scholarly journals A Qualitative Study to Explore the Experience of Parents of Newborns Admitted to Neonatal Care Unit in Rural Rwanda

2020 ◽  
Author(s):  
Samuel Byiringiro ◽  
Rex Wong ◽  
Jenae Logan ◽  
Deogratias Kaneza ◽  
Joseph Gitera ◽  
...  
Keyword(s):  
Qualitative Study ◽  
District Hospital ◽  
Financial Burden ◽  
Healthcare Providers ◽  
Neonatal Care ◽  
Sub Saharan Africa ◽  
Clear Understanding ◽  
Limited Information ◽  
Experience Of Care ◽  
Neonatal Care Unit

Abstract ABSTRACT (310/350 words) Background: Neonatal Care Units (NCUs) provide special care for sick and small newborns and can help reduce neonatal mortality. For parents, the experience of having a hospitalized newborn can be traumatic. In LMIC, especially sub-Saharan Africa, there is limited information about the parents’ experience of care in NCUs. Objective: Our study aimed to explore the experience of parents in the NCU of a rural district hospital in Rwanda. Methods: A qualitative study was conducted with parents whose newborns were hospitalized in the Ruli District Hospital NCU from September 2018 to January 2019. In-depth interviews were conducted using a semi-structured guide in the participants homes by trained data collectors. Data were transcribed, translated, and then coded using a structured code book. All data analyses were conducted using Dedoose software. Results: Twenty-one interviews were conducted primarily with mothers (90.5%, n=19) among newborns who were most often discharged home alive (90.5%, n=19). Parents reported stressful and emotional responses to having their newborns admitted particularly when they lacked clear understanding of their newborn’s condition, generally positive communication and interactions with healthcare providers and other parents, policies and procedures in the NCU that contributed to stress and limited access to newborns by fathers and other family members, and stress due to the high financial burden of NCU care. Conclusion: The admission of a newborn into the NCU alone was a source of stress for parents and caregivers in rural Rwanda. However, there were several positive factors of the NCU including involvement of mothers and support from healthcare providers. The experience in the NCU can be improved when healthcare providers communicate and explain the newborn’s status to the parents and actively involve them in the care of their newborn. Expanding the NCU access for families, encouraging peer support, and ensuring financial accessibility for neonatal care services could contribute to improved experiences for families. KEYWORDS: prematurity, neonatology, family-centered care, neonatal care unit, nurses, patient satisfaction, patient experience

scholarly journals A Qualitative Study to Explore the Experience of Parents of Newborns Admitted to Neonatal Care Unit in Rural Rwanda

2020 ◽  
Author(s):  
Samuel Byiringiro ◽  
Rex Wong ◽  
Jenae Logan ◽  
Deogratias Kaneza ◽  
Joseph Gitera ◽  
...  
Keyword(s):  
Qualitative Study ◽  
District Hospital ◽  
Financial Burden ◽  
Healthcare Providers ◽  
Neonatal Care ◽  
Sub Saharan Africa ◽  
Clear Understanding ◽  
Limited Information ◽  
Experience Of Care ◽  
Sub Saharan

Abstract Background: Neonatal Care Units (NCUs) provide special care for sick and small newborns and can help reduce neonatal mortality. For parents, the experience of having a hospitalized newborn can be traumatic. In LMIC, especially sub-Saharan Africa, there is limited information about the parents’ experience of care in NCUs. Objective: Our study aimed to explore the experience of parents in the NCU of a rural district hospital in Rwanda. Methods: A qualitative study was conducted with parents whose newborns were hospitalized in the Ruli District Hospital NCU from September 2018 to January 2019. In-depth interviews were conducted using a semi-structured guide in the participants homes by trained data collectors. Data were transcribed, translated, and then coded using a structured code book. All data analyses were conducted using Dedoose software. Results: Twenty-one interviews were conducted primarily with mothers (90.5%, n=19) among newborns who were most often discharged home alive (90.5%, n=19). Parents reported stressful and emotional responses to having their newborns admitted particularly when they lacked clear understanding of their newborn’s condition, generally positive communication and interactions with healthcare providers and other parents, policies and procedures in the NCU that contributed to stress and limited access to newborns by fathers and other family members, and stress due to the high financial burden of NCU care. Conclusion: The admission of a newborn into the NCU alone was a source of stress for parents and caregivers in rural Rwanda. However, there were several positive factors of the NCU including involvement of mothers and support from healthcare providers. The experience in the NCU can be improved when healthcare providers communicate and explain the newborn’s status to the parents and actively involve them in the care of their newborn. Expanding the NCU access for families, encouraging peer support, and ensuring financial accessibility for neonatal care services could contribute to improved experiences for families.

