Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India
Objective. We explored reasons for discharged against medical advice (DAMA) of neonates from a neonatal intensive care unit (NICU) through in-depth interviews of the parents/guardians. Methods. Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | International Journal of Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2016/1897039 |
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| author | Bhanu Devpura Pranav Bhadesia Somashekhar Nimbalkar Sandeep Desai Ajay Phatak |
| author_facet | Bhanu Devpura Pranav Bhadesia Somashekhar Nimbalkar Sandeep Desai Ajay Phatak |
| author_sort | Bhanu Devpura |
| collection | DOAJ |
| description | Objective. We explored reasons for discharged against medical advice (DAMA) of neonates from a neonatal intensive care unit (NICU) through in-depth interviews of the parents/guardians. Methods. Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA. Basic demographic information of the newborns was retrieved from hospital records. Results. The prevalence of DAMA was 25.4%. Of 50 parents approached, 41 in-depth interviews were completed. Nonaffordability (38.6%), no improvement (14.6%), poor prognosis (12%), and inappropriate behavior of the patient relation office personnel (10.6%) were major factors contributing to DAMA. Parents of 6.6% neonates wanted guarantee of survival and 5.3% parents reported poor behavior of nurses. No gender bias was observed related to DAMA. One-third of neonates (34.1%) were DAMA on first day of admission. Conclusions. The issue of DAMA needs attention. Besides nonaffordability and clinical characteristics of the baby, communication (breaking bad news, counseling, etc.) and lack of adequate infrastructure for relatives emerged as modifiable factors leading to DAMA. |
| format | Article |
| id | doaj-art-bf282a8cb3ad4c5989a5fb0ec3f443bb |
| institution | Kabale University |
| issn | 1687-9740 1687-9759 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Pediatrics |
| spelling | doaj-art-bf282a8cb3ad4c5989a5fb0ec3f443bb2025-02-03T01:20:53ZengWileyInternational Journal of Pediatrics1687-97401687-97592016-01-01201610.1155/2016/18970391897039Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, IndiaBhanu Devpura0Pranav Bhadesia1Somashekhar Nimbalkar2Sandeep Desai3Ajay Phatak4Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat 388325, IndiaDepartment of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat 388325, IndiaDepartment of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat 388325, IndiaCharutar Arogya Mandal, Karamsad, Anand, Gujarat 388325, IndiaCentral Research Services, Charutar Arogya Mandal, Karamsad, Anand, Gujarat 388325, IndiaObjective. We explored reasons for discharged against medical advice (DAMA) of neonates from a neonatal intensive care unit (NICU) through in-depth interviews of the parents/guardians. Methods. Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA. Basic demographic information of the newborns was retrieved from hospital records. Results. The prevalence of DAMA was 25.4%. Of 50 parents approached, 41 in-depth interviews were completed. Nonaffordability (38.6%), no improvement (14.6%), poor prognosis (12%), and inappropriate behavior of the patient relation office personnel (10.6%) were major factors contributing to DAMA. Parents of 6.6% neonates wanted guarantee of survival and 5.3% parents reported poor behavior of nurses. No gender bias was observed related to DAMA. One-third of neonates (34.1%) were DAMA on first day of admission. Conclusions. The issue of DAMA needs attention. Besides nonaffordability and clinical characteristics of the baby, communication (breaking bad news, counseling, etc.) and lack of adequate infrastructure for relatives emerged as modifiable factors leading to DAMA.http://dx.doi.org/10.1155/2016/1897039 |
| spellingShingle | Bhanu Devpura Pranav Bhadesia Somashekhar Nimbalkar Sandeep Desai Ajay Phatak Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India International Journal of Pediatrics |
| title | Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India |
| title_full | Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India |
| title_fullStr | Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India |
| title_full_unstemmed | Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India |
| title_short | Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India |
| title_sort | discharge against medical advice at neonatal intensive care unit in gujarat india |
| url | http://dx.doi.org/10.1155/2016/1897039 |
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