonatal intensive care, postnatal and community‐based primary care, as deficient (mean 45.3 ± 14.2). Emotional support (mean 16.6 ± 5.9) was rated lower than cognitive support (mean 28.6 ± 10.1). The highest rating was assigned to the item regarding taking respite (mean 4.0 ± 1.6). The item on family encouragement to narrate their illness experience, family strength and resilience received the lowest rating (mean 2.5 ± 1.8). Older family members and males felt excluded from care. Families requested consideration of their preferences, such as integrating alternative medicine and spirituality into care plans.

Cognitive support throughout the care continuum was perceived as average and emotional support was even lower. Family systems care guidelines and skills training are needed to strengthen healthcare professionals' communication skills to provide psychologically and emotionally safe support along the perinatal care continuum.

Family meetings that address previous experiences, provide details regarding illnesses and outline care plans can improve family participation and resilience.

What is known about the topic
○In high‐risk pregnancies or when caring for small and sick newborns, families require strong supportive care, including cognitive and emotional care.○Perinatal care is often hindered by disrespect and the exclusion of family members from care decisions.○Through family systems care, healthcare professionals can provide cognitive and emotional support to families throughout the perinatal period.
What this paper adds
○Shows that families perceive overall support from healthcare professionals across the care continuum as inadequate, with emotional support rated significantly lower than cognitive support.○Demonstrates the need to improve care experiences and quality in maternal and newborn health along the continuum of care, particularly focusing on emotional supportive care.○Emphasises the importance of providing timely, easy‐to‐understand information on illnesses to all family members, including male partners and older relatives.

What is known about the topic
○In high‐risk pregnancies or when caring for small and sick newborns, families require strong supportive care, including cognitive and emotional care.○Perinatal care is often hindered by disrespect and the exclusion of family members from care decisions.○Through family systems care, healthcare professionals can provide cognitive and emotional support to families throughout the perinatal period.

In high‐risk pregnancies or when caring for small and sick newborns, families require strong supportive care, including cognitive and emotional care.

Perinatal care is often hindered by disrespect and the exclusion of family members from care decisions.

Through family systems care, healthcare professionals can provide cognitive and emotional support to families throughout the perinatal period.

What this paper adds
○Shows that families perceive overall support from healthcare professionals across the care continuum as inadequate, with emotional support rated significantly lower than cognitive support.○Demonstrates the need to improve care experiences and quality in maternal and newborn health along the continuum of care, particularly focusing on emotional supportive care.○Emphasises the importance of providing timely, easy‐to‐understand information on illnesses to all family members, including male partners and older relatives.

Shows that families perceive overall support from healthcare professionals across the care continuum as inadequate, with emotional support rated significantly lower than cognitive support.

Demonstrates the need to improve care experiences and quality in maternal and newborn health along the continuum of care, particularly focusing on emotional supportive care.

Emphasises the importance of providing timely, easy‐to‐understand information on illnesses to all family members, including male partners and older relatives.