Élaboration, mise en oeuvre et évaluation d'un protocole d'interventions infirmières : une contribution à la réduction du bruit et de la lumière dans les unités néonatales du Cameroun

Authors: Missi, Philomene Marie
Advisor: Giguère, Jean-François
Abstract: The presence of various sensory stimuli in the neonatal intensive care environment is a major determinant in the development of preterm infants. The impact of excess noise and light on the short, medium- and long-term development of the premature infant is documented by studies. Measures to optimize the care environment are implemented in neonatal units in the West and in other parts of the world, but they are not in Cameroon. However, this problem is more important in these units that the infant mortality rate is considerable. The research involved developing and implementing a nursing intervention protocol aimed at reducing noise and light in two neonatal units in Cameroon and assessing their acceptability and feasibility. To do this, the Sidani and Braden method taking place in four phases and using a mixed estimate was used. Three approaches to data collection are proposed by this method, namely experiential, empirical and theoretical approaches. Levine’s conservation care model and Mefford’s (2004) premature health promotion theory were used to situate the problems experienced by preterm infants from a nursing perspective and to suggest nursing interventions. For the first three phases of the study, the objective data were obtained by direct observation of the environment of the neonatal units and a measurement of the sound and light intensities on these units. The experiential data comes from individual and group interviews with nurses (n = 18), doctors (n = 11) and family members (n = 7). The empirical data are from a literature review and the theoretical data are from the study and the theoretical nursing literature. At the end of this stage, needs were identified, and an intervention protocol developed. Phase 4 consists of implementing the intervention protocol in the form of a pilot project. This phase also included the implementation of correctional measures on the two participating units and a set of interventions aimed at changing the behavior of the personnel of these units, and that of families and visitors in favor of protocol interventions. Based on the framework of Michie et al., Training Program and awareness sessions were offered, supported by various means (signs, flyers and reminders). Then, the implementation of the intervention protocol was carried out over a two-week period with the implementation of a cyclical light program on the participating units. The pilot project was carried out through the recruitment of 29 staff members (22 nurses and seven doctors). The results show that the correctional measures were implemented in full on one unit and partially in the other. The results show a high degree of acceptability and feasibility of such a protocol aimed at reducing noise and light on neonatal units in Cameroon. In conclusion, the study showed that local culture, lack of means and financial resources were not an absolute obstacle in terms of feasibility and acceptability and that a research program could better examine the conditions implantation, efficacy and effects on premature babies. Keywords: premature newborns, noise, light, neonatal intensive care units, nursing interventions.
Document Type: Thèse de doctorat
Issue Date: 2020
Open Access Date: 7 March 2020
Permalink: http://hdl.handle.net/20.500.11794/38226
Grantor: Université Laval
Collection:Thèses et mémoires

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