Patient Experiences of Decentralized HIV Treatment and Care in Plateau State, North Central Nigeria: A Qualitative Study.
Patient Experiences of Decentralized HIV Treatment and Care in Plateau State, North Central Nigeria: A Qualitative Study.
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DOI：
10.1155/2017/2838059
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发表时间：
2017
影响因子：
1.7
通讯作者：
Ware NC
中科院分区：
文献类型：
--
作者：
Kolawole GO;Gilbert HN;Dadem NY;Genberg BL;Agaba PA;Okonkwo P;Agbaji OO;Ware NC
背景。非洲艾滋病毒感染护理和治疗的分散化使得当地卫生机构能够提供服务。权力下放与提高保留率和可比较或更好的治疗结果相关，但患者的体验尚不清楚。方法。我们对尼日利亚中北部高原州分散式艾滋病毒护理中的患者体验进行了定性研究。高原州权力下放倡议中特意选择了五个权力下放护理点。这些地点的 93 名患者和 16 名提供者参加了个人访谈和焦点小组。数据收集活动均被录音并转录。对成绩单进行归纳性内容分析，以得出代表分散护理患者体验的描述性类别。结果。这项研究的患者参与者经历了向分散护理的过渡，这是一系列的“权衡”。提到的优点包括节省去诊所就诊的时间和金钱、避免路上的危险，以及一些分散诊所的“家庭般的氛围”。缺点是无法获得辅助服务、与提供商互动的机会减少以及披露风险增加。总体而言，参与者更喜欢去中心化服务。结论。旅行的困难和费用仍然是在城市中心以外获得艾滋病毒护理的基本障碍，这表明增加社区服务的可用性将受到热烈欢迎。
Background. Decentralization of care and treatment for HIV infection in Africa makes services available in local health facilities. Decentralization has been associated with improved retention and comparable or superior treatment outcomes, but patient experiences are not well understood. Methods. We conducted a qualitative study of patient experiences in decentralized HIV care in Plateau State, north central Nigeria. Five decentralized care sites in the Plateau State Decentralization Initiative were purposefully selected. Ninety-three patients and 16 providers at these sites participated in individual interviews and focus groups. Data collection activities were audio-recorded and transcribed. Transcripts were inductively content analyzed to derive descriptive categories representing patient experiences of decentralized care. Results. Patient participants in this study experienced the transition to decentralized care as a series of “trade-offs.” Advantages cited included saving time and money on travel to clinic visits, avoiding dangers on the road, and the “family-like atmosphere” found in some decentralized clinics. Disadvantages were loss of access to ancillary services, reduced opportunities for interaction with providers, and increased risk of disclosure. Participants preferred decentralized services overall. Conclusion. Difficulty and cost of travel remain a fundamental barrier to accessing HIV care outside urban centers, suggesting increased availability of community-based services will be enthusiastically received.