Research Article
Emmanuel Okechukwu Nna
Molecular Pathology Institute
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6791-2336
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Discharged against medical advice (DAMA) is a risk factor that often leads to adverse outcomes and hospital re-admissions in neonatal units. Few studies have shown that spiritual/faith-based institutions (FBI) tend to have lower incidence of DAMA compared with public hospitals. Perhaps the holistic approach to patient care that addresses the spiritual needs, the soul and the body component of a being in this setting may account for the observed lower incidence of DAMA. Limited randomized control trials (RCT) exist on faith-based interventions with regards to DAMA in published literature. This study seeks to compare the effectiveness of FBI, social support, religiosity and types of FBI on neonatal DAMA against standard of care in tertiary hospitals in Nigeria.
Methods: This RCT will be carried out in 2 public tertiary teaching hospitals in 2 of 6 geopolitical zones in Nigeria. The socio-demographic and clinical details of all patients admitted to the neonatal wards during the study period will be documented. Study participants will be selected through a multistage sampling technique. Subjects will be randomized and allocated to treatment and control arms having established baseline measure of social support and religiosity. Ethical approval was obtained from the State Research Ethics Review Committee. Written informed consent will be obtained from the parents/caregivers prior to patient enrolment. The study will be conducted in line with Declaration of Hesinki 2013. Appropriate statistical tools will be used for data collection and analysis.
Discussion:
The outcome of this analysis will give insight into the effectiveness of FBI on DAMA. It will also predict the effect of the mediators of parents/caregivers’ religiosity, spirituality, forms of FBI, parents/caregivers’ religious sect and social support on rate of DAMA on neonatal admission in tertiary hospitals in Nigeria. This may help inform Public Health Institutions and Governments’ decisions on the determinants of neonatal DAMA and how to mitigate such outcomes. It is hoped that the evidence from this study may guide policy formulation and guidelines to enhance hospital retention of sick neonates until they are fit for discharge.
Trial registration: This study was registered in the Pan Africa Clinical Trial Registry (PACTR202102670906630).
Keywords
Discharged against medical advice, DAMA, religion, faith-based, intervention(s), spirituality, religiosity, social support, neonate, newborn, randomized control trial
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Research Article
Emmanuel Okechukwu Nna
Molecular Pathology Institute
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6791-2336
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 08 Mar, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Hospital Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Discharged against medical advice (DAMA) is a risk factor that often leads to adverse outcomes and hospital re-admissions in neonatal units. Few studies have shown that spiritual/faith-based institutions (FBI) tend to have lower incidence of DAMA compared with public hospitals. Perhaps the holistic approach to patient care that addresses the spiritual needs, the soul and the body component of a being in this setting may account for the observed lower incidence of DAMA. Limited randomized control trials (RCT) exist on faith-based interventions with regards to DAMA in published literature. This study seeks to compare the effectiveness of FBI, social support, religiosity and types of FBI on neonatal DAMA against standard of care in tertiary hospitals in Nigeria.
Methods: This RCT will be carried out in 2 public tertiary teaching hospitals in 2 of 6 geopolitical zones in Nigeria. The socio-demographic and clinical details of all patients admitted to the neonatal wards during the study period will be documented. Study participants will be selected through a multistage sampling technique. Subjects will be randomized and allocated to treatment and control arms having established baseline measure of social support and religiosity. Ethical approval was obtained from the State Research Ethics Review Committee. Written informed consent will be obtained from the parents/caregivers prior to patient enrolment. The study will be conducted in line with Declaration of Hesinki 2013. Appropriate statistical tools will be used for data collection and analysis.
Discussion:
The outcome of this analysis will give insight into the effectiveness of FBI on DAMA. It will also predict the effect of the mediators of parents/caregivers’ religiosity, spirituality, forms of FBI, parents/caregivers’ religious sect and social support on rate of DAMA on neonatal admission in tertiary hospitals in Nigeria. This may help inform Public Health Institutions and Governments’ decisions on the determinants of neonatal DAMA and how to mitigate such outcomes. It is hoped that the evidence from this study may guide policy formulation and guidelines to enhance hospital retention of sick neonates until they are fit for discharge.
Trial registration: This study was registered in the Pan Africa Clinical Trial Registry (PACTR202102670906630).
Figure 1
Figure 2
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