Department of Rehabilitation Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi.
Division of Community Pediatrics, Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Front Public Health. 2024 Jul 3;12:1390645. doi: 10.3389/fpubh.2024.1390645. eCollection 2024.
Caregiver training is a key component of rehabilitation for children with complex lifelong disabilities such as cerebral palsy. However critical shortages of therapists in low- and middle-income countries like Malawi, reduce access to therapy. Introducing expert caregivers to assist with the provision of basic training on the condition for fellow caregivers offers a potential solution. However, there is a paucity of evidence regarding the implementation of such strategies in low-resource settings. The aim of this study was to explore perspectives of stakeholders regarding the feasibility of implementing a caregiver-led and delivered training program for caregivers of children with cerebral palsy in Malawi.
Over 5 days in January 2023, a caregiver-led training program, the "Malamulele Onward Carer-to-Carer Training Program," was conducted in Blantyre, Malawi. A South African master trainer traveled to Malawi and delivered the program to potential stakeholders including caregivers of children with cerebral palsy; physiotherapists; and community-based organization representatives. Stakeholder perspectives regarding the acceptability, demand, practicality and adaptation of the program were obtained through a combination of focus group discussions, in-depth interviews, and daily field notes. Data from the focus group discussions and in-depth interviews were analyzed using thematic analysis.
The caregiver-led training program was deemed acceptable despite two areas identified as potential areas of concern; that the expert caregivers may cross practice boundaries and that their fellow caregivers may look down upon them. A demand for this program was expressed because of perceived relative advantages and relevance to caregiver needs. Participants indicated that the intervention could be easily delivered using local materials, absorbed and supported by existing community structures.
A caregiver-led training program offers an innovative way of supporting caregivers of children with complex disabilities such as cerebral palsy in low-resource settings. The stakeholder engagement demonstrated the positive perspectives of all stakeholders. The areas for modification and adaptation highlighted by the stakeholders will be useful in strengthening the implementation of the program in Malawi.
对于患有脑瘫等复杂终身残疾的儿童，护理人员培训是康复的关键组成部分。然而，像马拉维这样的中低收入国家治疗师严重短缺，减少了接受治疗的机会。引入专家护理人员来协助为其他护理人员提供关于该疾病的基本培训提供了一种潜在的解决方案。然而，关于在资源匮乏的环境中实施这种策略的证据很少。本研究旨在探讨利益相关者对在马拉维实施以护理人员为主导的脑瘫儿童护理人员培训计划的可行性的看法。
2023 年 1 月，在马拉维布兰太尔进行了为期 5 天的以护理人员为主导的培训计划，即“Malamulele Onward 护理人员对护理人员培训计划”。一位南非首席培训师前往马拉维，向可能的利益相关者（包括脑瘫儿童的护理人员、物理治疗师和社区组织代表）提供该计划。通过焦点小组讨论、深入访谈和日常实地笔记，获得了利益相关者对该计划的可接受性、需求、实用性和适应性的看法。焦点小组讨论和深入访谈的数据采用主题分析进行分析。
尽管有两个被认为是潜在关注领域的领域，即专家护理人员可能越过实践界限，他们的同行护理人员可能看不起他们，但以护理人员为主导的培训计划被认为是可以接受的。由于认为该计划具有相对优势且与护理人员的需求相关，因此表达了对该计划的需求。参与者表示，该干预措施可以使用当地材料轻松提供，并且可以由现有的社区结构吸收和支持。
以护理人员为主导的培训计划为在资源匮乏的环境中支持患有脑瘫等复杂残疾的儿童的护理人员提供了一种创新方式。所有利益相关者的参与表明了他们的积极看法。利益相关者强调的修改和适应领域将有助于加强该计划在马拉维的实施。