scholarly journals A qualitative study to explore the experience of parents of newborns admitted to neonatal care unit in rural Rwanda

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0252776
Author(s):  
Samuel Byiringiro ◽  
Rex Wong ◽  
Jenae Logan ◽  
Deogratias Kaneza ◽  
Joseph Gitera ◽  
...  
Keyword(s):  
Qualitative Study ◽  
District Hospital ◽  
Healthcare Providers ◽  
Neonatal Care ◽  
Sub Saharan Africa ◽  
Traumatic Experience ◽  
Environment Interaction ◽  
Care Services ◽  
Sub Saharan ◽  
Neonatal Care Unit

Background Neonatal Care Units (NCUs) provide special care to sick and small newborns and help reduce neonatal mortality. For parents, having a hospitalized newborn can be a traumatic experience. In sub-Saharan Africa, there is limited literature about the parents’ experience in NCUs. Objective Our study aimed to explore the experience of parents in the NCU of a rural district hospital in Rwanda. Methods A qualitative study was conducted with parents whose newborns were hospitalized in the Ruli District Hospital NCU from September 2018 to January 2019. Interviews were conducted using a semi-structured guide in the participants’ homes by trained data collectors. Data were transcribed, translated, and then coded using a structured code book. All data were organized using Dedoose software for analysis. Results Twenty-one interviews were conducted primarily with mothers (90.5%, n = 19) among newborns who were most often discharged home alive (90.5%, n = 19). Four themes emerged from the interviews. These were the parental adaptation to having a sick neonate in NCU, adaptation to the NCU environment, interaction with people (healthcare providers and fellow parents) in the NCU, and financial stressors. Conclusion The admission of a newborn to the NCU is a source of stress for parents and caregivers in rural Rwanda, however, there were several positive aspects which helped mothers adapt to the NCU. The experience in the NCU can be improved when healthcare providers communicate and explain the newborn’s status to the parents and actively involve them in the care of their newborn. Expanding the NCU access for families, encouraging peer support, and ensuring financial accessibility for neonatal care services could contribute to improved experiences for parents and families in general.

scholarly journals Perceptions of Treatment Burden Among Elders With Diabetes and Comorbid Alzheimer’s Disease and Related Dementias

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 276-276
Author(s):  
Victoria Vaughan Dickson ◽  
Halia Melnyk ◽  
Rosie Ferris ◽  
Joshua Chodosh ◽  
Caroline Blaum
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Qualitative Study ◽  
Financial Burden ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Patient Treatment ◽  
Treatment Burden ◽  
Treatment Plans

Abstract Background: An estimated 25% of older adults with diabetes (DM) may have co-occurring Alzheimer’s Disease and Related Dementias (ADRD), complicated by multiple treatment plans and providers. Assessing treatment burden has been limited to patients’ perspectives; little is known about caregiver perceptions of treatment burden despite their important role in personal care and treatment adherence. The purpose of this qualitative study was to describe caregiver perceptions of treatment burden for older adults with DM-ADRD. Methods: This qualitative study was conducted in the formative phase of “Enhanced Quality in Primary care for Elders with DM-ADRD (EQUIPED-ADRD) a pragmatic randomized controlled trial in a large, diverse healthcare system. A diverse sample of caregivers (n=15) of patients enrolled in the RCT participated in interviews about their caregiver role and perceptions of treatment burden of DM-ADRD clinical management. Qualitative data were analyzed using content analysis and themes about treatment burden were compared to domains on the Treatment Burden Questionnaire (TBQ). Results: Caregivers reported high levels of burden related to treatment plans for patients with DM-ADRD. Themes related to complexity and burden of medication management, monitoring (e.g., blood pressure, glucose monitoring), dietary and physical activity regimens, navigating healthcare providers and financial burden were reported. Caregivers also described high levels of emotional burden that was associated with patient’s cognitive decline and family functioning stress. Conclusions: Interventions to reduce treatment burden for patients and caregiver should include activating social/nursing services, respite care and care coordination that may support caregivers especially as patient treatment increases in complexity over time.

