scholarly journals The care provided by the family to the premature newborn: analysis under Leininger’s Transcultural Theory

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Ana Celi Silva Torres Nascimento ◽  
Aisiane Cedraz Morais ◽  
Rita da Cruz Amorim ◽  
Deisy Vital dos Santos
Keyword(s):  
Neonatal Intensive Care ◽  
Participant Observation ◽  
Family Members ◽  
Family Care ◽  
Study Participant ◽  
Maternity Hospital ◽  
Neonatal Unit ◽  
Structured Interviews ◽  
Analysis Technique ◽  
Qualitative Descriptive

ABSTRACT Objective: To analyze the care practices of family members of premature infants admitted to a Neonatal Intensive Care Unit in the light of Leininger’s transcultural theory. Methods: Qualitative, descriptive and exploratory study. Participant observation and semi-structured interviews were conducted with 16 family members of newborns, admitted to the neonatal unit of a public maternity hospital, during the months of May and June 2019. The software called Interface de R pour analyses Multidimensionnelles de Textes et de Questionnaire ® and the Bardin Content Analysis technique. Results: Two thematic categories emerged: Family care in the neonatal unit; (in)effective support for shared care. Conclusion: The participation of families in the care of babies is still unstable, but it must be an inseparable element of culturally congruent care, thus collaborating with the full recovery of the premature.

scholarly journals Fortalecimento do vínculo entre a família e o neonato prematuro

2019 ◽  
Vol 13 (2) ◽  
pp. 298
Author(s):  
Silvelene Carneiro de Sousa ◽  
Yvana Marília Sales Medino ◽  
Kaio Giordan Castelo Branco Benevides ◽  
Alinne De Sousa Ibiapina ◽  
Karine De Magalhães Nogueira Ataíde
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Maternity Hospital ◽  
Nursing Interventions ◽  
Structured Interviews ◽  
Analysis Technique ◽  
Qualitative Descriptive ◽  
Terapia Intensiva

RESUMO Objetivo: identificar quais são as intervenções de Enfermagem realizadas em uma Unidade de Terapia Intensiva Neonatal que promovem o fortalecimento do vínculo entre a família e o recém-nascido prematuro. Método: trata-se de estudo qualitativo, descritivo, realizado em uma maternidade pública, com a participação de nove enfermeiros. Obtiveram-se os dados por meio de entrevista´s semiestruturadas, a análise foi pela transcrição na íntegra e organizando em categorias empregando-se a técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: observou-se que as intervenções mais utilizadas para o fortalecimento do vínculo dos recém-nascidos prematuros e a família são: a entrada livre dos pais na Unidade de Terapia Intensiva Neonatal; trocas de fraldas; administração de dieta; uso de músicas e livros para acalmar os bebês; além do método canguru. Conclusão: conclui-se que a equipe de Enfermagem que assiste o neonato de alto risco procura estar atenta para a dimensão desse fenômeno, procurando desenvolver as intervenções de fortalecimento de vínculo, da melhor forma possível, tendo em vista que os benefícios são mútuos para todos os envolvidos. Descritores: Enfermagem; Unidades de Terapia Intensiva Neonatal; Recém-Nascido Prematuro; Família; Humanização da Assistência; Método Canguru.ABSTRACT Objective: to identify the Nursing interventions performed in a Neonatal Intensive Care Unit, which promote the strengthening of the bond between the family and the premature newborn. Method: this is a qualitative, descriptive study carried out in a maternity hospital, with the participation of nine nurses. The data was obtained through semi-structured interviews; the analysis was by transcription in full and organized into categories using the Content Analysis technique in the Thematic Analysis modality. Results: it was observed that the interventions that were most used to strengthen the bond between premature newborns and the families are: free entry of the parents in the Neonatal Intensive Care Unit; diaper changes; diet management; use of music and books to calm babies; and also the kangaroo method. Conclusion: it is concluded that the Nursing team that assists the high risk newborn tries to be attentive to the dimension of this phenomenon, seeking to develop the interventions of bond strengthening, in the best possible way, considering that the benefits are mutual for all those involved. Descriptors: Enfermagem; Unidades de Terapia Intensiva Neonatal; Recém-nascido Prematuro; Família; Humanização da Assistência; Método Canguru.RESUMENObjetivo: identificar cuáles son las intervenciones de Enfermería realizadas en una Unidad de Terapia Intensiva Neonatal que promueven el fortalecimiento del vínculo entre la familia y el recién nacido prematuro. Método: se trata de un estudio cualitativo, descriptivo, realizado en una maternidad pública, con la participación de nueve enfermeros. Se obtuvieron los datos por medio de entrevistas semiestructuradas, el análisis fue por la transcripción en su totalidad y organizando en categorías empleando la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: se observó que las intervenciones más utilizadas para el fortalecimiento del vínculo de los recién nacidos prematuros y la familia son: la entrada libre de los padres en la Unidad de Terapia Intensiva Neonatal; cambio de pañales; administración de la dieta; el uso de canciones y libros para calmar a los bebés; además del método canguro. Conclusión: se concluye que el equipo de Enfermería que asiste al neonato de alto riesgo busca estar atenta para la dimensión de ese fenómeno, buscando desarrollar las intervenciones de fortalecimiento del vínculo, de la mejor forma posible, teniendo en cuenta que los beneficios son mutuos para todos los involucrados. Descriptores: Enfermagem; Unidades de Terapia Intensiva Neonatal; Recém-nascido Prematuro; Família; Humanização da Assistência; Método Canguru.

