scholarly journals Perceptions of family, community and religious leaders and acceptability for minimal invasive tissue sampling to identify the cause of death in under-five deaths and stillbirths in North India: a qualitative study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Manoja Kumar Das ◽  
Narendra Kumar Arora ◽  
Gurkirat Kaur ◽  
Prikanksha Malik ◽  
Mahisha Kumari ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cause Of Death ◽  
Healthcare Providers ◽  
Minimal Invasive ◽  
Religious Leader ◽  
Religious Leaders ◽  
Tissue Sampling ◽  
Community Members ◽  
Child Deaths ◽  
Minimal Invasive Tissue Sampling

Abstract Background Minimal invasive tissue sampling (MITS) has emerged as a suitable alternative to complete diagnostic autopsy (CDA) for determination of the cause of death (CoD), due to feasibility and acceptability issues. A formative research was conducted to document the perceptions of parents, community and religious leaders on acceptability of MITS. Methods This qualitative study was conducted at and around the Safdarjung Hospital, Delhi, India. Participants for in-depth interview included the parents who had either child or neonatal death or stillbirth and the key community and religious representatives. The focus group discussions (FGDs) involved community members. Process of obtaining consent for MITS was observed. Data were analyzed inductively manually for emerging themes and codes. Results A total of 104 interviews (parents of deceased children, neonates or stillbirths, n = 93; community members, n = 8 and religious leaders, n = 7), 8 FGDs (n = 72) were conducted and process of obtaining consent for MITS (n = 27) was observed. The participants were positive and expressed willingness to accept MITS. The key determinants for acceptance of MITS were: (1) understanding and willingness to know the cause of death or stillbirth, (2) experience of the healthcare received and trust, (3) the religious and sociocultural norms. Parents and community favored for MITS over CDA when needed, especially where in cases with past stillbirths and child deaths. The experience of treatment, attitude and communication from healthcare providers emerged as important for consent. The decision making process was collective involving the elders and family. No religious leader was against the procedure, as both, the respect for the deceased and need for medical care were satisfied. Conclusions Largely, MITS appeared to be acceptable for identifying the causes of child deaths and stillbirths, if the parents and family are counseled appropriately considering the sociocultural and religious aspects. They perceived the quality of care, attitude and communication by the healthcare providers as critical factors for acceptance of MITS.

scholarly journals Grief reaction and psychosocial impacts of child death and stillbirth on bereaved North Indian parents: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0240270
Author(s):  
Manoja Kumar Das ◽  
Narendra Kumar Arora ◽  
Harsha Gaikwad ◽  
Harish Chellani ◽  
Pradeep Debata ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Economic Impacts ◽  
Child Death ◽  
Healthcare Providers ◽  
Financial Strain ◽  
Traumatic Experience ◽  
Community Members ◽  
Group Discussions ◽  
Psychological Disturbances ◽  
And Coping

Background Grief following stillbirth and child death are one of the most traumatic experience for parents with psychosomatic, social and economic impacts. The grief profile, severity and its impacts in Indian context are not well documented. This study documented the grief and coping experiences of the Indian parents following stillbirth and child death. Methods This exploratory qualitative study in Delhi (India) included in-depth interviews with parents (50 mothers and 49 fathers), who had stillbirth or child death, their family members (n = 41) and community representatives (n = 12). Eight focus group discussions were done with community members (n = 72). Inductive data analysis included thematic content analysis. Perinatal Grief Scale was used to document the mother’s grief severity after 6–9 months of loss. Results The four themes emerged were grief anticipation and expression, impact of the bereavement, coping mechanism, and sociocultural norms and practices. The parents suffered from disbelief, severe pain and helplessness. Mothers expressed severe grief openly and some fainted. Fathers also had severe grief, but didn’t express openly. Some parents shared self-guilt and blamed the hospital/healthcare providers, themselves or family. Majority had no/positive change in couple relationship, but few faced marital disharmony. Majority experienced sleep, eating and psychological disturbances for several weeks. Mothers coped through engaging in household work, caring other child(ren) and spiritual activities. Fathers coped through avoiding discussion and work and professional engagement. Fathers resumed work after 5–20 days and mothers took 2–6 weeks to resume household chores. Unanticipated loss, limited family support and financial strain affected the severity and duration of grief. 57.5% of all mothers and 80% mothers with stillbirth had severe grief after 6–9 months. Conclusions Stillbirth and child death have lasting psychosomatic, social and economic impacts on parents, which are usually ignored. Sociocultural and religion appropriate bereavement support for the parents are needed to reduce the impacts.

