{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:01:16Z","timestamp":1790316076531,"version":"4.1.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"crossref","award":["APP2009306"],"award-info":[{"award-number":["APP2009306"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Fatal and non-fatal drowning is a significant public health issue, which disproportionately impacts children and young people. In Australia, the highest fatal and non-fatal drowning rates occur in children under five years of age. To date, little qualitative research has been conducted on non-fatal drowning, with causal factor analysis generally conducted using coronial and hospital data. This study\u2019s aim was to identify causal factors in hospital treated cases of non-fatal drowning in children as qualitatively self-reported by parents and caregivers. Cases of unintentional child (0\u201316 years) non-fatal drowning admissions and Emergency Department presentations to three tertiary care paediatric hospitals in New South Wales, Australia were identified via International Classification of Diseases (ICD) coding. Parents and caregivers of drowning patients were invited to participate in a semi-structured interview. Data were thematically coded using an inductive approach, with a focus on causal factors and recommendations for preventive approaches. Of 169 incidents, 86 parents\/caregivers were interviewed. Children hospitalised for drowning were more often male (59.3%), aged 0\u20134 years (79.1%) and 30.2% were from household who spoke a language other than English. Qualitative incident descriptions were coded to five themes: lapse of supervision, unintended access (commonly in home swimming pools), brief immersion (usually young children bathing), falls into water and ongoing impacts. Drowning prevention recommendations were grouped under supervision, pool barriers and maintenance, cardiopulmonary resuscitation (CPR) training and emergency response, drowning is quick and silent, and learning swimming. Parents and caregivers of young children require ongoing education regarding supervision distractions and pool barrier compliance. Additional challenges are faced by those in rental properties with pools, parents\/caregivers who cannot swim, and parents\/caregivers from culturally and linguistically diverse backgrounds. Affordable, accessible, and culturally appropriate swimming lessons, water safety education and CPR training should be made more available for adult caregivers, particularly in languages other than English.<\/jats:p>","DOI":"10.1371\/journal.pone.0276374","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T19:28:03Z","timestamp":1669231683000},"page":"e0276374","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["A qualitative examination of causal factors and parent\/caregiver experiences of non-fatal drowning-related hospitalisations of children aged 0\u201316 years"],"prefix":"10.1371","volume":"17","author":[{"given":"Boshra","family":"Awan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Wicks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6424-1511","authenticated-orcid":true,"given":"Amy E.","family":"Peden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"pone.0276374.ref001","unstructured":"World Health Organization. Global report on drowning: Preventing a leading killer Geneva: World Health Organization; 2014."},{"issue":"Supp 1","key":"pone.0276374.ref002","doi-asserted-by":"crossref","first-page":"i83","DOI":"10.1136\/injuryprev-2019-043484","article-title":"The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study","volume":"26","author":"RC Franklin","year":"2020","journal-title":"Injury Prevention"},{"key":"pone.0276374.ref003","unstructured":"Royal Life Saving Society\u2014Australia. Royal Life Saving National Drowning Report 2021. Sydney: Royal Life Saving Society\u2014Australia; 2021."},{"issue":"11","key":"pone.0276374.ref004","first-page":"853","article-title":"A new definition of drowning: towards documentation and prevention of a global public health problem","volume":"83","author":"E van Beeck","year":"2005","journal-title":"Bulletin of the World Health Organization"},{"issue":"11","key":"pone.0276374.ref005","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-024868","article-title":"Understanding the full burden of drowning: a retrospective, cross-sectional analysis of fatal and non-fatal drowning in Australia","volume":"8","author":"AE Peden","year":"2018","journal-title":"BMJ Open"},{"key":"pone.0276374.ref006","unstructured":"Royal Life Saving Society\u2014Australia. Non-fatal drowning Sydney: Royal Life Saving Society\u2014Australia; 2022. https:\/\/www.royallifesaving.com.au\/research-and-policy\/drowning-research\/non-fatal-drowning."},{"key":"pone.0276374.ref007","article-title":"Neurocognitive outcomes in children following immersion: a long-term study","author":"MP Manglick","year":"2018","journal-title":"Archives of Disease in Childhood"},{"issue":"3","key":"pone.0276374.ref008","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/1753-6405.13124","article-title":"Analysis of fatal unintentional drowning in Australia 2008\u20132020: implications for the Australian Water Safety Strategy","volume":"45","author":"AE Peden","year":"2021","journal-title":"Australian and New Zealand Journal of Public Health"},{"key":"pone.0276374.ref009","unstructured":"National Centre for Classification in Health Australia. ICD-10-AM Tabular List of Diseases. Sydney; 2004."},{"key":"pone.0276374.ref010","unstructured":"Australian Bureau of Statistics. National, state and territory population\u2014September 2021 Canberra: Australian Bureau of Statistics,; 2022. https:\/\/www.abs.gov.au\/statistics\/people\/population\/national-state-and-territory-population\/latest-release."},{"key":"pone.0276374.ref011","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qual Res Psychol"},{"issue":"3","key":"pone.0276374.ref012","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1136\/injuryprev-2019-043432","article-title":"Identifying a gap in drowning prevention: high-risk populations","volume":"26","author":"SM Willcox-Pidgeon","year":"2020","journal-title":"Injury Prevention"},{"key":"pone.0276374.ref013","unstructured":"Royal Life Saving Society\u2014Australia. Keep Watch Web Site. Sydney: Royal Life Saving Society\u2014Australia; 2021. www.keepwatch.com.au."},{"issue":"3","key":"pone.0276374.ref014","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/jpc.14668","article-title":"Causes of distraction leading to supervision lapses in cases of fatal drowning of children 0\u20134 years in Australia: A 15-year review","volume":"56","author":"AE Peden","year":"2020","journal-title":"Journal of Paediatrics and Child Health"},{"issue":"S2","key":"pone.0276374.ref015","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/hpja.445","article-title":"Mobile phone use and social interactions among caregivers can reduce their ability to provide constant supervision to children at Australian public swimming pools","volume":"32","author":"N Wickens","year":"2021","journal-title":"Health Promotion Journal of Australia"},{"issue":"2","key":"pone.0276374.ref016","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/jpc.13688","article-title":"Unintentional fatal child drowning in the bath: A 12-year Australian review (2002\u20132014)","volume":"54","author":"A Peden","year":"2018","journal-title":"Journal of Paediatrics and Child Health"},{"issue":"7","key":"pone.0276374.ref017","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1111\/apa.15618","article-title":"Can child drowning be eradicated? A compelling case for continued investment in prevention","volume":"110","author":"AE Peden","year":"2021","journal-title":"Acta Paediatrica, International Journal of Paediatrics"},{"key":"pone.0276374.ref018","unstructured":"NSW Government. Swimming Pools Regulation 2018 2022. https:\/\/legislation.nsw.gov.au\/view\/whole\/html\/inforce\/current\/sl-2018-0503."},{"issue":"5","key":"pone.0276374.ref019","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s00038-018-1197-0","article-title":"What does \u2018Keep Watch\u2019mean to migrant parents? 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