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FAMILY CAREGIVER PERSPECTIVES ON STRENGTHS AND CHALLENGES IN THE CARE OF
PEDIATRIC INJURY PATIENTS AT A TERTIARY REFERRAL HOSPITAL IN NORTHERN TANZANIA.

Elizabeth M Keating, Francis Sakita, Maddy Vonderohe, Getrude Nkini, Ismail
Amiri, Kelly Loutzenheiser, Bryan Young, Sharla Rent, Catherine A Staton,
Blandina T Mmbaga, Melissa H Watt
PloS One 2023
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 family member 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 family member caregiver
perspectives on strengths and challenges in pediatric injury care throughout
hospitalization at a tertiary hospital in Northern Tanzania.

METHODS: This study was conducted at a 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 challenges in pediatric injury care. IDIs were
completed from November 2020 to October 2021 with 30 family member caregivers of
admitted pediatric injured patients. De-identified transcripts were synthesized
in memos and analyzed through a team-based, thematic approach informed by
applied thematic analysis.

RESULTS: Strengths and challenges were identified throughout the hospital
experience, including emergency medicine department (EMD) care, inpatient wards
care, and discharge. Across the three phases, strengths were identified such as
how quickly patients were evaluated and treated, professionalism and
communication between healthcare providers, attentive nursing care, frequent
re-evaluation of a patient's condition, and open discussion with caregivers
about readiness for discharge. Challenges identified related to lack of
communication with caregivers, perceived inability of caregivers to ask
questions, healthcare providers speaking in English during rounds with lack of
interpretation into the caregivers' preferred language, and being sent home
without instructions for rehabilitation, ongoing care, or guidance for
follow-up.

CONCLUSION: Caregiver perspectives highlighted strengths and challenges
throughout the hospital experience that could lead to interventions to improve
the care of pediatric injury patients in Northern Tanzania. These interventions
include prioritizing communication with caregivers about patient status and care
plan, ensuring all direct communication is in the caregivers' preferred
language, and standardizing instructions regarding discharge and follow-up.



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