scholarly journals Perceptions of health professionals regarding minimally invasive tissue sampling (MITS) to identify the cause of death in stillbirths and neonates: results from a qualitative study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Anam Feroz ◽  
Anum Shiraz Ali ◽  
Mohsina Noor Ibrahim ◽  
Elizabeth M. McClure ◽  
Shiyam Sunder Tikmani ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Minimally Invasive ◽  
Health System ◽  
Cause Of Death ◽  
Health Professionals ◽  
Positive Development ◽  
Successful Implementation ◽  
Tissue Sampling ◽  
Healthcare Facilities ◽  
Fast Procedure

Abstract Background Pakistan is considered to be one of the riskiest places in the world for childbirth as measured by its high stillbirth and neonatal mortality rates. Complete diagnostic autopsy remains the gold standard to determine the cause of death (CoD); however, it is not routinely implemented due to religious objections, sociocultural beliefs, limited resources and low demand from physicians and families. Recently, minimally invasive tissue sampling (MITS) using needle biopsies of multiple tissues to obtain tissue for histological examination and organism identification with PCR has been developed and promoted to determine CoD in low-resource areas. To ensure successful implementation of MITS, it is important to understand health professionals’ attitudes and perceptions related to MITS. Methods A qualitative study was conducted at the National Institute of Child Health (NICH), Karachi, Pakistan. Focus group discussions (FGDs) and Key-informant interviews (KIIs) were conducted with health professionals including doctors, nurses, trainees, clinicians, bioethics experts and public health experts to explore their perceptions and views on acceptability of MITS. Data were analyzed using NVivo 10 software. Results A total of 12 interviews (FGDs = 4; KIIs = 8) were conducted. Four overarching themes were identified: (I) acceptability of MITS; (II) perceived benefits of the MITS procedure; (III) factors facilitating the implementation of MITS; and (IV) health system requirements for implementing the MITS procedure. Generally, MITS was considered as a positive development for the health system. Diagnostic accuracy and identification of less common causes of death were highlighted as two main benefits of the MITS procedure. The study highlighted a number of facilitators for the acceptability of MITS including effective counseling, building trust with parents, fast procedure time, and approaching families within a few hours of death. In addition, lack of skilled staff, poorly equipped healthcare facilities and the potential high cost to conduct MITS were identified as challenges for the implementation of MITS. Conclusions This formative research provided a unique opportunity to explore health professionals’ views and attitudes towards the MITS procedure. Such insights are crucial to ensure successful implementation and integration of a new technique into the existing health system. The research identified the factors influencing the acceptability of MITS among health professionals in Pakistan. The study also informed factors that could help facilitate the implementation of the MITS procedures in the context of Pakistan and similar settings.

scholarly journals Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan: A Qualitative Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4736
Author(s):  
Uzma Rahim Khan ◽  
Naveed Ahmed ◽  
Rubaba Naeem ◽  
Umerdad Khudadad ◽  
Sarwat Masud ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare Professionals ◽  
Health Workers ◽  
Heat Waves ◽  
Healthcare Providers ◽  
Community Members ◽  
Home Based ◽  
Facility Level ◽  
Training Community ◽  
Access And Quality

Heat waves are the second leading cause of weather-related morbidity and mortality affecting millions of individuals globally, every year. The aim of this study was to understand the perceptions and practices of community residents and healthcare professionals with respect to identification and treatment of heat emergencies. A qualitative study was conducted using focus group discussions and in-depth interviews, with the residents of an urban squatter settlement, community health workers, and physicians and nurses working in the emergency departments of three local hospitals in Karachi. Data was analyzed using content analysis. The themes that emerged were (1) perceptions of the community on heat emergencies; (2) recognition and early treatment at home; (3) access and quality of care in the hospital; (4) recognition and treatment at the health facility; (5) facility level plan; (6) training. Community members were able to recognize dehydration as a heat emergency. Males, elderly, and school-going children were considered at high risk for heat emergencies. The timely treatment of heat emergencies was widely linked with availability of financial resources. Limited availability of water, electricity, and open public spaces were identified as risk factors for heat emergencies. Home based remedies were reported as the preferred practice for treatment by community members. Both community members and healthcare professionals were cognizant of recognizing heat related emergencies.

scholarly journals Perception of obesity and overweight among adults living in suburban Nepal: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043719
Author(s):  
Sachita Shrestha ◽  
Shanta Asthanee ◽  
Biraj Man Karmacharya ◽  
Seema Subedi ◽  
Rajendra Koju
Keyword(s):  
Qualitative Study ◽  
Group Discussion ◽  
Healthcare Providers ◽  
Community Members ◽  
Intervention Programme ◽  
Healthcare Facilities ◽  
Preventive Practices ◽  
Obesity And Overweight ◽  
Inadequate Knowledge ◽  
Suburban Community

