ArticleJournal of multidisciplinary healthcare2026
Development and Expert Validation of a Hospital-to-Home Care Pathway for Preterm Infants in Indonesia: A Qualitative and Delphi Study.
Article in Journal of multidisciplinary healthcare, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The transition of preterm infants from hospital to home requires coordinated care across hospital, primary care, community, and family settings. This study aimed to develop and validate a Hospital-to-Home Care Pathway for preterm infants in Indonesia. Patients and Methods: A sequential exploratory qualitative-Delphi consensus design was used. This study was conducted in Bandung, West Java, Indonesia, from May 2025 to November 2025. Stage 1 involved 70 stakeholders, including mothers, healthcare providers, community health volunteers (cadres), managers, hospital leaders, and health office representatives. Data were collected through focus group discussions, in-depth interviews, observations, and document review and analyzed using inductive thematic analysis. Stage 2 used three Delphi rounds with seven experts to refine and validate the pathway. Results: Stage 1 identified fragmentation across care settings beyond parental knowledge gaps. Synthesized findings yielded six pathway needs: parental readiness, information continuity, hospital-community coordination, defined roles for community health volunteers and primary care providers, community follow-up, and monitoring, evaluation, and referral feedback. Stage 2 confirmed expert consensus. Round 1 agreement ranged from 85.7% to 100%. In Round 2, item-level content validity ranged from 0.86 to 1.00, with scale-level content validity index based on average agreement (S-CVI/Ave) = 0.99 and scale-level content validity index based on universal agreement (S-CVI/UA) = 0.90. Round 3 confirmed final consensus and response stability. The final pathway comprised a visual care flow and an operational table specifying care settings, components, activities, responsible providers, and documents. Conclusion: This study produced an expert-validated Hospital-to-Home Care Pathway for preterm infants in Indonesia. The pathway integrates discharge planning, community follow-up, family education, documentation, and referral feedback. As a pre-implementation output, the pathway should be evaluated further through feasibility, acceptability, fidelity, and effectiveness testing before claims about clinical or health-system impact are made.
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