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袋鼠式护理:对乌干达东部一家三级教学医院中早产儿母亲的实践与体验的定性研究

KANGAROO MOTHER CARE: A QUALITATIVE STUDY ON THE PRACTICE AND EXPERIENCES OF MOTHERS OF PRETERM NEONATES IN A TERTIARY TEACHING HOSPITAL IN EASTERN UGANDA.

作者信息

Naloli Mercy, Ssenyonga Lydia V N, Kagoya Enid Kawala, Nteziyaremye Julius, Nekaka Rebecca

机构信息

Department of Nursing, Faculty of Health Sciences Busitema University.

Department of of Community and Public Health, Faculty of Health Sciences Busitema University.

出版信息

Int J Res Health Sci Nurs. 2021 Nov;7(11).

Abstract

INTRODUCTION

Globally, neonatal deaths continues to be a challenge especially to to attainment of sustainable development goal 3. About 4 million neonatal deaths per year, with 99% of the deaths occurring in low and middle resource countries, 75% of these occurring in the first week of life. Prematurity remains an indirect leading cause of mortality and morbidity. Uganda's progress on the improvement of perinatal morbidity and mortality has largely stagnated at 27 deaths per 1,000 live births from the year 2006. One of the cost-effective readily available interventions that would curtail perinatal mortality is kangaroo mother care(KMC)- a low tech four decades old intervention. However challenges about its implementation persist on in Uganda despite intensified implementation and roll-out startegies in 2010. This study, the first of its kind to the best of our knowledge in eastern Uganda sought to find the facilitators and barriers of KMC.

MATERIALS AND METHODS

This was a qualitative study using in-depth interviews(IDI) carried out at a tertiary university teaching hospital. Twenty IDIs were carried out among mothers/caretakers using the phenomena theory. After each IDI, each transcript was analyzed by two researchers working independently using NVIVO software version 11 plus (QSR International, Burlington, Massachusetts) and themes and subthemes developed.

RESULTS

Majority of mothers/caretakers, were adolescents and young adults and primiparous at 55%. The major facilitators to KMC were supportive staff that facilitated positive attitude, ability to substitute provider and family support.The major barriers were lack of family support, lack of male involvement, maternal stress and poor health and multiple gender roles, infrastructural challenges, and misconceptions associated with preterm births such as early sexual intercourse and lack of herbal medicine use.

CONCLUSION

More facility leadership involvement and engagement of mothers during antenatal, community and promotion of male involvement in sexual and reproductive health matters will improve uptake of KMC. This can be spearheadded by sexual and reproductive health, and neonatal and child health care service providers.

摘要

引言

在全球范围内,新生儿死亡仍然是一项挑战,尤其是对实现可持续发展目标3而言。每年约有400万新生儿死亡,其中99%发生在资源匮乏的中低收入国家,75%发生在出生后的第一周。早产仍然是导致死亡和发病的一个间接主要原因。自2006年以来,乌干达在改善围产期发病率和死亡率方面的进展基本停滞在每1000例活产中有27例死亡。袋鼠式护理(KMC)是一种低成本且已应用了40年的干预措施,是降低围产期死亡率的一种具有成本效益且易于实施的干预措施之一。然而,尽管2010年加强了实施和推广策略,但在乌干达,关于其实施的挑战仍然存在。据我们所知,本研究是乌干达东部首个此类研究,旨在找出袋鼠式护理实施的促进因素和障碍。

材料与方法

这是一项在一所大学教学医院进行的定性研究,采用深入访谈(IDI)。使用现象学理论对母亲/照顾者进行了20次深入访谈。每次深入访谈后,由两名独立工作的研究人员使用NVIVO 11 plus软件(QSR International,马萨诸塞州伯灵顿)对每份访谈记录进行分析,并确定主题和子主题。

结果

大多数母亲/照顾者为青少年和年轻成年人,初产妇占55%。袋鼠式护理的主要促进因素是提供支持的工作人员,他们促进了积极的态度、替代提供者的能力和家庭支持。主要障碍包括缺乏家庭支持、男性参与不足、母亲压力和健康状况不佳以及多种性别角色、基础设施挑战,以及与早产相关的误解,如过早性行为和未使用草药。

结论

更多的机构领导参与以及在产前、社区中让母亲参与并促进男性参与性与生殖健康事务,将提高袋鼠式护理的采用率。这可以由性与生殖健康以及新生儿和儿童保健服务提供者来带头推动。

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