TY - JOUR
T1 - Focus group discussions on low-flow oxygen and bubble CPAP treatments among mothers of young children in Malawi
T2 - A CPAP IMPACT substudy
AU - Sessions, Kristen L.
AU - Ruegsegger, Laura
AU - Mvalo, Tisungane
AU - Kondowe, Davie
AU - Tsidya, Mercy
AU - Hosseinipour, Mina C.
AU - Lufesi, Norman
AU - Eckerle, Michelle
AU - Smith, Andrew Gerald
AU - McCollum, Eric D.
N1 - Funding Information:
KS received funding for this work through a Doris Duke Charitable Foundation grant (2016177) supporting the Doris Duke International Clinical Research Fellows programme at the University of North Carolina Chapel Hill. The Bill & Melinda Gates Foundation (OPP1123419), International AIDS Society (141022) and Health Empowering Humanity provided funding for CPAP IMPACT.
Funding Information:
Funding KS received funding for this work through a Doris Duke Charitable Foundation grant (2016177) supporting the Doris Duke International Clinical Research Fellows programme at the University of North Carolina Chapel Hill. The Bill & Melinda Gates Foundation (OPP1123419), International AIDS Society (141022) and Health Empowering Humanity provided funding for CPAP IMPACT.
Publisher Copyright:
© © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
PY - 2020/5/12
Y1 - 2020/5/12
N2 - Objective To determine the acceptability of bubble continuous positive airway pressure (bCPAP) and low-flow oxygen among mothers of children who had received either therapy. Setting A district hospital in Salima, Malawi. Participants We conducted eight focus group discussions (FGDs) with a total of 54 participants. Eligible participants were mothers of children 1 to 59 months of age with severe pneumonia and a comorbidity (HIV-infection, HIV-exposure, malnutrition or hypoxaemia) who, with informed consent, had been enrolled in a randomised clinical trial, CPAP IMPACT (Improving Mortality for Pneumonia in African Children Trial), comparing low-flow oxygen and bCPAP treatments (ClinicalTrials.gov, NCT02484183). Primary and secondary outcome measures FGDs assessed mothers' attitudes and feelings towards oxygen and bCPAP before and after therapy along with general community perceptions of respiratory therapies. Data was analysed using inductive thematic analysis to assess themes and subthemes of the transcripts. Results Community perceptions of oxygen and bCPAP were widely negative. Mothers recounted that they are told that â € oxygen kills babies'. They are often fearful of allowing their child to receive oxygen therapy and will delay treatment or seek alternative therapies. Mothers report limiting oxygen and bCPAP by intermittently removing the nasal cannulas or mask. After oxygen or bCPAP treatment, regardless of patient outcome, mothers were supportive of the treatment their child received and would recommend it to other mothers. Conclusion There are significant community misconceptions around oxygen and bCPAP causing mothers to be fearful of either treatment. In order for low-flow oxygen treatment and bCPAP implementation to be effective, widespread community education is necessary.
AB - Objective To determine the acceptability of bubble continuous positive airway pressure (bCPAP) and low-flow oxygen among mothers of children who had received either therapy. Setting A district hospital in Salima, Malawi. Participants We conducted eight focus group discussions (FGDs) with a total of 54 participants. Eligible participants were mothers of children 1 to 59 months of age with severe pneumonia and a comorbidity (HIV-infection, HIV-exposure, malnutrition or hypoxaemia) who, with informed consent, had been enrolled in a randomised clinical trial, CPAP IMPACT (Improving Mortality for Pneumonia in African Children Trial), comparing low-flow oxygen and bCPAP treatments (ClinicalTrials.gov, NCT02484183). Primary and secondary outcome measures FGDs assessed mothers' attitudes and feelings towards oxygen and bCPAP before and after therapy along with general community perceptions of respiratory therapies. Data was analysed using inductive thematic analysis to assess themes and subthemes of the transcripts. Results Community perceptions of oxygen and bCPAP were widely negative. Mothers recounted that they are told that â € oxygen kills babies'. They are often fearful of allowing their child to receive oxygen therapy and will delay treatment or seek alternative therapies. Mothers report limiting oxygen and bCPAP by intermittently removing the nasal cannulas or mask. After oxygen or bCPAP treatment, regardless of patient outcome, mothers were supportive of the treatment their child received and would recommend it to other mothers. Conclusion There are significant community misconceptions around oxygen and bCPAP causing mothers to be fearful of either treatment. In order for low-flow oxygen treatment and bCPAP implementation to be effective, widespread community education is necessary.
KW - child
KW - continuous positive airway pressure
KW - developing countries
KW - focus groups
KW - hypoxia
KW - respiratory tract diseases
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U2 - 10.1136/bmjopen-2019-034545
DO - 10.1136/bmjopen-2019-034545
M3 - Article
C2 - 32404389
AN - SCOPUS:85084626320
SN - 2044-6055
VL - 10
JO - BMJ open
JF - BMJ open
IS - 5
M1 - e034545
ER -