scholarly journals Factors affecting the acceptability of isoniazid preventive therapy among healthcare providers in selected HIV clinics in Nairobi County, Kenya: a qualitative study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024286 ◽  
Author(s):  
Elvis Omondi Achach Wambiya ◽  
Martin Atela ◽  
Ejemai Eboreime ◽  
Latifat Ibisomi
Keyword(s):  
Qualitative Study ◽  
Healthcare Providers ◽  
Preventive Therapy ◽  
Sub Saharan Africa ◽  
Isoniazid Preventive Therapy ◽  
Public Healthcare ◽  
People Living With Hiv ◽  
Policy Makers ◽  
Factors Affecting ◽  
High Level

ObjectiveDespite being globally recommended as an effective intervention in tuberculosis (TB) prevention among people living with HIV, isoniazid preventive therapy (IPT) implementation remains suboptimal, especially in sub-Saharan Africa. This study explored the factors influencing the acceptability of IPT among healthcare providers in selected HIV clinics in Nairobi County, Kenya, a high HIV/TB burden country.DesignA qualitative study was conducted using in-depth interviews with healthcare providers in selected HIV clinics. All conversations were audio recorded, transcribed verbatim and analysed using a thematic approach.SettingThe study was conducted in the HIV clinics of three purposefully selected public healthcare facilities in Nairobi County, Kenya between February 2017 and April 2017.ParticipantsEighteen purposefully selected healthcare providers (clinicians, nurses, pharmacists and counsellors) working in the HIV clinics participated in the study.ResultsProvider acceptability of IPT was influenced by factors relating to the organisational context, provider training on IPT and their perception on its efficacy, length and clarity of IPT guidelines and standard operation procedures, as well as structural factors (policy, physical and work environment). Inadequate high-level commitment and support for the IPT programme by programme managers and policy-makers were found to be the major barriers to successful IPT implementation in our study context.ConclusionThis study provides insight into the complexity of factors affecting the IPT implementation in Kenya. Ensuring optimal acceptability of IPT among healthcare providers will require an expanded depth of engagement by policy-makers and IPT programme managers with both providers and patients, as well as on-the-job design specific actions to support providers in implementation. Such high-level commitment and support are consequently essential for quality delivery of the intervention.

scholarly journals Exploring the experiences of stroke survivors, informal caregivers and healthcare providers in Sierra Leone: a qualitative study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051276
Author(s):  
Jessica O'Hara ◽  
Melvina Thompson ◽  
Gibrilla Deen ◽  
Andrew J M Leather ◽  
Daniel Youkee ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Sierra Leone ◽  
Informal Caregivers ◽  
Healthcare Providers ◽  
Stroke Care ◽  
Sub Saharan Africa ◽  
Stroke Survivors ◽  
Scientific Review ◽  
Cross Sectional ◽  
Stroke Research

IntroductionStroke is now the second leading cause of adult death in Sub-Saharan Africa. Developed in dialogue with stroke survivors and caregivers in Sierra Leone, this will be the first study to explore the experience of stroke as well as the perceptions of the barriers and facilitators to accessing stroke care among stroke survivors, informal caregivers and healthcare providers. Findings will inform future stroke research and care in Sierra Leone.Methods and analysisA cross-sectional qualitative study employing semistructured interviews that will be audiorecorded, translated, transcribed and coded.SettingFreetown, Sierra Leone.ParticipantsInterviews with a purposive sample of stroke survivors, informal caregivers and healthcare providers.AnalysisInterviews will be coded by two authors and inductively analysed using thematic analysis.Ethics and disseminationThis study has received ethical approval from the Sierra Leone Ethics and Scientific Review Committee (8 December 2020) and the KCL Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference: HR-20/21-21050). The findings of the study and learning in terms of the process of coproduction and involvement of stroke survivors will be disseminated via peer-reviewed publications, conferences, media and lay reports.