scholarly journals Humanização da assistência neonatal na ótica dos profissionais da enfermagem

2019 ◽  
Vol 13 ◽  
Author(s):  
Clara Fróes de Oliveira Sanfelice ◽  
Juliana Vanessa da Silva Costa ◽  
Elenice Valentim Carmona
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Structured Interviews ◽  
Team Culture ◽  
The Family ◽  
De Se ◽  
Nursing Team ◽  
Qualitative Descriptive ◽  
Terapia Intensiva

Objetivo: identificar a percepção da equipe de Enfermagem sobre a humanização da assistência prestada em uma Unidade de Terapia Intensiva Neonatal. Método: trata-se de um estudo qualitativo, descritivo, exploratório. Entrevistaram-se 22 profissionais, dos quais um enfermeiro e 21 técnicos de enfermagem. Coletaram-se os dados por meio de entrevistas semiestruturadas, gravadas em áudio, transcritas e analisadas seguindo a técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: revelaram-se quatro categorias: a) Humanização enquanto segurança para os pais, profissionais e neonatos; b) Cuidado que abrange o recém-nascido e a família; c) Humanização como cultura da equipe e política institucional e d) Contradições do cuidado humanizado. Conclusão: evidencia-se a necessidade de se promover atividades educativas para que a abordagem humanizada seja melhor compreendida e implementada no cuidado neonatal. Descritores: Humanização da Assistência; Recém-Nascido; Unidades de Terapia Intensiva Neonatal; Enfermagem Neonatal; Equipe de Enfermagem; Pesquisa Qualitativa.AbstractObjective: to identify the perception of the Nursing team about the humanization of care provided in a Neonatal Intensive Care Unit. Method: this is a qualitative, descriptive, exploratory study. 22 professionals were interviewed, including one nurse and 21 nursing technicians. Data was collected through semi-structured interviews, audio recorded, transcribed and analyzed following the technique of Content Analysis in the Thematic Analysis modality. Results: four categories were revealed: a) Humanization as safety for parents, professionals and newborns; b) Care that covers the newborn and the family; c) Humanization as a team culture and institutional policy; and d) Contradictions of humanized care. Conclusion: there is a need to promote educational activities so that the humanized approach is better understood and implemented in neonatal care. Descriptors: Humanization of Assistance; Newborn; Neonatal Intensive Care Units; Neonatal Nursing; Nursing, Team; Qualitative Research.ResumenObjetivo: identificar la percepción del equipo de Enfermería sobre la humanización de la atención brindada en una Unidad de Cuidados Intensivos Neonatales. Método: este es un estudio cualitativo, descriptivo, exploratorio. Se entrevistaron 22 profesionales, entre ellos un enfermero y 21 técnicos de enfermería. Los datos fueron recolectados a través de entrevistas semiestructuradas, audio grabado, transcrito y analizado siguiendo la técnica de Análisis de Contenido en la modalidad de Análisis Temático. Resultados: se revelaron cuatro categorías: a) Humanización como seguridad para los padres, profesionales y recién nacidos; b) Cuidado que cubre al recién nacido y la familia; c) La humanización como cultura de equipo y política institucional, y d) Contradicciones de la atención humanizada. Conclusión: es necesario promover actividades educativas para que el enfoque humanizado se entienda mejor y se implemente en la atención neonatal. Descriptores: Humanización de la Atención; Recién Nacido; Unidades de Cuidado Intensivo Neonatal; Enfermería Neonatal; Grupo de Enfermería; Investigación Cualitativa.