ObjectiveTo explore the perception of obesity and overweight among Nepalese adults living in a suburban community.DesignA qualitative study composed of focus group discussion (FGD) and in-depth interview (IDI).SettingCommunity and healthcare facilities in Dhulikhel, Nepal.ParticipantsFour FGDs were conducted with community members (n=22) and four IDIs were conducted with healthcare providers (HCPs).ResultsObesity is a rising problem in this suburban community. Participants had inadequate knowledge regarding the consequences of obesity, and they perceived overweight as normal, healthy and attractive. The participants above 40 years of age did not perceive themselves to be overweight or obese. Despite participants’ awareness of the importance of diet control and exercise to prevent obesity, these were not translated into practice.ConclusionsThis study provided insight into perceptions of obesity in a suburban Dhulikhel community through both community members’ and HCPs’ perspective. Misconceptions and inadequate knowledge of obesity among people in this community indicate the need for health education and intervention programme to increase health awareness and preventive practices.

scholarly journals Refused and referred-persistent stigma and discrimination against people living with HIV/AIDS in Bihar: a qualitative study from India

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033790 ◽  
Author(s):  
Mohit Nair ◽  
Pragya Kumar ◽  
Sanjay Pandey ◽  
Amit Harshana ◽  
Shahwar Kazmi ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Transmission ◽  
Healthcare Providers ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Community Members ◽  
Universal Precautions ◽  
Stigma And Discrimination ◽  
Living With Hiv ◽  
Hiv Aids

ObjectivesThis study aimed to explore barriers to accessing care, if any, among people living with HIV/AIDS (PLHA) in two districts of Bihar. We also aimed to assess attitudes towards PLHA among healthcare providers and community members.DesignThis qualitative study used an exploratory study design through thematic analysis of semistructured, in-depth interviews.SettingTwo districts were purposively selected for the study, namely the capital Patna and a peripheral district located approximately 100 km from Patna, in order to glean insights from a diverse sample of respondents.ParticipantsOur team purposively selected 71 participants, including 35 PLHA, 10 community members and 26 healthcare providers.ResultsThe overarching theme that evolved from these data through thematic coding identified that enacted stigma and discrimination interfere with each step in the HIV care continuum for PLHA in Bihar, India, especially outside urban areas. The five themes that contributed to these results include: perception of HIV as a dirty illness at the community level; non-consensual disclosure of HIV status; reliance on identifying PLHA to guide procedures and resistance to universal precautions; refusal to treat identified PLHA and referrals to other health centres for treatment; and inadequate knowledge and fear among health providers with respect to HIV transmission.ConclusionsThe continued presence of discriminatory and stigmatising attitudes towards PLHA negatively impacts both disclosure of HIV status as well as access to care and treatment. We recognise a pressing need to improve the knowledge of HIV transmission, and implement universal precautions across all health facilities in the state, not just to reduce stigma and discrimination but also to ensure proper infection control. In order to improve treatment adherence and encourage optimal utilisation of services, it is imperative that the health system invest more in stigma reduction in Bihar and move beyond more ineffective, punitive approaches.

scholarly journals NICU and postpartum nurse perspectives on involving fathers in newborn care: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katharine W. Buek ◽  
Dagoberto Cortez ◽  
Dorothy J. Mandell
Keyword(s):  
Qualitative Study ◽  
Father Involvement ◽  
Perinatal Care ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Small Scale ◽  
Structured Interviews ◽  
Provider Attitudes ◽  
Attitudes And Practices ◽  
Sense Of Efficacy

Abstract Background Perinatal care nurses are well positioned to provide the education and support new fathers need to navigate the transition to fatherhood and to encourage positive father involvement from the earliest hours of a child’s life. To effectively serve fathers in perinatal settings, it is important to understand the attitudes, beliefs, and behaviors of healthcare providers that may encourage and engage them, or alternatively alienate and discourage them. Methods This qualitative study involved structured interviews with ten NICU and postpartum nurses from hospitals in two large Texas cities. The interview protocol was designed to elicit descriptive information about nurses’ attitudes and beliefs, sense of efficacy and intention for working with fathers, as well as their father-directed behaviors. Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by telephone and lasted approximately 25 to 35 min. Data were analyzed using a qualitative descriptive approach. Results Overall, study participants held very positive subjective attitudes toward fathers and father involvement. Nevertheless, many of the nurses signaled normative beliefs based on race/ethnicity, gender, and culture that may moderate their intention to engage with fathers. Participants also indicated that their education as well as the culture of perinatal healthcare are focused almost entirely on the mother-baby dyad. In line with this focus on mothers, participants comments reflected a normative belief that fathers are secondary caregivers to their newborns, there to help when the mother is unavailable. Conclusions Nurse attitudes and practices that place mothers in the role of primary caregiver may be interpreted by fathers as excluding or disregarding them. Further research is needed to validate the results of this small-scale study, and to assess whether and how provider attitudes impact their practices in educating and engaging fathers in newborn care.

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