dc.contributor.advisor | Gerber, Berna | en_ZA |
dc.contributor.author | Buys, Kristen H. S. | en_ZA |
dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech Language and Hearing Therapy. | en_ZA |
dc.date.accessioned | 2020-02-14T11:10:54Z | |
dc.date.accessioned | 2020-04-28T12:17:36Z | |
dc.date.available | 2020-02-14T11:10:54Z | |
dc.date.available | 2020-04-28T12:17:36Z | |
dc.date.issued | 2020-03 | |
dc.identifier.uri | http://hdl.handle.net/10019.1/108071 | |
dc.description | Thesis (MSL&HT)--Stellenbosch University, 2020. | en_ZA |
dc.description.abstract | ENGLISH ABSTRACT : Background: The concept of vulnerability, as defined by Adger (2006), relates to an individuals’ “state of susceptibility to harm, powerlessness, and marginality” (p. 286). Respectively, the ‘vulnerable’
participants consisted of mothers of preterm infants, belonging to a largely marginalised
indigenous cultural community (isiXhosa-speaking), living within low socioeconomic
circumstances. Preterm birth remains a rising global threat to maternal and infant mortality and
morbidity, with preterm birth accounting for 5-18% of births worldwide. Mothers, and other
primary caregivers of preterm infants, face many day-to-day caregiving challenges. These
mothers’ experiences are influenced both positively and negatively by a myriad of factors,
including traditional/cultural, socioeconomic and contextual influences. Understanding the daily
realities these mothers face is thus essential in designing and providing interventions that are
contextually appropriate for the patient populations. A need for and striving towards culturally
competent healthcare is being globally recognised, but studies with such vulnerable populations
are difficult to source. Such knowledge is necessary for evidence-based practice, however, a
notable knowledge gap in terms of such vulnerable populations is evident. Aims and Objective: The main objective of this study was to describe and explain the maternal experiences of having,
caring for, feeding and communicating with their (the mothers’) preterm infants in low socioeconomic
circumstances in South Africa. The study explored such experiences of those isiXhosaspeaking
mothers; a vulnerable population about whom limited knowledge is available. This
objective was achieved through eight sub-aims.
Participants and Methodology: The study employed a qualitative cross-sectional design that was explorative in nature. A semistructured
discussion schedule was used to guide 15 in-depth interviews that were later
thematically analysed. The participants were vulnerable mothers of preterm infants who were
born and received follow-up appointments at the tertiary hospital serving as the research site. The
participants’ infants were of stable medical health and between the ages of three and six months
chronological age (term – three months corrected age) and had spent a minimum of one week at
home after hospital discharge. Findings: Briefly, caring for a preterm infant was difficult, with concerns about medical stability and
negative perceptions of tube feeding contributing to this negative initial experience. In-hospital
support systems such as nursing staff, kangaroo mother care (KMC), information sessions and
religious services provided positive influences throughout the hospital stays. Furthermore, homebased
support systems (for example, with caregiving and chore-based, emotional and financial
support) appeared to be one of the most positive aspects of mothers’ overall experiences.
Additionally, prematurity influenced maternal decision-making and mothers showed high
perceptions of infant vulnerability. It was also found that the hospital staff’s poor understanding
and knowledge of cultural traditions surrounding infant birth impacted mothers’ abilities to
participate in certain traditional practices such as Imbeleko (the first ceremony that is performed
when a baby is born). Conclusion: The findings highlighted both universally shared and population-specific aspects of having and
caring for a preterm infant. Important information emerged regarding influential factors within
such maternal experiences, as well as information that may assist healthcare workers in providing
mothers with premature infants with culture-specific care. | en_ZA |
dc.description.abstract | AFRIKAANSE OPSOMMING : Agtergrond: Die konsep van kwesbaarheid, as omskryf deur Adger (2006), hou verband met ‘n individu se ‘toestand van vatbaarheid vir skade, magteloosheid en marginaliteit’ (p. 286). Die 'kwesbare'
deelnemers bestaan uit moeders van vroeggebore babas, wat deel uitmaak van 'n grootliks
gemarginaliseerde inheemse kultuurgemeenskap (isiXhosa-sprekend), wat onder lae sosioekonomiese
omstandighede leef. Premature geboortes hou wêreldwyd toenemend ’n bedreiging
in vir moeder- en babasterftes en -mortaliteit, met 5% tot 18% van alle babas oor die wêreld wat
prematuur gebore word. Moeders en ander primêre versorgers van premature babas kom daagliks
voor talle versorgingsuitdagings te staan. ʼn Menigte faktore, met inbegrip van
tradisionele/kulturele, sosio-ekonomiese en kontekstuele invloede, het ʼn positiewe sowel as ʼn
negatiewe invloed op hierdie moeders se ervarings. Gevolglik is dit noodsaaklik om die daaglikse
werklikhede waarmee hierdie moeders gekonfronteer word, te verstaan ten einde ingrypings te
ontwerp en te voorsien wat kontekstueel geskik is vir die pasiëntbevolking. ʼn Behoefte aan en ʼn
strewe na kultuurgeskikte gesondheidsorg word wêreldwyd erken, maar dit is moeilik om studies
oor sulke kwesbare populasies te vind. Ofskoon dié kennis noodsaaklik is vir bewysgebaseerde
versorging, is dit duidelik dat daar ongetwyfeld ’n tekort aan kennis betreffende sulke kwesbare
bevolkingsgroepe bestaan. Doelstelling en doelwitte: Die hoofdoelstelling van hierdie studie was die beskrywing en verduideliking van moeders in
swak sosio-ekonomiese omstandighede in Suid-Afrika se ervaring daarvan om premature babas
te hê, hulle te versorg en te voed, en met hulle te kommunikeer. Hierdie studie het sulke ervarings
van Xhosa-sprekende moeders ondersoek; ʼn kwesbare groep oor wie slegs ʼn beperkte
hoeveelheid inligting beskikbaar is. Hierdie doelstelling is deur agt sekondêre doelwitte bereik.
