The INCLEN Trust International, New Delhi, 110020, India.
Division of Reproductive Biology Maternal and Child Health, Indian Council of Medical Research, New Delhi, 110029, India.
Reprod Health. 2021 Aug 4;18(1):168. doi: 10.1186/s12978-021-01218-4.
Minimal invasive tissue sampling (MITS) has emerged as a suitable alternative to complete diagnostic autopsy (CDA) for determination of the cause of death (CoD), due to feasibility and acceptability issues. A formative research was conducted to document the perceptions of parents, community and religious leaders on acceptability of MITS.
This qualitative study was conducted at and around the Safdarjung Hospital, Delhi, India. Participants for in-depth interview included the parents who had either child or neonatal death or stillbirth and the key community and religious representatives. The focus group discussions (FGDs) involved community members. Process of obtaining consent for MITS was observed. Data were analyzed inductively manually for emerging themes and codes.
A total of 104 interviews (parents of deceased children, neonates or stillbirths, n = 93; community members, n = 8 and religious leaders, n = 7), 8 FGDs (n = 72) were conducted and process of obtaining consent for MITS (n = 27) was observed. The participants were positive and expressed willingness to accept MITS. The key determinants for acceptance of MITS were: (1) understanding and willingness to know the cause of death or stillbirth, (2) experience of the healthcare received and trust, (3) the religious and sociocultural norms. Parents and community favored for MITS over CDA when needed, especially where in cases with past stillbirths and child deaths. The experience of treatment, attitude and communication from healthcare providers emerged as important for consent. The decision making process was collective involving the elders and family. No religious leader was against the procedure, as both, the respect for the deceased and need for medical care were satisfied.
Largely, MITS appeared to be acceptable for identifying the causes of child deaths and stillbirths, if the parents and family are counseled appropriately considering the sociocultural and religious aspects. They perceived the quality of care, attitude and communication by the healthcare providers as critical factors for acceptance of MITS.
由于可行性和可接受性问题，微创组织取样 (MITS) 已成为确定死因 (CoD) 的完全诊断性尸检 (CDA) 的合适替代方法。进行了一项形成性研究，以记录家长、社区和宗教领袖对 MITS 可接受性的看法。
本定性研究在印度德里的 Safdarjung 医院及其周边地区进行。深入访谈的参与者包括有孩子、新生儿或死产死亡或死产的父母以及主要的社区和宗教代表。焦点小组讨论 (FGD) 涉及社区成员。观察了获得 MITS 同意的过程。使用手动方法对数据进行了归纳分析，以提取主题和代码。
共进行了 104 次访谈（已故儿童、新生儿或死产的父母，n=93；社区成员，n=8 和宗教领袖，n=7），进行了 8 次 FGD（n=72），并观察了获得 MITS 同意的过程（n=27）。参与者持积极态度，并表示愿意接受 MITS。接受 MITS 的关键决定因素包括：(1) 了解和愿意了解死因或死产的原因，(2) 对所获得的医疗保健的体验和信任，(3) 宗教和社会文化规范。当需要时，父母和社区赞成 MITS 而不是 CDA，尤其是在过去有死产和儿童死亡的情况下。医疗保健提供者的治疗经验、态度和沟通方式被认为是同意的重要因素。决策过程是集体的，涉及长辈和家人。没有宗教领袖反对该程序，因为尊重死者和满足医疗需求都得到了满足。
如果父母和家人在适当考虑社会文化和宗教方面的情况下得到适当的咨询，MITS 似乎可以接受用于确定儿童死亡和死产的原因。他们认为医疗保健提供者的护理质量、态度和沟通是接受 MITS 的关键因素。
