"Honestly, this problem has affected me a lot": a qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania.
"Honestly, this problem has affected me a lot": a qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania.
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DOI：
10.1186/s12889-023-15368-6
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发表时间：
2023-03-13
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
全球有5亿多人患有慢性呼吸道疾病，其中每年约有400万人过早死亡，他们大多来自包括撒哈拉以南非洲在内的中低收入国家。尽管CRD发病率和死亡率很高，但只有很少的研究描述了CRD，并且对撒哈拉以南非洲地区CRD的经济，社会和心理方面知之甚少。我们的目的是深入了解与CRD一起生活的社会，生计和心理层面，为苏丹和坦桑尼亚的CRD管理提供信息。我们于2019年对已知或疑似CRD患者进行了12次深入访谈，并与苏丹盖济拉州和坦桑尼亚多多玛区的社区成员进行了14次焦点小组讨论，以分享他们对CRD的理解和经验。使用专题框架分析法对数据进行了分析。在这两种情况下，CRD患者报告了两大主题下的经历：对经济福祉的影响以及对社会和心理福祉的影响。从事重体力劳动的能力大大降低，对她们及其家庭造成直接和间接的经济影响。在寻求医疗保健时发生了直接费用，包括前往医疗设施的交通费用以及诊断测试和治疗的采购费用，而工作时间和工作的损失导致了大量的间接费用。参与者描述了导致退出和社会排斥的制定和内化的耻辱，部分原因是慢性咳嗽与结核病和艾滋病毒/艾滋病的关联。在苏丹，哮喘被描述为对年轻妇女的婚姻前景产生负面影响，与耻辱有关的不披露是年轻人的一个特别问题。社区参与的减少和对社会活动的限制导致了CRD患者及其家人的心理压力。在苏丹和坦桑尼亚，慢性呼吸道疾病对慢性呼吸道疾病患者及其家人产生了重大的社会和经济影响。污名尤其强烈，似乎部分是由于慢性咳嗽与传染性的联系。迫切需要采取适合具体情况的措施，解决经济影响和慢性咳嗽污名问题，作为撒哈拉以南非洲这些地区慢性呼吸道疾病干预措施的一部分。在线版本包含补充材料，可通过10.1186/s12889-023-15368-6获得。
Over 500 million people live with chronic respiratory diseases globally and approximately 4 million of these, mostly from the low- and middle-income countries including sub-Saharan Africa, die prematurely every year. Despite high CRD morbidity and mortality, only very few studies describe CRDs and little is known about the economic, social and psychological dimensions of living with CRDs in sub-Saharan Africa. We aimed to gain an in-depth understanding of the social, livelihood and psychological dimensions of living with CRD to inform management of CRDs in Sudan and Tanzania. We conducted 12 in-depth interviews in 2019 with people with known or suspected CRD and 14 focus group discussions with community members in Gezira state, Sudan and Dodoma region, Tanzania, to share their understanding and experience with CRD. The data was analysed using thematic framework analysis. People with CRD in both contexts reported experiences under two broad themes: impact on economic wellbeing and impact on social and psychological wellbeing. Capacity to do hard physical work was significantly diminished, resulting in direct and indirect economic impacts for them and their families. Direct costs were incurred while seeking healthcare, including expenditures on transportation to health facility and procurement of diagnostic tests and treatments, whilst loss of working hours and jobs resulted in substantial indirect costs. Enacted and internalised stigma leading to withdrawal and social exclusion was described by participants and resulted partly from association of chronic cough with tuberculosis and HIV/AIDS. In Sudan, asthma was described as having negative impact on marital prospects for young women and non-disclosure related to stigma was a particular issue for young people. Impaired community participation and restrictions on social activity led to psychological stress for both people with CRD and their families. Chronic respiratory diseases have substantial social and economic impacts among people with CRD and their families in Sudan and Tanzania. Stigma is particularly strong and appears to be driven partly by association of chronic cough with infectiousness. Context-appropriate measures to address economic impacts and chronic cough stigma are urgently needed as part of interventions for chronic respiratory diseases in these sub-Saharan African contexts. The online version contains supplementary material available at 10.1186/s12889-023-15368-6.
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影响因子：
2.9
作者：
Mulupi, Stephen;Ayakaka, Irene;Tolhurst, Rachel;Kozak, Nicole;Shayo, Elizabeth Henry;Abdalla, Elhafiz;Osman, Rashid;Egere, Uzochukwu;Mpagama, Stellah G.;Chinouya, Martha;Chikaphupha, Kingsley Rex;ElSony, Asma;Meme, Helen;Oronje, Rose;Ntinginya, Nyanda Elias;Obasi, Angela;Taegtmeyer, Miriam
通讯作者：
Taegtmeyer, Miriam
影响因子：
2.8
作者：
Egere U;Shayo E;Ntinginya N;Osman R;Noory B;Mpagama S;Hussein E;Tolhurst R;Obasi A;Mortimer K;Sony AE;Taegtmeyer M;IMPALA Consortium
通讯作者：
IMPALA Consortium
影响因子：
1.4
作者：
El Sony, A. I.;Chiang, C-Y.;Enarson, D. A.
通讯作者：
Enarson, D. A.
影响因子：
7
作者：
Jacome, Cristina;Figueiredo, Daniela;Marques, Alda
通讯作者：
Marques, Alda
影响因子：
5.9
作者：
Eisner, Mark D.;Blanc, Paul D.;Yelin, Edward H.;Sidney, Stephen;Katz, Patricia P.;Ackerson, Lynn;Lathon, Phenius;Tolstykh, Irina;Omachi, Theodore;Byl, Nancy;Iribarren, Carlos
通讯作者：
Iribarren, Carlos