scholarly journals Assistência psiquiátrica prestada por técnicos de enfermagem

2018 ◽  
Vol 12 (3) ◽  
pp. 618
Author(s):  
Aldo Mattos ◽  
Marciana Fernandes Moll ◽  
Mariana Oliveira Souto ◽  
Moisés Augusto De Paiva Neves
Keyword(s):  
Mental Disorders ◽  
Participant Observation ◽  
Practical Implication ◽  
Descriptive Study ◽  
Analysis Technique ◽  
The Family ◽  
Data Production ◽  
Qualitative Descriptive ◽  
Care Practices

RESUMOObjetivo: investigar as práticas assistenciais dos técnicos de Enfermagem às pessoas com transtornos mentais. Método: estudo qualitativo, descritivo, com produção de dados por meio da observação participante dos cuidados prestados por 12 técnicos de Enfermagem. As observações foram registradas em um diário de campo e submetidas à técnica de Análise de Conteúdo, na modalidade Análise Temática. Resultados: destacou-se a medicalização do cuidado e as intervenções não medicamentosas centraram-se na higienização, alimentação e sono. Nesse sentido, esses profissionais transferiram ao familiar/acompanhante parte de suas responsabilidades como a observação do paciente, a oferta das refeições, a condução para o banho, a organização do leito e o acompanhamento para a realização dos exames. A conduta mais empática ocorria na alta hospitalar quando se dialogava e organizava os pertences do paciente e do acompanhante para conduzi-los à portaria. Conclusão: o tema é relevante e os resultados sinalizam a importância da qualificação dos técnicos de Enfermagem para cuidarem de pessoas com transtornos mentais. Faz-se necessário que esses profissionais integrem habilidades relacionais às habilidades técnicas, o que corresponde à principal implicação prática dos resultados desta investigação. Descritores: Enfermagem; Psiquiatria; Hospitalização; Assistência; Hospitais gerais; Medicalização. ABSTRACTObjective: to investigate nursing care practices of people with mental disorders. Method: qualitative, descriptive study, with data production through participant observation of the care provided by 12 Nursing technicians. The observations were recorded in a field diary and submitted to the Content Analysis technique, in the Thematic Analysis modality. Results: the medicalization of care was emphasized and non-medication interventions focused on hygiene, feeding and sleep. In this sense, these professionals transferred to the family member / companion part of their responsibilities such as patient observation, meal offerings, bathing, bed organization and follow-up for the examinations. The most empathic behavior occurred at hospital discharge when the patient and the companion's belongings were discussed and organized to lead them to the door. Conclusion: the theme is relevant and the results indicate the importance of the qualification of Nursing technicians to care for people with mental disorders. It is necessary that these professionals integrate skills related to technical skills, which corresponds to the main practical implication of the results of this research. Descriptors: Nursing; Psychiatry; Hospitalization; Assistance; Hospitals, General; Medicalization.RESUMENObjetivo: investigar las prácticas asistenciales de los técnicos de Enfermería a las personas con trastornos mentales. Método: estudio cualitativo, descriptivo, con producción de datos por medio de la observación participante de los cuidados prestados por 12 técnicos de Enfermería. Las observaciones fueron registradas en un diario de campo y sometidas a la técnica de Análisis de Contenido, en la modalidad Análisis Temático. Resultados: se destacó la medicalización del cuidado y las intervenciones no medicamentosas se centraron en la higienización, alimentación y sueño. En este sentido, estos profesionales transfirieron al familiar / acompañante parte de sus responsabilidades, como la observación del paciente, la oferta de las comidas, la conducción para el baño, la organización del lecho y el acompañamiento para la realización de los exámenes. La conducta más empática ocurría en el alta hospitalaria, cuando se dialogaba y organizaban las pertenencias del paciente y del acompañante para conducirlos a la portería. Conclusión: el tema es relevante y los resultados señalan la importancia de la calificación de los técnicos de Enfermería para cuidar de personas con trastornos mentales. Se hace necesario que estos profesionales integren habilidades relacionales a las habilidades técnicas, lo que corresponde a la principal implicación práctica de los resultados de esa investigación. Descriptores: Enfermería; Psiquiatría; Hospitalización; Asistencia; Hospitales Generales; Medicalización.

