Guidelines for healthcare professionals to manage children with foetal alcohol syndrome at health facilities in Khomas region, Namibia

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Date
2017
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Publisher
University of Namibia
Abstract
In this study, the researcher explored and described the views of health care professionals who are managing children with foetal alcohol syndrome at public health facilities in the Khomas Region in Namibia. The purpose of this research project was to develop and evaluate foetal alcohol syndrome guidelines. This study was qualitative, explorative, descriptive, and contextual in nature and was conducted in four phases. Phase 1: This phase focused on a situation analysis. The researcher conducted the situation analysis to explore and describe experiences of health care professionals who are providing health care for children with foetal alcohol syndrome at the Katutura State Hospital and the Windhoek Central Hospital in the Khomas Region. The participants were registered nurses, enrolled nurses, medical doctors, and social workers. The researcher used in-depth unstructured interviews to collect data from twelve (n = 12) participants at the Rehoboth District Hospital for a pilot study and from seventeen (n = 17) participants at the Katutura Hospital and the Central Hospital respectively. Six (n = 6) focus group discussions were conducted; two (n = 2) for the pilot study and four at the abovementioned hospitals. Tech’s methods were employed for the data analysis. Four themes and 12 sub-themes were identified. The results of the study were used as basis to develop the FAS guidelines for addressing the challenges experienced by health care professionals. Phase 2: In this phase, the conceptual framework served as guiding tools to develop the guidelines. The essential components identified by Dickoff, James, and Wiedenbach (1968) were used; namely purpose of the activity, and prescription of the activity to the attainment of the set goal. The guidelines included activities from the survey list of Dickoff et al., (1968). These elements were: Agent (researcher), recipient (health care professionals), context (health facilities), dynamics (challenges experienced by the health care professionals in the context of managing FAS, procedure (guidelines for health care professionals to facilitate the management of FAS, and terminus (individual health care professionals’ abilities to manage FAS competently in accordance of their scopes of practice). Phase 3: The third phase dealt with the development of the FAS guidelines for the health care professionals. The researcher utilised the findings from the situation analysis (Phase 1) and the survey list (Phase 2) of Dickoff et al., (1968) as a reasoning map. The content for the guidelines were supplemented with the information adopted from the Centre for Diseases Control (CDC) (2004), and the Canadian guidelines for diagnosis of FAS. The guidelines comprised six components. The first one focused on the general knowledge for health care professionals to understand the management of FAS, while the other components specifically targeted medical doctors, nurses, social workers and psychologist, occupational therapist, as well as speech therapists. The guidelines structure for each group of health care professionals comprised the aim, role, and responsibilities; management of FAS; management of the environment for mother and other family members, as well as strengthening interprofessional collaboration in terms of the treatment of FAS. Phase 4: Phase 4 aimed at evaluating the guidelines for the facilitation of the management of FAS by health professionals in the context of the health care facilities. This was done to ensure the authenticity, accessibility, and utilisation to enable the maintenance of such guidelines. This was done in collaboration with various stakeholders who were experts in the field of each category of health care professionals. The guidelines were evaluated in accordance with the criteria of Chinn and Kramer (1991) to observe how clear, simple, general, accessible, and important the guidelines were. That was achieved by conducting a one-day workshop during which the experts were provided with given guidelines to analyse and afforded an opportunity to give their recommendations for improvement of the guidelines. During Phase 4 of the study, the guidelines for health care professionals were identified with the purpose of facilitating the management of children with FAS. Those guidelines were derived and conceptualised from the challenges that the participants were experiencing in the context of health care facilities. The guidelines observed the parameters of international standard for FAS management. The health care professionals would manage the children with FAS in the context of their respective scopes of practice. The study recommends the incorporation of the study findings in the curricula for various health care professionals the augment their essential training growth during in-service training and continual education interventions. Furthermore, the researcher recommends that research should be conducted to generate new ideas from the mother, the family, and the community in general to explore their challenges since this study has narrowly focused on the needs of health care professionals. This research should be done in various regions. Equally, this study urges policy makers to make provision for implementing the developed guidelines that specifically target various health care professionals in the Ministry of Health and Social Services.
Description
A research dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy in Public Health
Keywords
Foetal alcohol syndrome
Citation