Deelnemers en metodologie: ʼn Kwalitatiewe deursnee-ontwerp wat verkennend van aard is, is in die studie gebruik. ʼn
Semigestruktureerde besprekingskedule is as riglyn gebruik vir 15 diepgaande onderhoude wat
later tematies ontleed is. Die deelnemers was kwesbare moeders van vroeggebore babas wat
gebore was en opvolgbehandeling ontvang het in die tersiêre hospitaal wat as die
navorsingsterrein gedien het. Al die deelnemers was vroue met ʼn lae sosio-ekonomiese status (soos bepaal deur opvoedkundige status en finansiële inkomste) wat in die omgewing van die
tersiêre hospitaal gewoon het. Die deelnemers se babas was stabiel en gesond en hulle
chronologiese ouderdom was tussen drie en ses maande (termyn – drie maande reggestelde
ouderdom) en was reeds vir minstens ʼn week tuis nadat hulle uit die hospitaal ontslaan is. Bevindings:
Kortliks, dat dit moeilik is om ʼn premature baba te versorg, en dat kommer oor mediese stabiliteit
en negatiewe persepsies van buisvoeding bygedra het tot die aanvanklik negatiewe ervaring. Die
hospitaal se interne ondersteuningstelsels soos verpleegpersoneel, kangaroe-moederversorging
(KMV), inligtingsessies en religieuse dienste was dwarsdeur die hospitaalverblyf positiewe
invloede. Verder het tuisgebaseerde ondersteuningstelsels (byvoorbeeld ondersteuning met
versorging en daaglikse huiswerk, asook emosionele en finansiële steun) geblyk een van die
positiefste aspekte van die moeders se algehele ervaring te wees. Verder het die premature
geboortes die moeders se besluitneming beïnvloed en hulle het sterk persepsies van die babas se
kwesbaarheid getoon. Ook is daar gevind dat die hospitaalpersoneel se swak begrip en
gebrekkige kennis van kulturele tradisies betreffende kindergeboorte ʼn impak gehad het op die
moeders se vermoë om deel te neem aan sekere tradisionele gebruike soos Imbeleko (die eerste
seremonie wat plaasvind nadat ʼn baba gebore is).
Slotsom: Die bevindings onderstreep sowel universele as bevolkingspesifieke aspekte daarvan om ʼn
premature baba te hê en te versorg. Belangrike inligting het aan die lig gekom oor faktore wat ʼn
invloed uitoefen op sulke ervarings van moeders, asook inligting wat gesondheidsorgwerkers kan
help in die voorsiening van kultuurgeskikte sorg aan moeders van premature babas. | af_ZA |
dc.format.extent | xi, 206 pages ; illustrations, includes annexures | |
dc.language.iso | en_ZA | en_ZA |
dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
dc.subject | Premature infants -- Nutrition -- South Africa | en_ZA |
dc.subject | Mothers of prematurely born children -- South Africa | en_ZA |
dc.subject | Low-income mothers -- South Africa | en_ZA |
dc.subject | Enteral feeding | en_ZA |
dc.subject | UCTD | |
dc.title | Maternal experiences of prematurity, feeding and infant communication within a vulnerable population in South Africa | en_ZA |
dc.type | Thesis | en_ZA |
dc.description.version | Masters | en_ZA |
dc.rights.holder | Stellenbosch University | en_ZA |