scholarly journals Estratégias lúdicas no cuidado de enfermagem à criança hospitalizada

2019 ◽  
Vol 13 ◽  
Author(s):  
Geicielle Karine de Paula ◽  
Fernanda Garcia Bezerra Góes ◽  
Aline Cerqueira Santos Santana da Silva ◽  
Juliana Rezende Montenegro Medeiros de Moraes ◽  
Liliane Faria da Silva ◽  
...  
Keyword(s):  
Child Care ◽  
Descriptive Study ◽  
Limiting Factors ◽  
Hospitalized Children ◽  
Structured Interviews ◽  
Scarce Resources ◽  
Full Development ◽  
Analysis Technique ◽  
Qualitative Descriptive ◽  
Nursing Professionals

RESUMOObjetivo: analisar o uso de estratégias lúdicas no cuidado à criança hospitalizada na perspectiva da equipe de Enfermagem. Método: trata-se de um estudo qualitativo, descritivo, no setor da Pediatria de um hospital municipal, por meio de entrevistas semiestruturadas com 15 profissionais de enfermagem, cujos dados foram submetidos à técnica de Análise de Conteúdo, na modalidade Análise Temática. Resultados: entende-se que as estratégias lúdicas são compreendidas majoritariamente como uma forma de entreter/distrair as crianças hospitalizadas. Utilizam-se materiais hospitalares, brincadeiras, desenhos, conversa/amizade, vestimentas diferenciadas e contação de histórias, especialmente, durante os cuidados procedimentais. Identificam-se, contudo, fatores limitantes do uso dessas estratégias lúdicas no cuidado à criança, como a escassez de recursos/materiais/investimentos, o medo das crianças em relação aos profissionais e aos procedimentos, a falta de tempo e a presença dos familiares. Conclusão: avalia-se que os fatores limitantes precisam ser superados para a garantia do atendimento integral às crianças hospitalizadas, considerando que o brincar é um direito garantido legalmente, além de contribuir para a recuperação mais prazerosa e para o pleno desenvolvimento infantil. Descritores: Saúde da Criança; Criança Hospitalizada; Enfermagem; Enfermagem Pediátrica; Jogos e Brinquedos; Cuidado de Enfermagem. ABSTRACT Objective: to analyze the use of play strategies in hospitalized child care from the perspective of the Nursing team. Method: this is a qualitative, descriptive study in the pediatrics sector of a municipal hospital, through semi-structured interviews with 15 nursing professionals, whose data were submitted to the Content Analysis technique in the Thematic Analysis modality. Results: it is understood that play strategies are understood mainly as a way to entertain/distract hospitalized children. Hospital materials, games, drawings, conversation/friendship, differentiated clothing and storytelling are used, especially during procedural care. However, there are limitations to the use of these play strategies in child care, such as scarce resources/materials/investments, children's fear of professionals and procedures, lack of time and the presence of family members. Conclusion: it is estimated that the limiting factors need to be overcome to guarantee the integral care of hospitalized children, considering that playing is a legally guaranteed right, as well as contributing to a more pleasant recovery and to the full development of children. Descriptors: Child Health; Hospitalized Child; Nursing; Pediatric Nursing; Games and Toys; Nursing Care. RESUMEN Objetivo: analizar el uso de estrategias