scholarly journals Qualitative study exploring the feasibility, usability and acceptability of neonatal continuous monitoring technologies at a public tertiary hospital in Nairobi, Kenya

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e053486
Author(s):  
Mai-Lei Woo Kinshella ◽  
Violet Naanyu ◽  
Dorothy Chomba ◽  
Mary Waiyego ◽  
Jessica Rigg ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
Care Quality ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Direct Observations ◽  
Sub Saharan ◽  
Depth Interviews

ObjectiveTo assess the feasibility, usability and acceptability of two non-invasive, multiparameter, continuous physiological monitoring (MCPM) technologies for use in neonates within a resource-constrained healthcare setting in sub-Saharan Africa.DesignA qualitative study using in-depth interviews and direct observations to describe healthcare professional and caregiver perspectives and experiences with investigational MCPM technologies from EarlySense and Sibel compared with selected reference technologies.SettingPumwani Maternity Hospital is a public, high-volume, tertiary hospital in Nairobi, Kenya.ParticipantsIn-depth interviews were conducted with five healthcare administrators, 12 healthcare providers and 10 caregivers. Direct observations were made of healthcare providers using the technologies on 12 neonates overall.ResultsDesign factors like non-invasiveness, portability, ease-of-use and ability to measure multiple vital signs concurrently emerged as key themes supporting the usability and acceptability of the investigational technologies. However, respondents also reported feasibility challenges to implementation, including overcrowding in the neonatal unit, lack of reliable access to electricity and computers, and concerns about cost and maintenance needs. To improve acceptability, respondents highlighted the need for adequate staffing to appropriately engage caregivers and dispel misconceptions about the technologies.ConclusionStudy participants were positive about the usefulness of the investigational technologies to strengthen clinical care quality and identification of at-risk neonates for better access to timely interventions. These technologies have the potential to improve equity of access to appropriate healthcare services and neonatal outcomes in sub-Saharan African healthcare facilities. However, health system strengthening is also critical to support sustainable uptake of technologies into routine care.Trial registration numberNCT03920761.

scholarly journals Acceptability of Clinical Trials on COVID-19 during Pregnancy among Pregnant Women and Healthcare Providers: A Qualitative Study

2021 ◽  
Vol 18 (20) ◽  
pp. 10717
Author(s):  
Elena Marbán-Castro ◽  
Clara Pons-Duran ◽  
Laura García-Otero ◽  
Haily Chen ◽  
Luis Bernardo Herrera ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Qualitative Study ◽  
Pregnant Women ◽  
Severe Disease ◽  
Healthcare Providers ◽  
Limited Information ◽  
Structured Interviews ◽  
Emotional Suffering ◽  
Women's Participation ◽  
Methodological Approaches

Participation of pregnant women in clinical trials entails challenges mainly related to concerns about the risks for fetuses. We undertook a qualitative study from June to October 2020 to assess the acceptability of participating in COVID-19 clinical trials among pregnant women in Spain. Phenomenology and grounded theory were used as methodological approaches. Semi-structured interviews were conducted with 24 pregnant women and six healthcare providers. Women were unsure if pregnancy was a risk factor to acquire the infection or to develop severe disease and expressed the limited information they had received, which led to uncertainties and emotional suffering. They had concerns regarding participation in clinical trials on COVID-19, regardless of the drug under study. Healthcare providers alluded to the importance of involving pregnant women’s relatives at the recruitment visit of the clinical trial. These findings may be useful to facilitate pregnant women’s participation in clinical trials.

scholarly journals Capturing the experience of the hospital-stay journey from admission to discharge using diaries completed by patients in their own words: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e027258 ◽  
Author(s):  
Craig S Webster ◽  
Tanisha Jowsey ◽  
Lucy M Lu ◽  
Marcus A Henning ◽  
Antonia Verstappen ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hospital Stay ◽  
Tertiary Education ◽  
Healthcare Providers ◽  
Great Majority ◽  
Experience Of Care ◽  
Metropolitan Hospital ◽  
Positive Experiences ◽  
Participant Response ◽  
Study Participants

