Adu-Bonsaffoh Kwame, Tamma Evelyn, Nwameme Adanna Uloaku, Mocking Martina, Osman Kwabena A, Browne Joyce L
Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana.
Holy Care Specialist Hospital, Accra, Ghana.
PLOS Glob Public Health. 2022 Dec 1;2(12):e0001303. doi: 10.1371/journal.pgph.0001303. eCollection 2022.
Preterm birth is a leading cause of death in children under five and a major public concern in Ghana. Women's lived experiences of care following preterm birth in clinical setting represents a viable adjunctive measure to improve the quality of care for premature infants. This qualitative study explored the knowledge and experiences of women who have had preterm birth and the associated challenges in caring for premature infants at a tertiary hospital. A qualitative design using in-depth interviews (IDIs) was conducted among women who experienced preterm birth with surviving infants at the Korle-Bu Teaching Hospital in Accra, Ghana. A thematic content analysis using the inductive analytic framework was undertaken using Nvivo. Thirty women participated in the study. We observed substantial variation in women's knowledge on preterm birth: some women demonstrated significant understanding of preterm delivery including its causes such as hypertension in pregnancy, and potential complications including neonatal death whilst others had limited knowledge on the condition. Women reported significant social and financial challenges associated with preterm birth that negatively impacted the quality of postnatal care they received. Admission of preterm infants at the neonatal intensive care unit (NICU) generated enormous psychological and emotional stress on the preterm mothers due to uncertainty associated with the prognosis of their babies, health system challenges and increased cost. Context-specific recommendations to improve the quality of care for prematurely born infants were provided by the affected mothers and include urgent need to expand the National Health Insurance Scheme (NHIS) coverage and more antenatal health education on preterm birth. Mothers of premature infants experienced varied unanticipated challenges during the care for their babies within the hospital setting. While knowledge of preterm birth seems adequate among women, there was a significant gap in the women's expectations of the challenges associated with the care of premature infants of which the majority experience psychosocial, economic and emotional impact.
早产是五岁以下儿童死亡的主要原因，也是加纳的一个重大公共关切问题。妇女在临床环境中早产之后的护理经历是提高早产儿护理质量的一项可行辅助措施。这项定性研究探讨了有过早产经历的妇女的知识和经历，以及在一家三级医院护理早产儿时面临的相关挑战。在加纳阿克拉的科勒-布教学医院，对有存活婴儿的早产妇女进行了一项采用深入访谈的定性设计研究。使用Nvivo进行了基于归纳分析框架的主题内容分析。30名妇女参与了该研究。我们观察到妇女对早产的知识存在很大差异：一些妇女对早产有显著的了解，包括其原因如妊娠期高血压，以及潜在并发症如新生儿死亡，而另一些妇女对这种情况的了解有限。妇女报告了与早产相关的重大社会和经济挑战，这些挑战对她们所接受的产后护理质量产生了负面影响。由于婴儿预后的不确定性、卫生系统的挑战以及成本增加，将早产儿收治到新生儿重症监护病房（NICU）给早产母亲带来了巨大的心理和情感压力。受影响的母亲们提出了针对具体情况的建议，以提高对早产儿的护理质量，包括迫切需要扩大国家健康保险计划（NHIS）的覆盖范围，以及开展更多关于早产的产前健康教育。在医院环境中照顾婴儿期间，早产儿母亲经历了各种意想不到的挑战。虽然妇女对早产的了解似乎足够，但在妇女对与护理早产儿相关挑战的预期方面存在显著差距，其中大多数人经历了心理社会、经济和情感方面的影响。
