Themes guided by SEM | Sub Themes | Categories | Examples of Quotations |
---|---|---|---|
Intrapersonal Factors | Expectations from CHD surgery | ‣Unrealistic expectations of surgery | “I thought after surgery … I wouldn’t have to worry about his heart problem and health anymore” |
‣Impact of residual CHD on daily functioning | “He is not able to play … gets angry …” | ||
‣Education as an important individual strategic resource | “He should get education from a good institute and achieve a good position in life” | ||
Interpersonal Factors | Health literacy and resource issues | ‣Poor health literacy within social networks | “Where did she get this disease from, what was the reason? Was it by birth or has it occurred now?” |
‣Strong kinship ties as a resource | “They [extended family] are concerned that my child should experience a good healthy life … The first thing they ask about is my child’s health” | ||
‣Family poverty | “I blame myself … My husband also feels so guilty that we are not able to fulfil her needs because of financial constraints”. | ||
‣Mothers as sole primary care providers | “The mother and the suffering child are left alone to fight and face the problems …” | ||
Institutional Factors | Lack of parental and teachers’ counselling | ‣Unclear expectations at school | “Teachers should be educated about the activities they [child with CHD] can perform … Or if any emergency situation arises, what they should do” |
‣Poor access to family counselling | “Parents should be told … not to plan for the next baby … If these things had been communicated … we would not have planned our baby” | ||
‣Poor clinical educational resources | “I wish these [post-surgery long term health issues] were communicated … We would have been mentally prepared for it.” | ||
Community and social–cultural factors | Religion and gender issues | ‣Religion and trust in God | “Allah has given this disease, so He is the one who will cure it …” |
‣CHD as a gendered experience | “… they [people] said that since she is a girl, there is no need for her to go through the surgery... and spend the huge cost” | ||
Public Policy Factors | Lack of CHD facilities across the country | ‣Lack of antenatal and CHD services | “There are very few hospitals for children with heart problems [in the country …” |
‣Potential for integrated local services and resources | “… workshops, training programs or activities arranged for children as well as parents.” |