Community perspectives on cardiovascular disease control in rural Ghana: A qualitative study.
Community perspectives on cardiovascular disease control in rural Ghana: A qualitative study.
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DOI：
10.1371/journal.pone.0280358
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
Heller, David
中科院分区：
文献类型：
--
作者：
Patil, Bhavana P.;Maddox, Isla Hutchinson;Aborigo, Raymond R.;Squires, Allison R.;Awuni, Denis F.;Horowitz, Carol R.;Oduro, Abraham J.;Phillips, James;Jones, Khadija;Heller, David
心血管疾病（CVD）的患病率在加纳很高，但意识，预防和治疗是稀疏的，特别是在农村地区。护士主导的社区健康规划和服务计划在这些领域提供一般预防和初级保健，但忽略了心血管疾病及其风险因素。我们进行了深入的采访，30个社区成员（CM）在农村纳夫龙戈，加纳了解他们的知识和信念的原因和治疗CVD和社区护士在提供CVD护理的潜在作用。我们转录音频记录，编码这些数据的内容，并定性分析这些代码的关键主题。CMs将CVD描述为一种急性，侵袭性疾病，而不是慢性无症状疾病，认为CVD患者经常突然死亡。然而，CMs确定了CVD的因果风险因素：不仅吸烟和不良饮食，而且还有导致和加剧CVD症状的情绪负担和压力。许多CM表示有兴趣就这些风险因素进行咨询，特别是饮食。然而，他们认为，护士可以提供全面的心血管疾病护理，只有当关键障碍（如药物获取和培训）得到解决。在此期间，许多人认为护士的主要CVD护理角色是指医院。CMs希望当地诊所的社区护士提供CVD行为教育，但认为当地的卫生系统现在太脆弱，无法提供其他CVD干预措施。医学博士认为，一个更全面的心血管疾病护理模式将需要可获得的药物，沿着培训护士筛查高血压和其他心血管疾病风险因素-除了对心血管疾病预防的咨询。这种咨询应该建立在现有的社区信仰和关注心血管疾病，包括其行为和心理健康的原因，除了通常的措施，以防止心血管疾病的死亡，如饮食的变化和体育锻炼。
Cardiovascular disease (CVD) prevalence is high in Ghana—but awareness, prevention, and treatment is sparse, particularly in rural regions. The nurse-led Community-based Health Planning and Services program offers general preventive and primary care in these areas, but overlooks CVD and its risk factors. We conducted in-depth interviews with 30 community members (CM) in rural Navrongo, Ghana to understand their knowledge and beliefs regarding the causes and treatment of CVD and the potential role of community nurses in rendering CVD care. We transcribed audio records, coded these data for content, and qualitatively analyzed these codes for key themes. CMs described CVD as an acute, aggressive disease rather than a chronic asymptomatic condition, believing that CVD patients often die suddenly. Yet CMs identified causal risk factors for CVD: not only tobacco smoking and poor diet, but also emotional burdens and stressors, which cause and exacerbate CVD symptoms. Many CMs expressed interest in counseling on these risk factors, particularly diet. However, they felt that nurses could provide comprehensive CVD care only if key barriers (such as medication access and training) are addressed. In the interim, many saw nurses’ main CVD care role as referring to the hospital. CMs would like CVD behavioral education from community nurses at local clinics, but feel the local health system is now too fragile to offer other CVD interventions. CMs believe that a more comprehensive CVD care model would require accessible medication, along with training for nurses to screen for hypertension and other cardiovascular risk factors–in addition to counseling on CVD prevention. Such counseling should build upon existing community beliefs and concerns regarding CVD–including its behavioral and mental health causes–in addition to usual measures to prevent CVD mortality such as diet changes and physical exercise.
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