| dc.description.abstract | ABSTRACT Background: There are nearly 1.2 billion adolescents worldwide, and approximately 90% of them live in low- and middle-income countries (LMICs). In Africa, research on needs and experiences of hospitalized adolescents is limited and yet in most cases adolescents are mainstreamed in children and adult wards. Achieving Universal Health Coverage is a core component for the 2030 agenda for Sustainable development, yet this cannot be achieved without reaching the 23.3% of Uganda’s population who are adolescents. Experiences and needs of hospitalized adolescents are not well understood yet negative experiences during hospitalization can make them fail to open up about their illness, leading to inadequate management, prolonged stay in hospital, recurrent hospital visits, and poor health seeking behavior in the future.
Objectives: To assess adolescents needs, and explore their experiences while hospitalized at Kiruddu (KNRH) and Mulago National Referral Hospitals (MNRH) Methodology: A cross-sectional qualitative study was carried out among adolescents admitted to MNRH and KNRH between November 2020 and March 2021 plus health workers attending to them. Forty-eight in-depth interviews were conducted among hospitalized adolescents, 18 of them were early adolescents ,16 were middle adolescents, 14 were late adolescents. Twenty-seven of the adolescents interviewed were admitted to MNRH and 21 to KNRH. Twelve key informant interviews were conducted among health workers including pediatricians, senior house officers, medical officers, and nurses from both hospitals. All interviews were audio recorded, transcribed manually and analyzed using content thematic approach.
Results: Of the 48-adolescents interviewed, 52.1% were female. Most of those interviewed in MNRH were early adolescents, at 48.1%, and for KNRH most of those interviewed were Middle adolescents at 42.9%. Majority were admitted with an acute illness associated with a known underlying chronic condition, at 66.6%. Involvement in decision making, peer support and interaction, family support, privacy, appropriate beds, adolescents friendly health workers, food and treatment at no cost, and an adolescent area or ward, were among the needs that stood out. The negative experiences, among hospitalized adolescents were more than positive. Being given information and using this information to make informed decision, peer visitation and interaction, family support, kind and friendly health workers, meals and some treatment provided free of charge, hospital being cleaned daily were some of the positive experiences. Some adolescents’ opinions not being considered in decision making, lack of family support among those with chronic
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illness, stigmatization especially among those with chronic illness, missing friends due to hospitalization, lack of privacy, unpleasant washrooms, unfriendly health workers, and lack of a variety of recreation activities, were among the negative experiences they faced.
Conclusion:
The needs of hospitalized adolescents included, involvement in decision making, peer support and interaction, family support, privacy, appropriate beds, adolescents friendly health workers, food and treatment at no cost, and adolescent area or ward.
Most of the adolescents’ experiences during hospitalization were negative, and included, lack of privacy, unfriendly health workers, lack of family support, stigmatization of adolescents with chronic illness, opinions not considered in decision making, lack of recreation activities, and missing friends due to hospitalization.
Recommendation: Immediate interventions to improve adolescents experience during hospitalization include, allocation of an area on the ward set apart for inpatient adolescents, having appropriate beds for adolescents, training health workers in adolescent care, introduction of indoor games, putting televisions on wards with adolescent friendly programs, and ensuring the wards and washrooms are cleaned more often. In the long run, the administration of the MNRH and KNRH should consider setting up adolescent wards, with adolescent friendly services.
Key words: Adolescents, Hospitalization, Needs, Experiences | en_US |