lúdicas en el cuidado al niño hospitalizado en la perspectiva del equipo de Enfermería. Método: se trata de un estudio cualitativo, descriptivo, en el sector de la Pediatría de un hospital municipal, por medio de entrevistas semiestructuradas con 15 profesionales de enfermería, cuyos datos fueron sometidos a la técnica de Análisis de Contenido, en la modalidad Análisis Temático. Resultados: se entiende que las estrategias lúdicas son comprendidas mayoritariamente como una forma de entretene/distraer a los niños hospitalizados. Se utilizan materiales hospitalarios, juegos, dibujos, conversación/amistad, vestimentas diferenciadas y cuenta de historias, especialmente, durante los cuidados procedimentales. Se identifican, sin embargo, factores limitantes del uso de esas estrategias lúdicas en el cuidado al niño, como la escasez de recursos / materiales / inversiones, el miedo de los niños hacia los profesionales y los procedimientos, la falta de tiempo y la presencia de los familiares. Conclusión: se evalúa que los factores limitantes necesitan ser superados para la garantía de la atención integral a los niños hospitalizados, considerando que el jugar es un derecho garantizado legalmente, además de contribuir para la recuperación más placentera y para el pleno desarrollo infantil. Descriptores: Salud del Niño; Niño Hospitalizado; Enfermería; Enfermería Pediátrica; Juego e Implementos de Juego; Atención de Enfermería. 

scholarly journals Technical nursing students interacting with family members of hospitalized children

2017 ◽  
Vol 70 (6) ◽  
pp. 1137-1144 ◽  
Author(s):  
Juliana Yukari Takahashi Onishi ◽  
Circéa Amália Ribeiro ◽  
Maria Cristina Ferreira Carlos Rodrigues da Silva ◽  
Regina Issuzu Hirooka de Borba
Keyword(s):  
Nursing Students ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Family Care ◽  
Study Data ◽  
Hospitalized Children ◽  
Structured Interviews ◽  
The City ◽  
Difficult Situations ◽  
Nursing Course

ABSTRACT Objective: To understand technical nursing students' meaning of interacting with family members of hospitalized children. Method: Symbolic Interactionism was used as the theoretical framework and Qualitative Content Analysis was the methodological procedure. A total of eight graduates from an institution situated in the city of Osasco, Sao Paulo state, participated in this study. Data were collected through semi-structured interviews. Results: A total of five representative themes were revealed: Dealing with difficult situations with family members; Perceiving oneself to be unprepared to interact with family members; Family members being a helpful tool; Developing strategies to obtain a good interaction with family members; and Teachers being facilitators of the interaction with family members. Final considerations: To be acquainted with this experience has led to the understanding of the need to include the theme of family care in the curriculum of the Technical Nursing Course. Additionally, the present study contributed to reflections on the importance of such knowledge for this population and to the development of future studies, as this theme has been scarcely explored in the literature.

scholarly journals Conflict management: challenges experienced by nurse-leaders in the hospital environment