ObjectiveTo capture and better understand patients’ experience during their healthcare journey from hospital admission to discharge, and to identify patient suggestions for improvement.DesignProspective, exploratory, qualitative study. Patients were asked to complete an unstructured written diary expressed in their own words, recording negative and positive experiences or anything else they considered noteworthy.Participants and settingPatients undergoing vascular surgery in a metropolitan hospital.Primary outcome measuresComplete diary transcripts underwent a general inductive thematic analysis, and opportunities to improve the experience of care were identified and collated.ResultsWe recruited 113 patients in order to collect 80 completed diaries from 78 participants (a participant response rate of 69%), recording patients’ experiences of their hospital-stay journey. Participating patients were a median (range) age of 69 (21–99) years and diaries contained a median (range) of 197 (26–1672) words each. Study participants with a tertiary education wrote more in their diaries than those without—a median (range) of 353.5 (48–1672) vs 163 (26–1599) words, respectively (Mann-Whitney U test, p=0.001). Three primary and eight secondary themes emerged from analysis of diary transcripts—primary themes being: (1) communication as central to care; (2) importance of feeling cared for and (3) environmental factors shaping experiences. In the great majority, participants reported positive experiences on the hospital ward. However, a set of 12 patient suggestions for improvement were identified, the majority of which could be addressed with little cost but result in substantial improvements in patient experience. Half of the 12 suggestions for improvement fell into primary theme 1, concerning opportunities to improve communication between healthcare providers and patients.ConclusionsUnstructured diaries completed in a patient’s own words appear to be an effective and simple approach to capture the hospital-stay experience from the patient’s own perspective, and to identify opportunities for improvement.

scholarly journals Clinical management and mortality among COVID-19 cases in sub-Saharan Africa: A retrospective study from Burkina Faso and simulated case analysis

2020 ◽  
Author(s):  
Laura Skrip ◽  
Karim Derra ◽  
Mikaila Kaboré ◽  
Navideh Noori ◽  
Adama Gansané ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Oxygen Therapy ◽  
Demographic Data ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Sub Saharan Africa ◽  
Individual Risk ◽  
Limited Information ◽  
African Countries ◽  
Sub Saharan

AbstractBackgroundAbsolute numbers of COVID-19 cases and deaths reported to date in the sub-Saharan Africa (SSA) region have been significantly lower than those across the Americas, Asia, and Europe. As a result, there has been limited information about the demographic and clinical characteristics of deceased cases in the region, as well as the impacts of different case management strategies.MethodsData from deceased cases reported across SSA through May 10, 2020 and from hospitalized cases in Burkina Faso through April 15, 2020 were analyzed. Demographic, epidemiological, and clinical information on deceased cases in SSA was derived through a line-list of publicly available information and, for cases in Burkina Faso, from aggregate records at the Center Hospitalier Universitaire de Tengandogo in Ouagadougou. A synthetic case population was derived probabilistically using distributions of age, sex, and underlying conditions from populations of West African countries to assess individual risk factors and treatment effect sizes. Logistic regression analysis was conducted to evaluate the adjusted odds of survival for patients receiving oxygen therapy or convalescent plasma, based on therapeutic effectiveness observed for other respiratory illnesses.ResultsAcross SSA, deceased cases for which demographic data are available have been predominantly male (63/103, 61.2%) and over 50 years of age (59/75, 78.7%). In Burkina Faso, specifically, the majority of deceased cases either did not seek care at all or were hospitalized for a single day (59.4%, 19/32); hypertension and diabetes were often reported as underlying conditions. After adjustment for sex, age, and underlying conditions in the synthetic case population, the odds of mortality for cases not receiving oxygen therapy was significantly higher than those receiving oxygen, such as due to disruptions to standard care (OR: 2.07; 95% CI: 1.56 – 2.75). Cases receiving convalescent plasma had 50% reduced odds of mortality than those who did not (95% CI: 0.24 – 0.93).ConclusionInvestment in sustainable production and maintenance of supplies for oxygen therapy, along with messaging around early and appropriate use for healthcare providers, caregivers, and patients could reduce COVID-19 deaths in SSA. Further investigation into convalescent plasma is warranted, as data on its effectiveness specifically in treating COVID-19 becomes available. The success of supportive or curative clinical interventions will depend on earlier treatment seeking, such that community engagement and risk communication will be critical components of the response.

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