Barriers and facilitators of adherence to TB treatment in patients on concomitant TB and HIV treatment: a qualitative study.
Barriers and facilitators of adherence to TB treatment in patients on concomitant TB and HIV treatment: a qualitative study.
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DOI：
10.1186/1471-2458-10-651
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发表时间：
2010-10-28
影响因子：
4.5
通讯作者：
Frich JC
中科院分区：
文献类型：
--
作者：
Gebremariam MK;Bjune GA;Frich JC
结核病是埃塞俄比亚的一个主要公共卫生问题，许多结核病患者同时感染了艾滋病毒。有必要更多地了解影响合并感染患者治疗依从性的因素。本研究的目的是探讨患者和卫生保健专业人员对结核病/艾滋病合并感染患者在结核病和艾滋病联合治疗中坚持治疗的障碍和促进因素的看法。定性研究采用对15名结核/艾滋病毒合并感染患者和9名保健专业人员的深入访谈和对14名合并感染患者的焦点小组讨论。我们发现各种因素的相互作用参与了药物摄入的决策。对坚持结核病治疗产生积极影响的因素是对结核病可治愈性的信念、对存在艾滋病毒感染的结核病严重程度的信念以及家庭和卫生专业人员的支持。坚持治疗的障碍包括副作用、药丸负担、经济限制、缺乏食物、因缺乏披露而产生的耻辱感，以及缺乏与卫生专业人员的充分沟通。卫生专业人员和政策制定者应了解影响结核/艾滋病毒合并感染患者在结核和艾滋病毒联合治疗中进行结核治疗的因素。我们的研究结果表明，提供食物和最低限度的财政支持可能有助于依从性。咨询也可能促进依从性，特别是对于那些在结核病治疗早期阶段开始抗逆转录病毒治疗的人，并且应该解决与副作用和药丸负担有关的信念。向公众提供信息可以减少结核病和艾滋病毒相关的污名。
Tuberculosis is a major public health problem in Ethiopia, and a high number of TB patients are co-infected with HIV. There is a need for more knowledge about factors influencing treatment adherence in co-infected patients on concomitant treatment. The aim of the present study is to explore patients' and health care professionals' views about barriers and facilitators to TB treatment adherence in TB/HIV co-infected patients on concomitant treatment for TB and HIV. Qualitative study using in-depth interviews with 15 TB/HIV co-infected patients and 9 health professionals and focus group discussions with 14 co-infected patients. We found that interplay of factors is involved in the decision making about medication intake. Factors that influenced adherence to TB treatment positively were beliefs in the curability of TB, beliefs in the severity of TB in the presence of HIV infection and support from families and health professionals. Barriers to treatment adherence were experiencing side effects, pill burden, economic constraints, lack of food, stigma with lack of disclosure, and lack of adequate communication with health professionals. Health professionals and policy makers should be aware of factors influencing TB treatment in TB/HIV co-infected patients on concomitant treatment for TB and HIV. Our results suggest that provision of food and minimal financial support might facilitate adherence. Counseling might also facilitate adherence, in particular for those who start ART in the early phases of TB treatment, and beliefs related to side-effects and pill burden should be addressed. Information to the public may reduce TB and HIV related stigma.
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DOI：
10.1046/j.1365-3156.1997.d01-380.x
发表时间：
1997-08-01
影响因子：
3.3
作者：
Liefooghe, R;Baliddawa, JB;DeMunynck, AO
通讯作者：
DeMunynck, AO
DOI：
10.1080/09540120701244943
发表时间：
2007-01-01
影响因子：
1.7
作者：
Hardon, A. P.;Akurut, D.;Laing, R.
通讯作者：
Laing, R.
影响因子：
10
作者：
Breen, R. A. M.;Miller, R. F.;Lipman, M. C.
通讯作者：
Lipman, M. C.
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