Browsing by Author "Rent, Sharla"
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Item Open Access Family caregiver perspectives on strengths and challenges in the care of pediatric injury patients at a tertiary referral hospital in Northern Tanzania.(PloS one, 2023-01) Keating, Elizabeth M; Sakita, Francis; Vonderohe, Maddy; Nkini, Getrude; Amiri, Ismail; Loutzenheiser, Kelly; Young, Bryan; Rent, Sharla; Staton, Catherine A; Mmbaga, Blandina T; Watt, Melissa HBackground
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.Item Open Access Global health training during neonatal fellowship: fellow and program director perspectives(Journal of Perinatology) Rent, Sharla; Valentine, Gregory; Ehret, Danielle; Kukora, StephanieItem Open Access Neuropsychiatric Systemic Lupus Erythematosus: A Teenager With Acute Agitation and Altered Mental Status(Consultant for Pediatricians) Rent, Sharla; Forreser, Katherine; King, MartaItem Open Access Tachypnea and Epistaxis in a Full-term Infant.(Pediatrics in review, 2021-01) Titchiner, Daniela; Dukes, Priya; Speier, Rebecca; Rent, SharlaItem Embargo The Impact of Time, Region, and Income Level on Stillbirth and Neonatal Mortality(2022) Rent, SharlaBackground: Neonatal mortality and stillbirth remain prominent global health issues. The majority of these perinatal losses occur in low- and middle-income countries and are related to lack of quality care around delivery. Brazil transitioned from a lower-middle income country to an upper-middle income country in 2006 and has over 95% of its births occurring within the health system. Methods: We conducted a longitudinal, ecological cohort study based on publicly available data from the Brazilian Ministry of health’s data repository on live births and deaths. Data was analyzed at the municipality level from 2000 to 2019. Records from the Atlas of Human Development in Brazil were then used to associate each region with a World Bank income classification. Results: National neonatal mortality rate decreased from 21.2 in 2000 to 12.4 in 2019. Stillbirth rate decreased from 12.0 to 10.2 over this time. Rates were lower when infants born before 28 weeks gestation were excluded. For infants born between 22- and 27-weeks’ gestation, worsening perinatal outcomes were seen after 2012. Municipalities with higher wealth status have lower stillbirth and neonatal mortality rates across all years of the study. Conclusion: Brazil has made significant progress in neonatal mortality and stillbirth rates from 2000 to 2019, yet inequity in perinatal outcomes remains across the country and is correlated with economic status. Nationally, ongoing improvement is needed for infants below 28 weeks gestation and closer exploration is needed into why there are increasing rates of negative perinatal outcomes amongst infants 22-27 weeks gestation.
Item Open Access Treatment of Severe Unilateral Pulmonary Interstitial Emphysema in a Preterm Infant(Annals of Medical Case Reports) Rent, Sharla; Donn, Steven