Assessment of Parents‘ Involvement and Associated Factors in Decision Making Regarding Treatment For the Critically Ill Neonates in the Neonatal Intensive Care Unit Of Public Hospitals, Addis Ababa, Ethiopia
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Date
2014-06
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Addis Ababa University
Abstract
Background: There are 130 million babies born every year worldwide. Of those births, 15% are
born premature, 5% of those premature infants are born weighing less than 1kilogram, and 75%
of those infants will survive. A significant controversy has emerged regarding the role of parents,
relative to health care providers, in relation to treatment decision for critically ill children. Little
research has actually been conducted that explores whether and how parents are involved in the
decision making process especially in developing countries.
Objective: The objective of this study is to assess Parents‘ Involvement and Associated Factors
in Decision Making Regarding Treatment for the Critically Ill Neonates in the Neonatal Intensive
Care Unit of Public Hospitals, Addis Ababa, Ethiopia.
Methods: Institution based cross-sectional design which was supported by a qualitative study
was conducted in five public hospitals with Neonatal intensive care unit in Addis Ababa from
December 2013 to June 2014. A total of 160 parents were selected from the five public
hospitals using systematic random sampling method. A pre-tested and structured
questionnaire was used for data collection.
Conveniently selected eligible study participants (Neonatologists and neonatal nurses) were
interviewed during the qualitative study.
Result: The study found that most of the respondents 112(70%) were not participated in
decisions. Majority of them 133(83.1%) believed that HCPs were the responsible person to
decision making. More than half 86(53.8%) of the parents preferred shared decision making.
Most 131(81.9%) of the parents were satisfied with parent-staff therapeutic relationship.
Multiple logistic regression model revealed that mother‘s residence and prior history with
premature, disabled, or any death of a child were found to be associated with parental
involvement in treatment decisions [AOR (95%CI) =7.024(2.151, 22.936)] and [AOR
(95%CI) =106.704(10.779, 1056.309)] respectively. Similarly mother‘s age, educational
status, and satisfaction with parent-staff therapeutic relationship have a statistically
significant association with parental involvement in treatment decisions for their critically ill
neonate.
Conclusion & Recommendation: The study showed a lower involvement of parents in
treatment decisions of their critically ill neonates. Therefore government, health
administrators and concerned stakeholders should make an effort empower parents to make
decisions on their neonate‘s treatment.
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Keywords
Decision making, Public Hospitals