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The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting
Background Hypoxic-Ischemic Encephalopathy (HIE) is a debilitating neurological injury at birth due to a hypoxic event. The recommended treatment is therapeutic hypothermia (TH) provided at certain neonatal facilities and should commence within the treatment window of 6 hours (1). The outborn neonat...
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| Format: | Thesis |
| Language: | English |
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Division of Emergency Medicine
2023
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| _version_ | 1867613331720765440 |
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| access_status_str | Open Access |
| author | de Wet, Wardie |
| author2 | Stassen, Willem |
| author_browse | Stassen, Willem de Wet, Wardie |
| author_facet | Stassen, Willem de Wet, Wardie |
| author_sort | de Wet, Wardie |
| collection | Thesis |
| description | Background Hypoxic-Ischemic Encephalopathy (HIE) is a debilitating neurological injury at birth due to a hypoxic event. The recommended treatment is therapeutic hypothermia (TH) provided at certain neonatal facilities and should commence within the treatment window of 6 hours (1). The outborn neonates are at a disadvantage because they require timely transport to a TH-capable neonatal ICU. The study aimed to identify the perceived barriers to care of HIE neonates born outside the cooling facility within the private healthcare setting. Methods This study made use of one-on-one structured open-ended interviews that were recorded on two separate digital recording devices. All the interviews were transcribed and stored within a cloud-based secured folder. All the interviews were subjected to qualitative content analysis using dedicated qualitative software. All audio files were destroyed after transcription to ensure participant confidentiality, including participants' names and locations. Results A total of seven participants were interviewed during the data collection phase of this study. The participants were all employed in South Africa within the private healthcare system and comprised of paediatricians, neonatologists, and neonatal nursing staff. The participants represented both the referral and receiving facilities. The descriptive analysis of the data obtained showed overlapping of emerged themes, ranging in repetitive strength. During the data analysis, three main themes were identified, with other supporting themes providing additional insight: HIE recognition and decision-making, navigating the referral process, and communication barriers. Discussion Despite the availability of resources within the private healthcare system and private patient transfer services, there are perceived barriers to timely care for HIE or Birth Asphyxia (BA) neonatal patients needing an urgent interhospital transfer. This study concluded that changes within the referral system are needed to mitigate the perceived barriers to time-sensitive care. Further research is required to motivate changes and must include the roleplayers' input within the referral process to match the patient's best interest. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/37135 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:34:27.383Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Division of Emergency Medicine |
| publisherStr | Division of Emergency Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/37135 The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting de Wet, Wardie Stassen, Willem Dippenaar, R Emergency Medicine Background Hypoxic-Ischemic Encephalopathy (HIE) is a debilitating neurological injury at birth due to a hypoxic event. The recommended treatment is therapeutic hypothermia (TH) provided at certain neonatal facilities and should commence within the treatment window of 6 hours (1). The outborn neonates are at a disadvantage because they require timely transport to a TH-capable neonatal ICU. The study aimed to identify the perceived barriers to care of HIE neonates born outside the cooling facility within the private healthcare setting. Methods This study made use of one-on-one structured open-ended interviews that were recorded on two separate digital recording devices. All the interviews were transcribed and stored within a cloud-based secured folder. All the interviews were subjected to qualitative content analysis using dedicated qualitative software. All audio files were destroyed after transcription to ensure participant confidentiality, including participants' names and locations. Results A total of seven participants were interviewed during the data collection phase of this study. The participants were all employed in South Africa within the private healthcare system and comprised of paediatricians, neonatologists, and neonatal nursing staff. The participants represented both the referral and receiving facilities. The descriptive analysis of the data obtained showed overlapping of emerged themes, ranging in repetitive strength. During the data analysis, three main themes were identified, with other supporting themes providing additional insight: HIE recognition and decision-making, navigating the referral process, and communication barriers. Discussion Despite the availability of resources within the private healthcare system and private patient transfer services, there are perceived barriers to timely care for HIE or Birth Asphyxia (BA) neonatal patients needing an urgent interhospital transfer. This study concluded that changes within the referral system are needed to mitigate the perceived barriers to time-sensitive care. Further research is required to motivate changes and must include the roleplayers' input within the referral process to match the patient's best interest. 2023-03-02T09:42:24Z 2023-03-02T09:42:24Z 2022 2023-02-20T12:32:49Z Master Thesis Masters MPhil http://hdl.handle.net/11427/37135 eng application/pdf Division of Emergency Medicine Faculty of Health Sciences |
| spellingShingle | Emergency Medicine de Wet, Wardie The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting |
| thesis_degree_str | Master's |
| title | The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting |
| title_full | The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting |
| title_fullStr | The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting |
| title_full_unstemmed | The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting |
| title_short | The perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic-ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting |
| title_sort | perceived barriers to timely therapeutic hypothermia treatment for neonates diagnosed with hypoxic ischaemic encephalopathy when born outside the cooling facility within the private healthcare setting |
| topic | Emergency Medicine |
| url | http://hdl.handle.net/11427/37135 |
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