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Caring for High-Risk Newborns after Release from Hospital Treatment: A Parent's Perspective
MACUROVÁ, Štěpánka
My Bachelor?s thesis focuses on the issue of children with a development risk, and deals mainly with the care provided to these children after they are released from hospital. The thesis is divided into a theoretical and practical part. The theoretical part defines important used terms. In the Perinatology chapter, general provisions are described as well as the system of perinatologic centres. To understand the topic, it is necessary to know the classification of infants and understand the manifestations and consequences of premature birth, so the second chapter provides basic information about neonatology. A separate chapter deals with the definition of chronological age and corrected age. These are important to secure proper monitoring of the child?s development. The development of prematurely born children differs from the development of children born in the standard term, and this fact must be taken into consideration. Nutrition is an important aspect for proper development. Recent trends especially stress breastfeeding of the child by its own mother. Information about nutrition and breastfeeding and the specifics of nutrition for prematurely born children are described in a separate chapter of the thesis. The following chapter deals with the issues related to releasing children with a development risk from hospital, and the care following their release. The care provided by a development care centre is emphasised. The last chapter provides a selection of the most common diagnoses experienced by prematurely born infants. The practical part contains qualitative research carried out by means of a semi-structured interview. The interviewed sample contains ten mothers of prematurely born children or children with other development risks. Respondents were women that I know, who regularly visit a development care centre with their children. A key selection criterion was the corrected age of the child, which had to be less than 24 months. The goal of the research was to evaluate the activity of the development care centre from the parents? perspective. A single research question was asked: Which deficiencies do the parents see in the activity of the development care centre. The collected data was analysed and lead to a clear conclusion and answer to the research question laid down in the thesis. The results of my research clearly justified the activity of development care centres, which are usually part of large maternity wards. The centres are accepted very positively in all aspects. The interviews also showed some deficiencies, which were described in the discussion and summarized in the conclusion. Since neonatology care is constantly improving, the ratio of surviving children with an extremely low or low birth weight is much higher than in the past. It is necessary to take into account that care does not end after the child is released from hospital. Premature birth carries many risks, which threated the child?s development. It is thus necessary to secure continuous care and monitor the child after release from hospital into home care. This topic has recently been often discussed. The mental development of the child is as important as the child?s physical development. It has been proved that prematurely born children may have some psychological problems. The conclusion summarizes the deficiencies that mothers find in the activities of development care centres, and describes recommendations that should lead to improvement of this care. These include a need for greater engagement of nutrition and breastfeeding counsellors, improved education of nurses employed in community care and improvement of the quality of cooperation with children?s physicians. I would recommend my thesis to the expert and general public. It could also be of use to students of nursing ? midwives, children?s nurses and others who are interested in the issues of children with a development risk.
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