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

Abstract 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 famil...

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Main Authors: Christina Schuler, Faith Agbozo, Emmanuel Bansah, Richard Owusu, George Edward Ntow, Barbara Preusse-Bleuler, Riccardo E. Pfister
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-025-01001-2
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author Christina Schuler
Faith Agbozo
Emmanuel Bansah
Richard Owusu
George Edward Ntow
Barbara Preusse-Bleuler
Riccardo E. Pfister
author_facet Christina Schuler
Faith Agbozo
Emmanuel Bansah
Richard Owusu
George Edward Ntow
Barbara Preusse-Bleuler
Riccardo E. Pfister
author_sort Christina Schuler
collection DOAJ
description Abstract 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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spelling doaj-art-9befb827e3ff474cbcd21318e9f0aa8f2025-08-20T03:05:04ZengBMCJournal of Health, Population and Nutrition2072-13152025-08-0144111510.1186/s41043-025-01001-2Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in GhanaChristina Schuler0Faith Agbozo1Emmanuel Bansah2Richard Owusu3George Edward Ntow4Barbara Preusse-Bleuler5Riccardo E. Pfister6Institute of Global Health, Faculty of Medicine, University GenevaDepartment of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied SciencesVolta Regional HospitalDepartment of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied SciencesDodowa Health Research CentreInstitute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied SciencesInstitute of Global Health, Faculty of Medicine, University GenevaAbstract 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.https://doi.org/10.1186/s41043-025-01001-2Family centered carePatient participationNewbornPregnancyFamily NursingGhana
spellingShingle Christina Schuler
Faith Agbozo
Emmanuel Bansah
Richard Owusu
George Edward Ntow
Barbara Preusse-Bleuler
Riccardo E. Pfister
Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in Ghana
Journal of Health, Population and Nutrition
Family centered care
Patient participation
Newborn
Pregnancy
Family Nursing
Ghana
title Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in Ghana
title_full Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in Ghana
title_fullStr Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in Ghana
title_full_unstemmed Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in Ghana
title_short Family involvement along the care continuum for small and sick newborns – attitudes and skills of healthcare providers in Ghana
title_sort family involvement along the care continuum for small and sick newborns attitudes and skills of healthcare providers in ghana
topic Family centered care
Patient participation
Newborn
Pregnancy
Family Nursing
Ghana
url https://doi.org/10.1186/s41043-025-01001-2
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