2014 ◽  
Vol 35 (2) ◽  
pp. 79-85 ◽  
Author(s):  
Simone Coelho Amestoy ◽  
Vânia Marli Schubert Backes ◽  
Maira Buss Thofehrn ◽  
Jussara Gue Martini ◽  
Betina Hörner Schlindwein Meirelles ◽  
...  
Keyword(s):  
Participant Observation ◽  
Research Strategy ◽  
Nurse Leaders ◽  
Hospital Environment ◽  
Structured Interviews ◽  
Interpersonal Conflicts ◽  
Participatory Leadership ◽  
Qualitative Descriptive ◽  
The City

This study aimed to understand the main conflicts experienced by nurses-leaders in the hospital environment, as well as the strategies adopted to face them. The study reflects a qualitative descriptive type approach, which was used in the case study as research strategy. The study included 25 nurses who worked in three hospitals in the city of Florianopolis, Santa Catarina. Information where obtained in the months of May to December of 2010 through semi-structured interviews, non-participant observation and dialogical workshops. Data were analyzed using the Thematic Analysis. The results demonstrated the predominant of interpersonal conflicts involving the multidisciplinary team, nurses and the nursing staff. Adopting a participatory leadership, based on dialogue emerges as a strategy for coping with conflicts in the hospital environment.

scholarly journals Healthcare Professionals’ Perceptions of Support for Family Members in Specialist Palliative Care Inpatient Units – a Qualitative Descriptive Study

2021 ◽  
Author(s):  
Anu Soikkeli-Jalonen ◽  
Kaisa Mishina ◽  
Heli Virtanen ◽  
Andreas Charalambous ◽  
Elina Haavisto
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Family Members ◽  
Family Care ◽  
Essential Element ◽  
Focus Group Interviews ◽  
Qualitative Descriptive ◽  
Group Interviews ◽  
Additional Support ◽  
Inpatient Units

Abstract Purpose: The aim of this study was to describe healthcare professionals’ (HCPs) perceptions of the support for family members (FMs) of palliative care cancer patients in specialist palliative inpatient units. Methods: A qualitative descriptive design was applied. The data were collected with focus group interviews and analysed with inductive content analysis.Results: Information sharing was recognised as an essential element of support. Also, emotional support, discussions and additional support were offered. Practices to improve support of FMs included a possibility to allocate recourses to the families, systematic support and strengthening HCPs’ competence in family care. Conclusions: The opportunities to implement support focusing directly on FMs were described as restricted. Organisational resources were limited in inpatient units. HCPs felt that they did not have enough time to spend with FMs, and the facilities were also not always suitable to support FMs’ presence and participation. Therefore, there is a need for systematic support and interventions for FMs that could be implemented in inpatient units by the HCPs as a part of the daily care. Furthermore, additional training for the HCPs in palliative family care is needed.

Contradicting perceptions of nursing teachers on the neoliberal context of labor

2021 ◽  
Vol 74 (4) ◽  
Author(s):  
Camila Arantes Ferreira Brecht D’ Oliveira ◽  
Márcia Tereza Luz Lisboa ◽  
Carolina Cabral Pereira da Costa ◽  
Sheila Nascimento Pereira de Farias ◽  
Thereza Christina Mó y Mó Loureiro Varella ◽  
...  
Keyword(s):  
Content Analysis ◽  
Exploratory Research ◽  
Structured Interviews ◽  
Negative Effects ◽  
Thematic Content Analysis ◽  
Teachers Perceptions ◽  
Current Configuration ◽  
Analysis Technique ◽  
Qualitative Descriptive ◽  
Nursing Teachers

ABSTRACT Objectives: To identify and analyze the perceptions of nursing teachers on the new configurations of the job world and the repercussions for their labor activities. Methods: Qualitative, descriptive, exploratory research, carried out at two federal nursing colleges in Rio de Janeiro. Data collection occurred with 27 nursing teachers, between May and June 2016, through semi-structured interviews. The data were treated using the thematic content analysis technique. Results: The results showed contradictions in the teachers’ perceptions about the job world, which has been guided by neoliberal precepts. Such contradictions are characterized by manifestations in favor of incorporating these precepts, highlighting their negative effects on nursing teaching work. Final considerations: There are incongruities in the way of perceiving the current configuration of the job world, proposing more and profound reflections on such a work scenario.

