The Cry to Be Involved: Experiences of Caregivers on Participation in Decision Making and Care Provision at Mercy James PICU in Blantyre, Malawi.

Grace Chasweka, Maureen Daisy Majamanda, Annie Namathanga
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Abstract

A child's illness and admission in a hospital are stressful and can negatively affect the child and his/her caregivers. The stress is further exacerbated when a child is critically ill and has been admitted to an intensive care unit (ICU). The effects can be reduced when caregivers of the sick children are present and involved in decision making and actual care of their hospitalized children, a care model called family-centered care. Malawi has adopted family-centered care model in the newly instituted Mercy James Pediatric ICU. Little is known about experiences of caregivers with FCC in Malawi. This qualitative study was therefore conducted to explore experiences of caregivers on their involvement in decision making and care at Mercy James Pediatric ICU in Blantyre, Malawi. This was a descriptive qualitative study with a sample size of fifteen participants, however, data saturation was reached with ten participants. One on one in-depth interviews were conducted among a purposively selected sample of ten caregivers whose children had been discharged from the PICU. Content analysis was deductively and manually undertaken to analyze data with the aid of delve software to organize the data. Findings show that not every caregiver was involved in the decision making of their children's care, and if they did, it was not adequate. Barriers to effective involvement such as using a foreign language had a negative impact on comprehensive involvement of caregivers in decision making for their children's care. All participants were, however, involved in the physical care of their children. It is important that health care workers should continuously encourage caregivers to get involved in the decision making and care of their children.

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参与的呼声:马拉维布兰太尔Mercy James PICU护理人员参与决策和护理提供的经验。
儿童的疾病和住院是有压力的,可能对儿童及其照顾者产生负面影响。当儿童病危并被送进重症监护病房(ICU)时,压力会进一步加剧。当患病儿童的看护人在场并参与决策和住院儿童的实际护理时,这种影响可以减少,这种护理模式被称为以家庭为中心的护理。马拉维在新成立的Mercy James儿科重症监护室采用了以家庭为中心的护理模式。在马拉维,人们对患有FCC的护理人员的经历知之甚少。因此,本定性研究旨在探讨马拉维布兰太尔Mercy James儿科ICU护理人员参与决策和护理的经验。这是一项描述性定性研究,样本量为15名参与者,然而,10名参与者达到了数据饱和。一对一的深度访谈是在有目的地选择的10名护理人员的样本中进行的,他们的孩子已经从PICU出院。内容分析采用演绎法和人工进行分析,借助delve软件对数据进行整理。研究结果表明,并不是每个照顾者都参与了孩子照顾的决策,即使他们参与了,也是不够的。有效参与的障碍,如使用外语,对照顾者全面参与照顾子女的决策有负面影响。然而,所有的参与者都参与了对孩子的身体照顾。重要的是,卫生保健工作者应不断鼓励照顾者参与其子女的决策和照顾。
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