237 - Caregiver perspectives on strengths and barriers in the care of pediatric injury patients at a tertiary referral hospital in Northern Tanzania

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 237
Publication Number: 237.45

Maddy Vonderohe, Primary Children's Hospital, Salt Lake City, UT, United States; Francis Sakita, Kilimanjaro Christian medical Centre, Moshi, Kilimanjaro, Tanzania; Getrude Melkizedeck. Nkini, Duke Collaboration, Moshi Town, Kilimanjaro, Tanzania; Ismail Amiri, Duke University, Durham, NC, United States; Kelly B.. Loutzenheiser, Primary Children's Hospital, Salt Lake City, UT, United States; Bryan Young, University of Utab, Salt Lake City, UT, United States; Sharla Rent, Duke University School of Medicine, Durham, NC, United States; Melissa Watt, University of Utah, Department of Population Health Sciences, Salt Lake City, UT, United States; Catherine A. Staton, Duke University School of Medicine, Durham, NC, United States; Blandina T. Mmbaga, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania; Elizabeth M. Keating, University of Utah, Salt Lake City, UT, United States

Presenting Author(s)

Maddy Vonderohe, MD (she/her/hers)

Pediatric Resident
Primary Children's Hospital
Salt Lake City, Utah, United States

Background:

Pediatric injuries are a leading cause of morbidity and mortality in low- and middle-income countries (LMICs). It is important that injured children get quality care in order to improve their outcomes. Injured children are nearly always accompanied by caregivers invested in their outcome, and who will be responsible for their recovery and rehabilitation after discharge.

Objective: The purpose of this study was to identify caregiver perspectives on strengths and barriers in pediatric injury care throughout hospitalization at a tertiary zonal referral hospital in Northern Tanzania.

Design/Methods: This study was conducted at a tertiary zonal referral hospital in Northern Tanzania. Qualitative semi-structured in-depth interviews (IDIs) were conducted by trained interviewers who were fluent in English and Swahili in order to examine the strengths and barriers in pediatric injury care. 30 IDIs were completed from November 2020 and October 2021 with 30 family member caregivers of an admitted pediatric injured patient. De-identified transcripts were condensed into memos that were then analyzed through a team-based, thematic approach informed by applied thematic analysis.

Results:

Recurring themes throughout the interviews included both strengths and barriers. In the emergency department (ED), one strength was how quickly patients were evaluated and treated. One barrier was that staff sometimes seemed too busy to answer questions, and the severity of the patient’s condition or plan of care was not communicated to the caregiver until the patient reached the ward. During hospitalization, attentive nursing care and the willingness of nurses to answer questions was noted as a strength. A barrier during hospitalization was that physician teams would often speak in English and not always take the time to translate patient status or plan to the caregiver. At time of discharge, caregivers appreciated that they were generally allowed an opinion on the readiness of the patient to discharge home, however many families felt they were sent home without any instructions for rehabilitation, ongoing care, or guidance for follow-up.

Conclusion(s):

hese IDIs highlighted strengths and barriers throughout hospitalization that could lead to interventions to improve the care of pediatric injury patients in Northern Tanzania. These interventions include prioritizing communication with families about patient status and care plan in the ED, ensuring all direct communication is in the families’ native language, and standardizing instructions regarding discharge and follow-up.