The nutritional preoperative management for children with Ventricular Septal Defect (VSD) in rural Thailand

Abstract

The purpose of this study was to improve the care of children with VSD in rural Thailand. Based on the literature review, these children experienced long waiting times or surgery and had difficulty in gaining or maintaining optimal weight prior to surgery. An ethnographic approach was used to explore and understand the aregivers’ problems in their cultural context; especially the experiences of how the amilies managed the care of their child, in order to overcome the issues of gaining or maintaining optimal weight prior to surgery.

Ten family case studies resulted from semi-structured interviews, field notes, observations, and photographs from the ten main caregivers of children with VSD. Ten health professionals who dealt with these children were interviewed to ascertain any differences in perspective between the professionals and the caregivers with respect to nutritional management. Data were collected between January and May 2012 in a egional hospital and at the homes of the participating caregivers. A thematic approach was used to analyse the data. The triangulated findings generated themes indicating hat both health professionals and caregivers had insufficient knowledge in taking care of children with VSD in rural Thailand, who were waiting for surgery. The key issues elated to the caregivers’ insufficient knowledge were the limited knowledge of health professionals, inadequate resources at the clinic and the clinical environment did not provide useful information. Furthermore, some of the knowledge the caregivers used was inappropriate for supporting weight gain in their child. Drawing on the literature and findings, the content for nutritional preoperative information package for the aregivers to help enable their child to gain or maintain optimal weight prior to surgery has been designed. The findings suggested that, particularly in the rural areas, any written materials to support the caregivers should be designed for those who have a eading age
of at least primary school level.

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