Preterm infant caregivers’ perspectives on basic infant life support training before discharge : a descriptive case study at a secondary hospital in the Western Cape, South Africa

Africa, Anne Beatrice (2019-04)

Thesis (MNur)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : Background: Basic infant life support (BILS) includes providing emergency ventilation/breathing and manual cardiac massage/compressions to maintain circulation when a preterm infant has a cardiorespiratory arrest. Preterm infants receive expensive hospitalisation sometimes for two to three months. Smaller preterm infants are discharged in a clinically stable condition. However, these infants still have immature systems which put them at risk of apnoea, infections, and sudden infant death syndrome (SIDS). They are discharged to socioeconomic circumstances that pose risks of inhalation of smoke and unhygienic circumstances, which could result in death within the first week after discharge. Providing preterm infants’ parents with BILS knowledge and skills could empower them to save their infants’ lives after discharge. International policies, and the Western Cape Department of Health, Kangaroo mother care (KMC) policies are advocating BILS training to preterm infant’s parents before discharge. The purpose of this study was to explore the perspectives of preterm infant’s caregivers about the pre-discharge BILS skills training at a secondary public hospital in Cape Town Metropole, in Western Cape, South Africa. Methods: The study was conducted as a qualitative descriptive single case study with two embedded units of analysis. Multimethod data collection included Individual semi-structured in-depth interviews with four parents and four health care professionals and two focus group discussions with midwives. The participants were sampled purposively at a secondary level hospital. The participants in the first unit of analysis were four parents who received the BILS training before discharge. The second unit of analysis included healthcare professionals HCPs who were involved in the BILS training and discharge readiness. Qualitative data analysis was done through coding categorising and theme formation. The principle themes were deduced from the objectives. Research Findings: Three themes emerged from the first unit of analysis, which included: importance of BILS training, discharge information and development factors identified. Parents reflected on the BILS training they received before discharge and revealed what they learnt about themselves, made them feel empowered, to be able to provide BILS to their preterm infants successfully after discharge. The three themes that emerged from the second embedded unit of analysis included: Rationale for BILS training before discharge and BILS training provided and enhancement factors. The HCPs elaborated on the justification that preterm infants’ caregivers need BILS training to be empowered to save their infants’ lives after discharge. Conclusion: The parents of preterm infants’ perspectives are that preterm infants are still at risk of life-threatening events which could result in death soon after discharge. The training empowered preterm infant parents. They initially felt anxious, but then felt confident, competent and reassured to provide BILS to their infants successfully after discharge. They felt empowered to enrich family members and communities with BILS information. Barriers and supporting factors were identified from both units of analysis to systematically improve the BILS training programme at the hospital.

AFRIKAANSE OPSOMMING : Agtergrond: Basiese baba lewensondersteuning sluit in nood toediening van asemhaling, en hart kompressies om sirkulasie te behou, wanneer die vroeggebore baba n kardio-respiratoriese aanval het. Vroeggebore babas onvang duur hospitalisasie vir omtrent twee tot drie maande. Kleiner vroeggebore babas word ontslaan uit die hospitaal in n kliniese bevredigende stabiele toestand. Nogtans, hierdie babas het nogsteeds onvolgroeide systeme wat n hoë risiko is vir hierdie babas is en ontbloot hulle om op te hou asemhaal, infeksies te kry en n skielike baba dood sindroom te kry. Hulle word ontslaan na sosioekonomiese toestande wat hoë risiko’s van inhalasie van rook, onhigiëniese toestande wat kan lei tot dood binne die eerste week nadat hulle ontslaan is vanaf die hospitaal. Toediening van nood baba lewensondersteuning opleiding van versorgers van vroeg gebore babas kan hulle bemagtig met kennis en vaardighede om hul babas se lewens te red nadat hulle ontslaan was uit die hospitaal. Internationale beleide en die Wes-Kaapse Departement van Gesondheid se Kangaroo Moeder Sorg beleid beveel aan dat versorgers van vroeggebore babas basiese lewens ondersteuning opleiding kry voordat hul babas ontslaan word uit die hospitaal. Die doel van die studie was om die perspektiewe van die vroeggebore babas se versorgers te eksploreer aangaande die voor ontslag basiese lewens ondersteuning opleiding wat hulle in die sekondêre publieke hospitaal in Kaapstad Metrpool, in Wes-Kaap, Suid-Afrika. Metode: Die studie was uigevoer as ‘n kwalitatiewe enkel, beskrywende saak studie met twee ingebedde eenhede van analisering. Veelsydige metodes van data versameling het ingesluit; individuele semi-gestruktureerde indiepte onderhoude met vier versorgers, vier gesondheidsprofessionele versorgers en twee fokus groep besprekings/onderhoude. Die monster van deelnemers was doelbewus gekies by die sekondêre vlak hospitaal. Die deelnemers in die eerste eenheid van analisering was vier versorgers wat basiese baba lewens ondersteuning opleiding ontvang het voordat hulle babas ontslaan was uit die hospitaal. Die tweede eenheid van analisering was gesondheidsorg professionele versorgers wat betrokke was in die basiese lewens ondersteuning opleiding en ontslaan gereedheid van die ouers. Data analisering was gedoen deur kodering, kategorisering en tema vorming. Die hoof temas was afgelei van die doelwitte. Resultate/Navorsing Bevindinge: Drie temas het na vore gekom wat insluit; die belangrikheid van basiese baba lewens ondersteuning opleiding, ontslag informasie en ontwikkeling faktore was geidentifiseer. Ouers het gereflekteer op die basiese baba lewens ondersteuning opleiding wat hulle ontvang het voordat hulle ontslaan was van die hospitaal. Hulle het geleer omtrent hulleself; hulle het emotioneel bemagtig gevoel en hulle het basiese baba lewens ondersteuning suksesvol toegedien nadat hulle babas ontslaan was uit die hospitaal. Verder, drie temas het na vore gekom onder ingebedde eenheid van analisering twee het ingelsuit; basiese baba lewens ondersteuning opleiding voor ontslag, basiese baba lewens ondersteuning toegedien en verbetering faktore. Die gesondheidsorg professionele versorgers het uitgebrei op die regverdiging dat vroeg gebore babas se ouers basiese baba lewens ondersteuning opleiding benodig om hulle babas se lewens te red nadat hulle babas ontslaan was vanaf die hospitaal. Slotsom: Ouers van vroeggebore babas se perspektiewe is dat vroeg gebore babas nogsteeds ‘n hoë risiko van lewens bedreigende gebeurtenisse is wat kan opeindig in dood binnekort na ontslag vanaf die hospitaal. Hulle het aanvanklik anstig gevoel, maar het selfvertroue gewen, bevoeg en gerusgestel gevoel om baba lewensondersteuning suksesvol toe te dien na ontslag vanaf die hospitaal. Hulle is bemagtig om familie lede en gemeenskappe te bemagtig met basiese baba lewensondersteuning informasie. Hindernisse en ondersteuning faktore was geidentifiseer vanaf albei eenhede van analisering om die basiese baba ondersteuning opleiding program sistematies te verbeter.

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