Relationship between perceptions of home discharge readiness and parental health literacy (PHL) of NICU parents of Black preterm infants
Dr. Mia K. Waldron, PhD, MSN-Ed, NPD-BC
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Background: The United States (U.S.) ranks last among western nations in overall infant mortality rates and ranks second highest in rates of preterm birth among the same nation group (MacDorman, Matthews, Mohangoo & Zeitlin, 2014). The U.S. infant mortality data show that Black infants have the highest incidence among all groups (Ely, Driscoll & Matthews, 2018; Murphy, Xu, Kochanek & Arias, 2018). Infants born prematurely are among those at highest risk for infant death with Black women delivering premature infants at rates higher than all other U.S. groups (Ely, Driscoll & Matthews, 2018; Murphy, Xu, Kochanek & Arias, 2018; Xu, Murphy, Kochaanek & Bastian, 2016). A number of factors have been postulated to explain this persistent disparity. One such factor is Parental Health Literacy (PHL). PHL is defined as the ability to learn, read, comprehend, and act on health information specifically related to the care and condition of a dependent child. Poorer child health outcomes and low levels of PHL, are associated with inconsistent health promotion behaviors by parents (Kumar, et al., 2010; Shone, Conn, Sanders & Halterman, 2009; Velardo & Drummond, 2013).
Purpose: The purpose of the study was to explore the relationships between levels of PHL, perceived discharge teaching effectiveness and parental readiness to provide care for their Black preterm infants at home after discharge from the Neonatal Intensive Care Unit (NICU) with parent and infant demographics.
Methods: A descriptive approach was used for this study of parents of Black preterm infants from a Level IV NICU, located in an urban area. Qualitative analysis of the perceptions of the parents, prior to NICU discharge, was via semantic content analysis of interview data organized into thematic categories for cluster analysis. The framework guiding the study was the revised Kenner Transition Model (Boykova & Kenner, 2012) which was developed specifically for NICU parents. Quantitative analyses of relationships among the variables using parent scores from the Parent Health Activities Test (PHLAT), Transition Questionnaire (TQ) and Quality of Discharge Teaching Survey (QDTS) were completed using descriptive statistics (Boykova & Kenner, 2012; Kumar et al., 2010; Weiss et al., 2008).
Results: The study sample of ten parents had high (50%) or moderate (30%) PHL; high (30%) or moderate (50%) transition readiness and high (20%) or moderate (40%) perceptions of the quality of discharge teaching as measured by the PHLAT, TQ and QDTS. Qualitative analysis of parent data affirmed all five domains of the revised Kenner Transition framework; ‘Informational Needs’ and ‘Professional Support’ were the domains unanimously endorsed by coded parent responses. A sub-group of demographically similar NICU mothers described a markedly negative experience with healthcare staff that may indicate the presence of stereotyping and/ or implicit biases.
Implications: Consideration of PHL, implicit bias and optimization of parent- provider communication and discharge teaching practices can contribute positively to the readiness of parents to provide care at home after NICU discharge; thus, potentially decreasing disparate infant morbidity and mortality outcomes experienced by U.S. Blacks.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 27736021; ProQuest document ID: 2354894821. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
|Review Type||None: Degree-based Submission|
|Research Approach||Qualitative Research|
|Keywords||Neonatal Intensive Care Unit (NICU);
Parental Health Literacy
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