Family caregiver perspectives on strengths and challenges in the care of pediatric injury patients at a tertiary referral hospital in Northern Tanzania.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 25 05 2023
accepted: 26 11 2023
medline: 15 12 2023
pubmed: 15 12 2023
entrez: 15 12 2023
Statut: epublish

Résumé

Pediatric injuries are a leading cause of morbidity and mortality in low- and middle-income countries (LMICs). It is important that injured children get quality care in order to improve their outcomes. Injured children are nearly always accompanied by family member caregivers invested in their outcome, and who will be responsible for their recovery and rehabilitation after discharge. The purpose of this study was to identify family member caregiver perspectives on strengths and challenges in pediatric injury care throughout hospitalization at a tertiary hospital in Northern Tanzania. This study was conducted at a zonal referral hospital in Northern Tanzania. Qualitative semi-structured in-depth interviews (IDIs) were conducted by trained interviewers who were fluent in English and Swahili in order to examine the strengths and challenges in pediatric injury care. IDIs were completed from November 2020 to October 2021 with 30 family member caregivers of admitted pediatric injured patients. De-identified transcripts were synthesized in memos and analyzed through a team-based, thematic approach informed by applied thematic analysis. Strengths and challenges were identified throughout the hospital experience, including emergency medicine department (EMD) care, inpatient wards care, and discharge. Across the three phases, strengths were identified such as how quickly patients were evaluated and treated, professionalism and communication between healthcare providers, attentive nursing care, frequent re-evaluation of a patient's condition, and open discussion with caregivers about readiness for discharge. Challenges identified related to lack of communication with caregivers, perceived inability of caregivers to ask questions, healthcare providers speaking in English during rounds with lack of interpretation into the caregivers' preferred language, and being sent home without instructions for rehabilitation, ongoing care, or guidance for follow-up. Caregiver perspectives highlighted strengths and challenges throughout the hospital experience that could lead to interventions to improve the care of pediatric injury patients in Northern Tanzania. These interventions include prioritizing communication with caregivers about patient status and care plan, ensuring all direct communication is in the caregivers' preferred language, and standardizing instructions regarding discharge and follow-up.

Sections du résumé

BACKGROUND BACKGROUND
Pediatric injuries are a leading cause of morbidity and mortality in low- and middle-income countries (LMICs). It is important that injured children get quality care in order to improve their outcomes. Injured children are nearly always accompanied by family member caregivers invested in their outcome, and who will be responsible for their recovery and rehabilitation after discharge.
OBJECTIVE OBJECTIVE
The purpose of this study was to identify family member caregiver perspectives on strengths and challenges in pediatric injury care throughout hospitalization at a tertiary hospital in Northern Tanzania.
METHODS METHODS
This study was conducted at a zonal referral hospital in Northern Tanzania. Qualitative semi-structured in-depth interviews (IDIs) were conducted by trained interviewers who were fluent in English and Swahili in order to examine the strengths and challenges in pediatric injury care. IDIs were completed from November 2020 to October 2021 with 30 family member caregivers of admitted pediatric injured patients. De-identified transcripts were synthesized in memos and analyzed through a team-based, thematic approach informed by applied thematic analysis.
RESULTS RESULTS
Strengths and challenges were identified throughout the hospital experience, including emergency medicine department (EMD) care, inpatient wards care, and discharge. Across the three phases, strengths were identified such as how quickly patients were evaluated and treated, professionalism and communication between healthcare providers, attentive nursing care, frequent re-evaluation of a patient's condition, and open discussion with caregivers about readiness for discharge. Challenges identified related to lack of communication with caregivers, perceived inability of caregivers to ask questions, healthcare providers speaking in English during rounds with lack of interpretation into the caregivers' preferred language, and being sent home without instructions for rehabilitation, ongoing care, or guidance for follow-up.
CONCLUSION CONCLUSIONS
Caregiver perspectives highlighted strengths and challenges throughout the hospital experience that could lead to interventions to improve the care of pediatric injury patients in Northern Tanzania. These interventions include prioritizing communication with caregivers about patient status and care plan, ensuring all direct communication is in the caregivers' preferred language, and standardizing instructions regarding discharge and follow-up.

Identifiants

pubmed: 38100475
doi: 10.1371/journal.pone.0286836
pii: PONE-D-23-15434
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0286836

Informations de copyright

Copyright: © 2023 Keating et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Elizabeth M Keating (EM)

Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, Utah, United States of America.

Francis Sakita (F)

Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Maddy Vonderohe (M)

Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States of America.

Getrude Nkini (G)

Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Ismail Amiri (I)

Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Kelly Loutzenheiser (K)

College of Nursing, University of Utah, Salt Lake City, UT, United States of America.

Bryan Young (B)

Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, Utah, United States of America.

Sharla Rent (S)

Department of Pediatrics, Duke School of Medicine, Durham, North Carolina, United States of America.

Catherine A Staton (CA)

Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center, Duke University Medical Center, Durham, North Carolina, United States of America.
Department of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America.
Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.

Blandina T Mmbaga (BT)

Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Kilimanjaro Clinical Research Institute, Moshi, Tanzania.

Melissa H Watt (MH)

Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, United States of America.

Classifications MeSH