Exploring the experiences of healthcare professionals in South Africa and Uganda around communicating with children about life-threatening conditions: a workshop-based qualitative study to inform the adaptation of communication frameworks for use in these settings.

Journal: BMJ open

Volume: 13

Issue: 1

Year of Publication: 2023

Affiliated Institutions:  Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK elizabeth.rapa@psych.ox.ac.uk. Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK. Psychological and Mental Health Services, Great Ormond Street Hospital for Children, London, UK. Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa. Department of Paediatrics, Nelson Mandela Medical School, Durban, South Africa. Department of Medicine, Makerere University, Kampala, Uganda. Department of Health Sciences, Mildmay Uganda Institute of Health Sciences, Kampala, Uganda. Palliative Care Education and Research Consortium, Kampala, Uganda. United Nations Interim Security Force for Abyei, Abyei, South Sudan. The Surgery Uganda, Kampala, Uganda. Umduduzi - Hospice Care for Children, Durban, South Africa. Grey's Hospital, Pietermaritzburg, South Africa. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

Abstract summary 

This study aimed to explore how published communication frameworks could be amended to ensure applicability and cultural appropriateness for professionals to support family-centred conversations by investigating' healthcare professionals' (1) experiences of providing support to families when a caregiver or a dependent child (<18 years old) has a life-threatening condition, (2) perceived challenges for caregivers and healthcare professionals in communicating with children about illness, (3) perceptions of how clinicians could be equipped to facilitate conversations between caregivers and children about an adult or the child's own life-threatening condition and (4) suggestions for amendments to previously published guidelines to ensure cultural relevance in South Africa and Uganda.A qualitative study involving two 2-day workshops with embedded focus group discussions, break out rooms and consensus discussions.Health and social care and third sector organisations in South Africa and Uganda.Thirty-two professionals providing care to families affected by life-threatening conditions in South Africa or Uganda who were aged 18 years or older and able to converse in English.Participants identified obstacles to having conversations with caregivers about children and to telling children about serious illness during consultations. These included patients' beliefs about illness, medicine and death, language barriers between families and the healthcare team, and emotional and practical challenges for professionals in having these conversations. Culturally appropriate adaptations were made to previously published communication frameworks for professionals to support family-centred conversations.Culturally sensitive communication frameworks could help healthcare professionals to talk with families about what children need to know when they or a caregiver have a serious illness. More broadly, effective communication could be facilitated by promoting healthcare professionals' and communities' understanding of the benefits of telling children about illness within the family. Together these strategies may mitigate the psychological impact of global disease on children and their families.

Authors & Co-authors:  Rapa Elizabeth E Hanna Jeffrey R JR Pollard Teresa T Santos-Paulo Stephanie S Gogay Yasmin Y Ambler Julia J Namukwaya Elizabeth E Kavuma David D Nabirye Elizabeth E Kemigisha Ruth Mary RM Namyeso Juliet J Brand Tracey T Walker Louise L Neethling Beverley G BG Downing Julia J Ziebland Sue S Stein Alan A Dalton Louise J LJ

Study Outcome 

Source Link: Visit source

Statistics
Citations :  UNAIDS . Global HIV & AIDS statistics 2020 fact sheet. 2020. Available: https://www.unaids.org/en/resources/fact-sheet
Authors :  18
Identifiers
Doi : e064741
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
community child health;education & training (see medical education & training);medical education & training;mental health;qualitative research
Study Design
Study Approach
Qualitative
Country of Study
Uganda
Publication Country
England