Improving tuberculosis care in low income countries - a qualitative study of patients' understanding of "patient support" in Nepal.
Improving tuberculosis care in low income countries - a qualitative study of patients' understanding of "patient support" in Nepal.
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DOI：
10.1186/1471-2458-9-190
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发表时间：
2009-06-17
影响因子：
4.5
通讯作者：
Newell JN
中科院分区：
文献类型：
--
作者：
Lewis CP;Newell JN
在新的结核病护理遏制结核病策略中，直接观察治疗已被“监督和患者支持”取代。然而，目前尚不清楚患者支持的含义以及如何最好地实施。本研究的目的是从患者自身的角度准确记录结核病治疗期间的支持需求，为制定满足患者需求的适当支持和监督策略提供信息。在尼泊尔的三个地区进行了深入的个人访谈和焦点小组讨论。分析与数据收集同时进行，以便新出现的问题能够指导后续受访者的选择。总共采访了 23 名患者，其中 15 名男性和 8 名女性，并进行了 6 次焦点小组讨论。这些访谈中的问题被分为新出现的主题。受访者报告说，结核病的治疗负担很高，特别是在接受治疗的社会和心理方面存在困难。他们在治疗过程中看到了三个主要方面的支持：为他们及其家人提供有关他们的疾病、治疗、潜在副作用以及出现副作用时应该做什么的相关信息；平易近人、乐于助人的医护人员，让患者能够轻松地与他们讨论治疗期间出现的问题（通常是非医疗问题）；治疗方面具有一定的灵活性，以使患者生活的基本要素（例如创收、粮食种植和儿童保育）得以继续。他们急于确保家人的支持不会免除医护人员自己的支持责任。为了在治疗期间为结核病患者提供更多支持，卫生政策和实践必须认识到结核病影响结核病患者生活的各个方面。治疗的各个方面都应注重照顾每位患者的个体。改善医疗保健提供者和患者之间的沟通，增加患者对治疗方案的了解和理解，将使接受治疗的人有一种个人赋权感，并增强他们对治疗的信心。
In the new Stop TB Strategy for Tuberculosis (TB) Care, direct observation of treatment has been replaced by "supervision and patient support". However, it is still unclear what patient support means and how it is to be best implemented. The objective of this study was to accurately document patients' support needs during TB treatment from their own perspectives, to inform development of appropriate support and supervision strategies that meet patients' needs. In-depth individual interviews and focus group discussions were conducted in three districts in Nepal. Analysis took place concurrently with data collection to allow emerging issues to guide selection of subsequent interviewees. In total 23 patients, 15 male and 8 female, were interviewed and six focus group discussions were held. Issues from these interviews were grouped into emergent themes. Respondents reported that the burden of treatment for TB was high, particularly in terms of difficulties with social and psychological aspects of undergoing treatment. They saw three main areas for support during their treatment: relevant information for them and their families about their disease, its treatment, potential side-effects and what they should do if side-effects arise; approachable and supportive healthcare staff with whom patients feel comfortable discussing (often non-medical) problems that arise during treatment; and some flexibility in treatment to allow essential elements of patients' lives (such as income generation, food-growing and childcare) to continue. They were anxious to ensure that family support did not absolve healthcare workers from their own support responsibilities. In order to support people with TB more during their treatment, health policy and practice must appreciate that TB affects all aspects of TB patients' lives. A focus on caring for each patient as an individual should underlie all aspects of treatment. Improved communication between healthcare providers and patients and increased patient knowledge and understanding of the treatment programme would give those receiving treatment a sense of individual empowerment and raise their confidence in treatment.
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影响因子：
3.5
作者：
Mishra, Pranaya;Hansen, Ebba Holme;Kafle, Kumud Kumar
通讯作者：
Kafle, Kumud Kumar
影响因子：
5.4
作者：
Demissie, M;Getahun, H;Lindtjorn, B
通讯作者：
Lindtjorn, B
影响因子：
4.5
作者：
Kaona FA;Tuba M;Siziya S;Sikaona L
通讯作者：
Sikaona L
影响因子：
3.8
作者：
Dick, J;Lewin, S;van der Walt, H
通讯作者：
van der Walt, H
对结核病诊断和治疗的延迟进行系统的综述。
影响因子：
4.5
作者：
Storla, Dag Gundersen;Yimer, Solomon;Bjune, Gunnar Aksel
通讯作者：
Bjune, Gunnar Aksel