家庭环境中热性惊厥的管理：加纳 Cape Coast 都会区多种照护者实践的定性研究。

Management of febrile convulsion in home settings: a qualitative study of multiple caregiver practices in the Cape Coast Metropolis in Ghana.

机构信息

Department of Population and Health, University of Cape Coast, Cape Coast, Ghana

出版信息

BMJ Open. 2024 Aug 13;14(8):e075541. doi: 10.1136/bmjopen-2023-075541.

DOI:10.1136/bmjopen-2023-075541

PMID:39142674

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11331976/

Abstract

BACKGROUND

Febrile convulsion (FC) among children is a common emergency concern received in hospitals and clinics. However, in Ghana, FC is commonly perceived as a non-hospital disease and usually managed at home. There is limited research on the home management of FC. This study, therefore, explored the home management of FC.

METHODS

The study design was a descriptive and interpretive phenomenology. Data sources were triangulated among 42 participants across 5 communities within 2 km distance from regional hospitals in the Cape Coast Metropolis. Participants were purposively selected and interviewed face to face in their homes and treatment centres using semistructured interview guides. Interviews were transcribed and thematically analysed with QSR NVivo V.14.

RESULTS

Three themes were identified from the inductive analysis. These themes were treatment, prevention and case referral. Subthemes on treatment were tepid sponging with lukewarm water, the use of herbal medicine and spiritual approaches. FC was referred to as 'asram suro'. The 'asram' literally means the moon, and 'suro' connotes the skies, indicating possibly that the condition emanates from a god of the moon. Caregivers prevented FC through behavioural approaches, herbal medicine, and mystical approaches including making scarification and tying amulets and beads particularly on the child's face and wrists respectively. FC cases were referred for clinical attention after home care resulted in undesirable treatment outcomes. A conceptual framework depicting the decision-making and practices towards FC management is presented.

CONCLUSION

FC is commonly managed at home independent of orthodox care availability. Caregivers employed herbal and ad hoc treatment regimens, usually unwarranted, visually frightening and spiritual approaches which were not the best home management approaches. These findings call for the need to educate caregivers about the best home management of FC.

摘要

背景

儿童热性惊厥（FC）是医院和诊所常见的急诊关注点。然而，在加纳，FC 通常被认为是一种非医院疾病，通常在家中治疗。关于 FC 的家庭管理，研究有限。因此，本研究探讨了 FC 的家庭管理。

方法

研究设计为描述性和解释性现象学。数据来源在距离 Cape Coast 大都市地区医院 2 公里范围内的 5 个社区中，通过 42 名参与者进行三角测量。参与者是通过目的抽样选择的，并在他们的家中和治疗中心使用半结构化访谈指南进行面对面访谈。访谈被转录，并使用 QSR NVivo V.14 进行主题分析。

结果

从归纳分析中确定了三个主题。这些主题是治疗、预防和病例转介。治疗方面的子主题包括用温水进行温和擦拭、使用草药和精神方法。FC 被称为“asram suro”。“asram”字面意思是月亮，而“suro”表示天空，这可能表明这种情况源自月亮之神。看护人通过行为方法、草药和神秘方法预防 FC，包括在孩子的脸上和手腕上进行割伤和系上护身符和珠子。在家中护理导致不理想的治疗结果后，FC 病例被转介到临床关注。提出了一个描述 FC 管理决策和实践的概念框架。