Department of Community Health Sciences, The Aga Khan University, Stadium Road, Box 3500, Karachi, PO, 74800, Pakistan.
National Institute of Child Health, Karachi, Pakistan.
Reprod Health. 2019 May 10;16(1):53. doi: 10.1186/s12978-019-0730-9.
Recently, the minimal invasive tissue sampling (MITS) procedure has been developed to support determination of the cause of death as an alternate to conventional autopsy, especially in countries where complete diagnostic autopsy is not routine. To assess the feasibility of implementation of the MITS procedure for a study to determine cause of death in premature births and stillbirths in south Asia, we explored the views and perceptions of parents and religious leaders on the acceptability of MITS.
A qualitative study was conducted at the National Institute of Child Health (NICH) hospital of Karachi, Pakistan. Focus group discussions (FGDs) were conducted with parents of newborns who visited well-baby clinics of the NICH hospital for post-natal check-ups. Key-informant interviews (KIIs) were conducted with religious leaders. Data were analyzed using NVivo 10 software.
A total of 13 interviews (FGDs = 8; KIIs = 5) were conducted. Three overarching themes were identified: (I) acceptability of MITS; (II) concerns affecting the implementation of MITS; and (III) religious and cultural perspectives. Participants' acceptance of MITS was based on personal, religious, cultural and social beliefs. Parents widely recognized the need for this procedure in cases where the couple had experienced multiple stillbirths, neonatal deaths and miscarriages. Counseling of parents was considered vital to address emotional concerns of the parents and the family. Religious leaders indicated acceptability of the MITS procedure from a religious perspective and advised that respect for the deceased and consent of the guardians is mandatory when performing MITS.
This qualitative study provided a unique opportunity to understand the views of parents and religious leaders towards the use of MITS. Generally, MITS appears to be an acceptable method for identifying the cause of death in neonates and stillbirths, provided that the deceased is respected and buried as soon as possible without any delays and parents are counseled appropriately. Findings from this research are essential in approaching families for consent for MITS.
最近，微创组织取样（MITS）程序已被开发出来，以支持确定死亡原因，作为传统尸检的替代方法，特别是在没有常规进行全面诊断性尸检的国家。为评估在南亚进行早产和死产死亡原因研究中实施 MITS 程序的可行性，我们探讨了父母和宗教领袖对 MITS 可接受性的看法和看法。
在巴基斯坦卡拉奇的国家儿童健康研究所（NICH）医院进行了一项定性研究。对在 NICH 医院新生儿诊所进行产后检查的新生儿父母进行了焦点小组讨论（FGD）。对宗教领袖进行了关键知情者访谈（KII）。使用 NVivo 10 软件分析数据。
共进行了 13 次访谈（FGD=8；KII=5）。确定了三个总体主题：（I）MITS 的可接受性；（II）影响 MITS 实施的关注点；和（III）宗教和文化观点。参与者对 MITS 的接受程度基于个人、宗教、文化和社会信仰。父母普遍认识到在夫妇经历多次死产、新生儿死亡和流产的情况下，需要进行此程序。对父母进行咨询被认为是解决父母和家庭情绪问题的关键。宗教领袖从宗教角度表示接受 MITS 程序，并建议在进行 MITS 时，必须尊重死者并获得监护人的同意。
这项定性研究为了解父母和宗教领袖对使用 MITS 的看法提供了一个独特的机会。一般来说，MITS 似乎是一种可接受的方法，可以确定新生儿和死产的死亡原因，前提是死者尽快得到尊重和埋葬，没有任何拖延，并且父母得到适当的咨询。本研究的结果对于寻求家庭同意进行 MITS 至关重要。
