Factors influencing parents/guardians' participation in the Care of their hospitalised under 5 years children at Kenyatta National hospital paediatrics medical wards

Abstract

Parents/guardians participation in the care of their hospitalized children is part of the integrated family health care, which has become the cornerstone of today's pediatric nursing practice. Parents/guardians participation in care of their hospitalized children has been shown to have benefits to both the child and the parent/guardian. It is common practice for parents to stay with their sick children in the hospital, however most hospitals lack operational procedures and staff guidelines for involving parents in care processes and decisions. The purpose of this study was to establish factors influencing parents/guardians participation in the care of their hospitalized children under five years old at the pediatric medical wards of Kenyatta National Hospital (KNH). This was a descriptive cross-sectional study conducted among the parents/guardians and the nurses in the pediatric medical wards of KNH. Data were collected from a sample of 178 parents/guardians and 54 nurses using two sets of semi-structured questionnaires, one for the parents/guardians and the other for the nurses. Statistical analysis was conducted using statistical package for social sciences (SPSS) version 15 and Stata version 10. The main study outcome was participation in care. ANOV A was used to compare participation in care across different levels of independent variables broadly classified into demographic and socioeconomic factors. The data were then presented in form of figures and tables. Pneumonia, gastroenteritis and meningitis were the leading causes of hospitalization among the children. Majority of the parents/guardians were of low education level, unemployed or employed with low income levels of less than Kshs.10, 000 per month. The hospitalized children were mainly infants (53.1%). Parents/guardians were willing to participate in the care of their hospitalized children. The parents/guardians' participation in care was influenced by their level of education (p= 0.014) and age group (p= 0.039). The characteristics of children did not significantly influence the parents/guardians participation in care. (p>0.05). There were discrepancies in care activities and role of parents/guardians amongst the nurses and between the parents/guardians. There was no consensus on who should perform some care activities, for example some nurses said nasogastric feeding should be performed by the parents/guardians. Twenty nine (55.8%) of the xu nurses had the opinion that parents/guardians should not be involved in the decision making of their child's management. Only 5.6% of the nurses had a specialized training in paediatric nursing. Majority of the parents/guardians felt that the nurses were uncooperative, and were too busy to talk to them. Health education on the importance and practice of parents/guardians participation in the care of their hospitalized children should be enhanced. Formulation of guidelines and! or policies on the level of participation of parents/guardians in the care of their hospitalized children be undertaken to standardize and enhance the practice of parents/guardians participation in the care of their hospitalized children. More nurses should go for specialized training in paediatric nursing to enhance their skills to work effectively in a paediatric set up.