Development of a Risk Assessment Guideline for Persistent Pulmonary Hypertension of the Newborn at Sichon Hospital, Nakhon Si Thammarat Province
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Abstract
Objective: This study employed a mixed methods research design to develop a guideline for assessing risk factors of Persistent Pulmonary Hypertension of the Newborn (PPHN).
Methods: Quantitative data were obtained through a retrospective review of medical records of 15 newborns diagnosed with PPHN between 2022 and 2024. Qualitative data were collected through in-depth interviews with 10 healthcare providers, including two pediatricians and eight registered nurses. Quantitative data were analyzed using descriptive statistics and Fisher’s Exact test, whereas qualitative data were analyzed using content analysis. Data from literature review, medical records, and qualitative findings were integrated to synthesize the components of the risk assessment guideline.
Results: The results showed that most mothers were older than 35 years (60.0%), had pregnancy complications (53.3%), and delivered by cesarean section (66.7%). Most newborns had a birth weight greater than 2,500 grams (86.7%), and all experienced birth asphyxia requiring mechanical ventilation. The neonatal mortality rate was 60.0%. Qualitative findings indicated that the management of newborns with PPHN is complex and constrained by limited resources, highlighting the need for a clear and context-appropriate risk assessment guideline for community hospitals. The developed guideline includes the assessment of maternal and neonatal risk factors and classifies risk into three levels: low, moderate, and high risk. Expert evaluation indicated that the guideline demonstrated the highest level of appropriateness and feasibility (mean = 4.86, SD = 0.11). In conclusion, the developed risk assessment guideline for PPHN was found to be appropriate and may be useful for screening and monitoring newborns at risk for PPHN in community hospital settings. However, further studies are needed to evaluate its validity, reliability, and effectiveness across different health care contexts.
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