scholarly journals Disruption, control and coping: responses of and to the person with dementia in hospital

2013 ◽  
Vol 35 (1) ◽  
pp. 37-63 ◽  
Author(s):  
DAVINA POROCK ◽  
PHILIP CLISSETT ◽  
ROWAN H. HARWOOD ◽  
JOHN R. F. GLADMAN
Keyword(s):  
Participant Observation ◽  
Family Care ◽  
Sense Of Control ◽  
Care Giver ◽  
Structured Interviews ◽  
Coping Responses ◽  
Care Givers ◽  
Sharing Space ◽  
Person With Dementia ◽  
Constant Comparative Analysis

ABSTRACTThis qualitative study aimed to gain insight into the experience of hospitalisation from the perspectives of the older person with dementia, their family care-giver and other patients sharing the ward (co-patients). Non-participant observation of care on 11 acute hospital wards was supplemented by 39 semi-structured interviews with 35 family care-givers and four co-patients following discharge. Constant comparative analysis produced the core problem facing all those involved: disruption from normal routine meaning that the experience of hospitalisation was disrupted by the presence and behaviour of the person with dementia. Disruption adversely affected the person with dementia, triggering constructive, disengaged, distressed and neutral behaviours. Using Kitwood's model of person-centred care, these behaviours were interpreted as attempts by the person with dementia at gaining a sense of control over the unfamiliar environment and experience. Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation. They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff. Co-patients experienced disruption from sharing space with the person with dementia and were left feeling vulnerable and sometimes afraid. They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.

scholarly journals A Qualitative Study exploring health workers and patient caregivers’ hand hygiene practices in a neonatal unit in Blantyre, Malawi, implications for controlling outbreaks of drug resistant infections

2021 ◽  
Author(s):  
Eleanor MacPherson ◽  
Helen Mangochi ◽  
Rachel Tolhurst ◽  
Victoria Simpson ◽  
Kondwani Kawaza ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Neonatal Sepsis ◽  
Health Workers ◽  
Participant Observation ◽  
Neonatal Unit ◽  
Infection Prevention And Control ◽  
Drug Resistant ◽  
Structured Interviews ◽  
African Countries ◽  
Sub Saharan

Introduction: Neonatal sepsis is responsible for a considerable burden of morbidity and mortality in sub-Saharan African countries. Outcomes from neonatal sepsis are worsening due to increasing rates of antimicrobial resistance. Sub-optimal Infection Prevention and Control (IPC) practices of health care workers and caregivers are important drivers of infection transmission.Aim: The Chatinkha Neonatal Unit at Queen Elizabeth Central Hospital, Blantyre, Malawi has experienced multiple outbreaks of neonatal sepsis, associated with drug resistant Klebsiella pneumoniae. We aimed to understand the barriers to implementation of optimal IPC focusing on hand hygiene practice.Materials and Methods: We used a qualitative research methodology to meet the study aim. Combining participant observation (PO) over a seven-month period with semi structured interviews (SSI) to provide an in-depth understanding of activities relating to hygiene and IPC existing on the ward. Results: While most staff and some caregivers, had a good understanding of ideal IPC and understood the importance of good handwashing practices, they faced substantial structural limitations, and scarce resources (both material and human) which made implementation challenging. For staff, the overwhelming numbers of patients meant the workload was often unmanageable and practicing optimal IPC was typically impossible. Caregivers lacked access to basic amenities, including linen and chairs, meaning that it was almost impossible for them to maintain good hand hygiene. Limited access to soap and the erratic water supply for both caregivers and healthcare workers further worsened the situation. Communication challenges between different cadres of staff and with patient caregivers meant that those handling neonates and cleaning the wards were often unaware of outbreaks of drug resistant infection. Conclusion: For IPC to be improved, interventions need to address the chronic shortages of material resources and create an enabling environment for HCWs and patient caregivers.

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