CHAPTER 5
They also outlined the measures they practise in their institutions to reduce preterm birth and decrease deaths due to complications of prematurity.
5.3 Summary
A qualitative research approach which is descriptive and explorative was used to determine the challenges encountered by midwives when providing care to preterm babies at selected hospitals in the Mopani District of Limpopo Province, South Africa.
The inclusion criteria of the study population were all midwives who have been working in maternity ward for at least two full years and were available during the period of data collection. Analysis was done following the six steps as described by Creswell. The description of the chapters in this study is provided in Table 5.1.
5.4 Limitations of the Study
The study was conducted in the three hospitals of Mopani District which are Maphutha Malatji, Kgapane and Letaba hospitals. Therefore, the findings may not be applicable to the other hospitals which were not included in this study. Data were collected from the midwives who were on duty during the period of data collection; it was a challenge to recruit the participants as they were busy most of the days and could not take lunch breaks. The interviews were conducted from the participants who gave their consent and interviews were audiotaped. Some midwives were willing to participate in the study, but they did not like the idea of being recorded, even after the researcher has explained to them the importance of recording interviews they still hesitated and believed that the recorded voices will be used against them some time in the future.
5.5 Recommendations
On the basis of the findings, it is of great importance to improve the standard of practice of midwives working in maternity wards and develop awareness programmes to educate the community about the causes, prevention and other aspects relating to
preterm birth.
Table 5.1: A brief summary of the chapters Chapter Description
1 The researcher introduced the background of the whole study in chapter 1.
The chapter discussed the problem statement, objectives and questions, and the theory of Jean Watson which was applied in the study. The purpose of the study was to determine the challenges encountered by midwives when providing care to preterm babies at selected hospitals in the Mopani District of Limpopo Province, South Africa. The detailed description of the reviewed literature relevant to the study was provided to support the background of the study.
2 Chapter 2 is detailed description of reviewed literature which focused on the challenges encountered by midwives during provision of care to preterm babies.
3 Chapter 3 described in detail the research methodology of the study. The methods, designs, settings, ethical considerations and measures to ensure trustworthiness were discussed in this chapter. A qualitative approach which is both descriptive and exploratory was used in this study. The study was conducted in a natural setting which is the workplace of the midwives.
Non-probability purposive sampling was used to select 23 participants from the three selected hospitals. Data were collected through face-to-face unstructured Interviews which were audio recorded and transcribed verbatim.
4 This chapter presented and discussed the results of the study which at the end were found to have achieved the objectives outlined in Chapter 1. The demographic data of participants were discussed here; and the results were presented through the themes and the sub-themes which reflected the challenges encountered by midwives when providing care to preterm babies at selected hospitals in the Mopani District of Limpopo Province, South Africa. The results were presented through the 4 themes:
• A description of facts by midwives related to preterm condition and expected care
• Challenges experienced by midwives during provision of care to preterm infants
• Knowledge of midwives related to provision of care to preterm infants
• Identified needs and problems of mothers of preterm infants The described themes were in accordance with the 4 major concepts of the philosophy of science and caring (theory of human caring) which are human-being, health, environment and nursing as described by Jean Watson.
5 This chapter focuses on the summary, limitation, recommendations and conclusion of the study.
The standard of care being provided to preterm babies may be improved through training of midwives, staffing and having regular meetings with the policy makers.
5.5.1 Recommendations for Ensuring That Midwives Are Able to Provide Expected Care to Preterm Babies
The results of the current study revealed that due to staff shortages, midwives are facing problems of exhaustion and burnout which are due to workload and this has been found to impact on the care being provided to the patients. Midwives are missing a lot of warning signs on the preterm babies because they are unable to do constant monitoring as they are short-staffed. It is recommended that the practice of neonatal nursing and midwifery be improved. This can be done by ensuring that there is enough staff allocated in all units of the maternity ward. The staff should be in accordance with the guidelines which stated that it should be one midwife with one baby in units like NICU (Essential Newborn Care, 2012:22), and there should not be rotation of midwives working with preterm babies. Material resources also need to be made available in all hospitals to promote care to preterm babies. It is also recommended that the management team of the hospitals motivate for more workshops on preterm care in order to equip midwives with more relevant knowledge and skills.