Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in Ghana

Résumé

BACKGROUND: The high social and emotional burden on families with small or sick newborns necessitates family-focused care. Positive attitudes towards family involvement and skilled healthcare providers are crucial for improving the health and well-being of small/sick newborns and their families. While family systems care (FSC) has been explored and implemented in high-income countries, it is rarely reported in low- and middle-income countries. This study aims to assess knowledge, attitudes and skills of healthcare providers on FSC and the family care practices, interactions, and reciprocity in the provider-family relationship throughout the care continuum of sick/small infants and their families. METHODS: A cross-sectional survey involved healthcare providers offering maternal and newborn care at secondary and primary-level facilities. Participants were sampled from one secondary-level hospital and 13 primary health facilities in the Hohoe Municipality of Ghana. The survey instruments included the standardized and validated instruments ‘Family Importance in Care - Nurses’ attitudes’ (FINC-NA) and ‘Family Nursing Practice Scale’ (FNPS), which measure healthcare providers’ attitudes and skills in working with families, alongside four open-ended questions. Quantitative data were analyzed using descriptive statistics, while answers to open-text components were categorized thematically. RESULTS: Overall, 143 healthcare providers, comprising nurses, midwives and physicians, participated in the study. The median score of FINC-NA was 93 (83–99), while the FNPS was 30 (24–35). Most healthcare providers had a positive attitude towards family involvement in care, whereas practice skills were moderate. From the open-ended questions, care providers’ perceptions and actions in relation to family care practices were communication difficulties, intra-family challenges and confidentiality concerns. They also reported reduced workload, stronger healthcare provider-family relationship and improved quality of care through increased family collaboration and support. CONCLUSIONS: Overall, healthcare providers valued family involvement in the care but had only moderate skills in working with them. Advocacy for the inclusion of family systems care in healthcare education, in-service training and policy development in Ghana is warranted. This will support healthcare providers to deliver high-quality care to families with small or sick newborns from pregnancy to post-discharge.

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