Health seeking and perceived causes of tuberculosis among patients in Manila, Philippines
Health seeking and perceived causes of tuberculosis among patients in Manila, Philippines
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DOI：
10.1046/j.1365-3156.2000.00615.x
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发表时间：
2000-09-01
影响因子：
3.3
通讯作者：
Weiss, M
中科院分区：
文献类型：
--
作者：
Auer, C;Sarol, J;Weiss, M
病例发现效率低是结核病控制成功的重要障碍。多次就医可能是延迟发现病例的原因。通过对319例痰涂片阳性肺结核患者的访谈，研究了与肺结核相关的就医行为、就医延迟、感知原因和感知护理质量。患者在菲律宾大马尼拉市马拉邦的22个政府卫生中心接受治疗。只有29%的受访者在出现结核病相关症状后首先去了健康中心，超过一半（53%）的人最初看过私人医生。几乎所有人（97%）都进行了胸部X光检查。三分之二的患者（66%）在前往政府保健中心之前收到了抗结核药物处方，29%的患者在前往政府保健中心之前购买并服用了至少三周的抗结核药物。关于社区互动，36%的人表示莱利认识至少一个因结核病而被治疗但没有成功的人。症状出现后的就医延迟相对较短- 64%的受访者表示他们在1个月内前往卫生机构。案例研究说明了寻求健康的理由，并解释了许多患者延迟开始适当治疗的原因。研究结果强调了卫生传播的必要性，并指出了改善结核病控制的方法。我们的调查结果，从采访叙述还表明，提高人际交往能力的保健中心的工作人员和私人医生和保健中心之间的协调，可以大大改善结核病患者的服务。
Inefficient case finding is an important stumbling block to successful control of tuberculosis (TB). Multiple health seeking may account for delayed case finding. Health-seeking behaviour, health seeking delay, perceived causes, and perceived quality of care related to TB were studied in interviews with 319 sputum smear-positive TB patients. The patients were treated in 22 governmental health centres of Malabon, a municipality of Metro Manila, Philippines. Only 29% of the respondents had gone first to a health cent-re after onset of TB-related symptoms, and more than half (53%) had initially consulted a private doctor. A chest X-ray was obtained for nearly everyone (97%). Two thirds of the patients (66%) had received a prescription far drugs, and 29% had purchased and taken anti-TB drugs for at least three weeks before they came to a governmental health centre. Concerning community interactions, 36% said riley knew at least one person who had been created for TB without success. The health seeking delay after symptom onset was relatively short - 64% of the respondents said they went to a health facility within 1 month. Case studies illustrate the rationale for health seeking and explain delayed initiation of appropriate treatment for many patients. Findings underscore the need for and indicate approaches to health communication for improved control of TB. Our findings from interview narratives also suggest that improved interpersonal skills of health centre staff and co-ordination between the private doctors and the health centres may substantially improve services for TB patients.