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Browsing Research Articles (DNS) by Author "Small, Louis F."
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Item Beyond routine care for children with heart diseases from the vulnerable context: A clinical practice perspective(2014) Amakali, Kristofina; Small, Louis F.The statistics of children with heart diseases are notable in Namibia many of whom are from the rural area. While waiting for surgical corrections or when the child is a case for palliative care, these children have to be cared for at home, a task that can be doubtful for a rural caregiver. A qualitative, exploratory, phenomenological and contextual study was conducted to describe the experiences of rural caregivers regarding provision of home care for children with heart disease. The children’s experiences of living with the disease at home were also assessed because the burden of the diseases intensifies the demands for care. The findings revealed that both the caregivers and the children experience challenged emotions, disruptive social functioning, lacking of support from the family, lack of support from societal organisations as well as experiences of low vitality among the children. These experiences together, signify the overall poor coping by the caregivers and the children. Therefore, caring for a child with a heart disease at home requires a plan of individualized care which considers the context and the socio-economic status of the caregivers as the determinants for coping with providing care at home. Based on the findings, key recommendations were made among others to the clinical practice setting as an entry point to the care provided to these children. This paper provides a detailed description of the proposed health care intervention in the clinical setting to facilitate effective home care to children with heart diseases from the rural context.Item Empowerment of the rural parents/caregivers of children with heart diseases in Namibia to facilitate coping with the demands of caring at home(2013) Amakali, Kristofina; Small, Louis F.Aim: The purpose of this study was to describe how the parents/caregivers of children with heart diseases cope with the demands of caring for these children at home, with the purpose to develop a home-based health care programme to facilitate the parents/caregivers’ coping with the demands of care. Methods: A qualitative, exploratory, descriptive, and contextual study was conducted. Phenomenological data on the lived experiences of coping with the demands to care by the parents/caregivers and of living with the burden of the disease by the children were gathered and interpreted from a purposefully selected sample of 5 multiple cases of parents/caregivers and children with heart disease from the rural areas. Results: The findings have revealed poor coping with the demands of caring among the parents/caregivers, as characterized by the experiences of emotional challenges, disruptive social functioning and social relations, lack of support from the family and societal organizations, financial difficulties and of course the experiences of decreased vitality by the children. As a result, the need to empower the parents/caregivers for them to cope with providing a continuum care to their children who have heart disease was identified. The dynamics to mitigate the negative experiences were conceptualized. Therefore, the interventions of a home-based health care programme as an interface to facilitate the parents/caregivers to cope with the challenges caused by the demands to care were developed. Conclusions: The need for empowerment of these parents/caregivers can be met through the implementation of multi-component interventions, which draw together all the possible determinants factors and the coping methods to facilitate coping.Item The plight of parents/caregivers of children with heart disease in the rural areas of Namibia: A problem of coping(2013) Amakali, Kristofina; Small, Louis F.Providing care for a child with heart disease is a daunting task for any parent/caregiver, particularly for those living in poor conditions in rural Namibia. A qualitative, exploratory, phenomenological and contextual study was conducted to describe such parents’/caregivers’ experiences of providing care for a child with a heart disease. The study also examined the children’s experiences of living with the burden of disease at home. The findings revealed experiences of emotional turmoil, disruptive social functioning and social relations, lack of support from the family, lack of organised forms of support from societal organisations, as well as experiences of low vitality among the children. These experiences together signify the overall poor coping by the parents/caregivers and the children. This paper presents the findings of a situational analysis of the experiences of caring for a child with heart disease and of living with heart disease.Item A support programme for caregivers of children with heart disease in rural Namibia(2014) Amakali, Kristofina; Small, Louis F.The majority of children suffering from heart disease in Namibia receive treatment as outpatients, with their caregivers taking responsibility for their continuing care. To provide the care required by these children, the caregiver has to remain vigilant. Many of these children live in rural areas and their caregivers may have only a limited educational background, as well as limited financial resources, as they depend on subsistence agriculture for a living. The development of the support programme discussed in this article originated from the results of a qualitative, exploratory, phenomenological study that addressed the issue of how these caregivers managed this responsibility. The findings of this study revealed that the caregivers generally had poor coping experiences. Subsequently, these findings formed the basis for the proposal about a support programme for the rural caregivers of children with heart disease in Namibia. As part of the study, interventions for home-based health care were developed, implemented and evaluated in order to facilitate the caregiver’s coping with the demands of home care. The findings of an outcomes evaluation indicated that the caregivers’ knowledge of the child’s condition, as well as the skills for providing care at home and the information about community-based resources that could provide them with support to cope, increased. If the programme were to be extended to other families in similar contexts, the programme interventions could make a difference in terms of their coping with the demands of care. This paper describes the implementation process involved in a home-based health care programme intervention of the study, and the subsequent outcomes of the programme evaluation.